Download:
pdf |
pdfIU1
IU1
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
IUPROBE
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
20
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
If SP is Institutionalized, display "Other than the current institutional
stay that started on (DATE OF INSTITUTIONALIZATION), between
(REFERENCE DATE) and (DATE OF INSTITUTIONALIZATION)
was (SP)"
Else if SP is Deceased, display "Between (REFERENCE DATE)
and (DATE OF DEATH), was (SP)".
Else display "Since (REFERENCE DATE), [have you/has (SP)]
been"
If SP is Institutionalized, display "another".
Else display "a".
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
SHOW CARD IU
Question Text:
[Since (REFERENCE DATE), [have you/has (SP)] been/Between
11:29:47 AM Thursday, February 26, 2009
Page 1 of 22
IU1
(REFERENCE DATE) and (DATE OF DEATH), was (SP)/Other than
the current institutional stay that started on (DATE OF
INSTITUTIONALIZATION), between (REFERENCE DATE) and
(DATE OF INSTITUTIONALIZATION) was (SP)] a patient in
(a/another) nursing home or any similar place that provides longterm care -- such as the places shown on this card?
LONG-TERM CARE PLACES INCLUDE SKILLED NURSING
HOMES, INTERMEDIATE CARE FACILITIES, BOARD AND CARE
HOMES, NURSING HOME UNITS IN HOSPITALS, FACILITIES
FOR THE MENTALLY RETARDED, PSYCHIATRIC FACILITIES
AND GROUP HOMES.
Int. Instr II:
INPUT FIELDS / ROUTING
IUPROBE
Field1:
Cheshire Name:
Item Text display:
( IUQ1020 )
HRND.IUPROBE
Do not display option 3/IndicatedYesByDataprep.
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TProbe
1
No
No
Number Label
1 Yes
FieldSize:
Min Value:
Max Value:
Mask:
Route
IU2 - PROVIDER_IU ( IUQ1030 )
2
English text: YES
No
3
English text: NO
IndicatedYesByDataPrep
BOX IU3 - (IUQ1155 )
DO NOT DISPLAY.
DATA EDITING ONLY.
English text: INDICATED YES BY DATAPREP
Attribute
Don't know
Route
BOX IU3 - (IUQ1155 )
Refusal
BOX IU3 - (IUQ1155 )
BACKGROUND VARIABLE ASSIGNMENTS
11:29:53 AM Thursday, February 26, 2009
Page 2 of 22
IU1
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
40
SPInstitute
SP is institutionalized =
MRES.SPALIVE=2/AliveAndInstitute on MRES where
MRES.MRESRND = current round.
DESIGN NOTES
11:29:53 AM Thursday, February 26, 2009
Page 3 of 22
IU2
IU2
Page Order # :
Design Screen Type:
Roster
Fields:
Field 1:
PROVIDER_IU
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Name:
Provider Roster
Roster Type:
Single Item Select
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
Yes
Yes
No
No
Grid Functions:
Add Line
Delete Line
No
No
30
Display as ' Add a Facility '
Display as ' Edit a Facility '
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Multi Field display:
Roster/Grid Instructions:
Display all Providers except for Providers where
PROV.PROVNUM=01 and 02, which are reserved for PM and OM
events.
Display in order of entry.
Roster/Grid display:
COL #
HEADER
1
Provider Name
INSTRUCTIONS
Display PROV.PROVNAME.
Report display:
TEXT:
Context Header:
REFERENCE PERIOD: (REFERENCE DATE) - (TODAY/DATE OF
DEATH/DATE OF INSTITUTIONALIZATION)
Int. Instr I:
Question Text:
Where [were you/was (SP)] a patient -- in which nursing home?
Int. Instr II:
SELECT OR ADD ONLY ONE FACILITY.
11:29:54 AM Thursday, February 26, 2009
Page 4 of 22
IU2
INPUT FIELDS / ROUTING
PROVIDER_IU
Field1:
( IUQ1030 )
TEMP
Cheshire Name:
Item Text display:
Item Text:
Label:
Label Position:
String
TProvPick4
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
1
No
No
Number Label
1 [Continuous answer.]
FieldSize:
Min Value:
Max Value:
Mask:
4
Route
BOX IU1 - (IUQ1040 )
BACKGROUND VARIABLE ASSIGNMENTS
PROVIDER INSTRUCTIONS:
Roster details will be collected on PROV:
PROV key = PROV.PROVBASE + PROV.PROVNUM
PROV.PROVNUM = Number of Provider selected at IU2.
If Provider added at Provider Roster, see PROVIDER ROSTER POP-UP specifications for
pop-up window programming instructions.
Variables populated in Provider Roster Pop-Up Window:
PROV.PROVNUM
PROV.PROVRNDC
PROV.PROVNAME
Provider number
Round number
Hospital name (Also known as Provider name)
If Provider added, set provider type as instructed below.
EVENT INSTRUCTIONS:
Current round IU visits are stored on EVNT. An EVNT is generated once the Provider is
selected at IU2:
EVNT key = EVNT.EVNTBASE + EVNT.EVNTNUM
EVNT.EVNTNUM = number of event generated at IU2.
BASE.LASTEVNT holds the highest EVNT.EVNTNUM prior to fielding cases. Not all
EVNT records are fielded. The first time an EVNT record is generated in the field,
BASE.LASTEVNT should be >= to the highest EVNT.EVNTNUM fielded. The new
EVNT.EVNTNUM should be calculated based on BASE.LASTEVNT + 001. Each time an
EVNT record is generated in the field, BASE.LASTEVNT will be updated to match the
highest EVNT.EVNTNUM in the field. Therefore, each time an EVNT record is generated in
11:29:56 AM Thursday, February 26, 2009
Page 5 of 22
IU2
the field, the new EVNT.EVNTNUM should be calculated based on BASE.LASTEVNT +
001. See detailed instructions below.
Set Event Provider as the Provider selected at IU2. Set additional EVNT variables as
instructed below.
LASTEVNT
Once new EVNT record is generated, set
BASE.LASTEVNT = new EVNT.EVNTNUM.
EVNTNUM
Set new EVNT.EVNTNUM = BASE.LASTEVNT +
001. This assumes that BASE.LASTEVNT is
incremented each time an EVNT record is generated
in the field.
EVNTRNDC
EVNT.EVNTRNDC = current round.
EVNTTYPE
EVNT.EVNTTYPE = 'IU'.
STEVTYPE
EVNT.STEVTYPE = 7/IU.
EVNTPROV
EVNT.EVNTPROV = PROV.PROVNUM of provider
selected at IU2.
PROVTYPE
PROV.PROVTYPE=5/Institution.
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
Begin Loop 1: Probe for one provider (facility), collect event date for this
provider.
11:29:56 AM Thursday, February 26, 2009
Page 6 of 22
BOX IU1
BOX IU1
Page Order # :
40
BOX INSTRUCTIONS
( IUQ1040 )
IF (SP REPORTED RECEIVING HEALTH CARE SERVICES THROUGH V.A.
IN THE CURRENT ROUND OR ANY PREVIOUS ROUND) AND (IF THIS
PROVIDER IS ASSOCIATED WITH V.A. IS UNKNOWN), GO TO IU3 VAPLACE ( IUQ1050 ).
ELSE TO IU4 - EVBEGMM ( IUQ1070 ).
ASSIGNMENTS
TECHNICAL NOTES
423
SPReceivedCaretThruV
A
SP reported receiving health care services through V.A.in
the current or any previous round =
There is an HRND where HRND.HRNDRND = current
round and HRND.VACOVER = 1/Yes.
HRND.VACOVER is set at BOX HI20 or collected at HI36.
127
ProviderVAUnknown
If Provider is associated with V.A. is unknown =
PROV.VAPLACE = empty.
DESIGN NOTES
11:29:56 AM Thursday, February 26, 2009
Page 7 of 22
IU3
IU3
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
VAPLACE
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
50
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display name of facility, PROV.PROVNAME, currently being asked
about.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
Question Text:
Is (FACILITY NAME) a Department of Veterans Affairs, or V.A.,
facility?
Int. Instr II:
INPUT FIELDS / ROUTING
11:29:59 AM Thursday, February 26, 2009
Page 8 of 22
IU3
VAPLACE
Field1:
Cheshire Name:
( IUQ1050 )
PROV.VAPLACE
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TYesNoDKRF
1
No
No
Number Label
1 Yes
2
FieldSize:
Min Value:
Max Value:
Mask:
Route
IU4 - EVBEGMM ( IUQ1070 )
English text: YES
No
IU4 - EVBEGMM ( IUQ1070 )
English text: NO
Attribute
Don't know
Route
IU4 - EVBEGMM ( IUQ1070 )
Refusal
IU4 - EVBEGMM ( IUQ1070 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
11:30:03 AM Thursday, February 26, 2009
Page 9 of 22
IU4
IU4
Page Order # :
Design Screen Type:
Date
Fields:
Field 1:
EVBEGMM
Field 2:
EVBEGDD
Field 3:
EVBEGYY
Field 4:
EVENDMM
Field 5:
EVENDDD
Field 6:
EVENDYY
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
Enable Functions:
70
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display name of facility, PROV.PROVNAME, currently being asked
about.
Multi Field display:
Vertical Alignment
Display Admission date input fields, EVBEGMM, EVBEGDD,
EVBEGYY, on 1st line.
Display Discharge date input fields, EVENDMM, EVENDDD,
EVENDYY, on 2nd line.
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
11:30:09 AM Thursday, February 26, 2009
REFERENCE PERIOD: (REFERENCE DATE) - (TODAY/DATE OF
DEATH/DATE OF INSTITUTIONALIZATION)
Page 10 of 22
IU4
Int. Instr I:
When [were you/was (SP)] admitted to and discharged from
(FACILITY NAME)?
Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING
EVBEGMM
Field1:
Cheshire Name:
( IUQ1070 )
EVNT.EVBEGMM
Item Text display:
Item Text:
ADMISSION DATE:
Label:
Label Position:
MM
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TMonthInt
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Don't know
Route
IU4 - EVBEGDD ( IUQ1072 )
Refusal
IU4 - EVBEGDD ( IUQ1072 )
11:30:16 AM Thursday, February 26, 2009
FieldSize:
Min Value:
Max Value:
Mask:
2
01
12
Route
IU4 - EVBEGDD ( IUQ1072 )
Page 11 of 22
IU4
EVBEGDD
Field2:
Cheshire Name:
( IUQ1072 )
EVNT.EVBEGDD
Item Text display:
Item Text:
Label:
Label Position:
DD
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TDayDKRF
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Don't know
Route
IU4 - EVBEGYY ( IUQ1074 )
Refusal
IU4 - EVBEGYY ( IUQ1074 )
11:30:27 AM Thursday, February 26, 2009
FieldSize:
Min Value:
Max Value:
Mask:
2
1
31
Route
IU4 - EVBEGYY ( IUQ1074 )
Page 12 of 22
IU4
EVBEGYY
Field3:
Cheshire Name:
( IUQ1074 )
EVNT.EVBEGYY
Item Text display:
Item Text:
Label:
Label Position:
YY
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TYear2DKRF
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Don't know
Route
IU4 - EVENDMM ( IUQ1080 )
Refusal
IU4 - EVENDMM ( IUQ1080 )
11:30:37 AM Thursday, February 26, 2009
FieldSize:
Min Value:
Max Value:
Mask:
2
00
99
Route
IU4 - EVENDMM ( IUQ1080 )
Page 13 of 22
IU4
EVENDMM
Field4:
Cheshire Name:
( IUQ1080 )
EVNT.EVENDMM
Item Text display:
Item Text:
DISCHARGE DATE:
Label:
Label Position:
MM
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TMonthInt
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Don't know
Route
IU4 - EVENDDD ( IUQ1100 )
Refusal
IU4 - EVENDDD ( IUQ1100 )
11:30:46 AM Thursday, February 26, 2009
FieldSize:
Min Value:
Max Value:
Mask:
2
01
12
Route
IU4 - EVENDDD ( IUQ1100 )
Page 14 of 22
IU4
EVENDDD
Field5:
Cheshire Name:
( IUQ1100 )
EVNT.EVENDDD
Item Text display:
Item Text:
Label:
Label Position:
DD
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TDayDKRF
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Don't know
Route
IU4 - EVENDYY ( IUQ1120 )
Refusal
IU4 - EVENDYY ( IUQ1120 )
11:30:53 AM Thursday, February 26, 2009
FieldSize:
Min Value:
Max Value:
Mask:
2
1
31
Route
IU4 - EVENDYY ( IUQ1120 )
Page 15 of 22
IU4
EVENDYY
Field6:
Cheshire Name:
( IUQ1120 )
EVNT.EVENDYY
Item Text display:
Item Text:
Label:
Label Position:
YY
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TYear2DKRF
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Don't know
Route
IU7 - IUMORE ( IUQ1150 )
Refusal
IU7 - IUMORE ( IUQ1150 )
FieldSize:
Min Value:
Max Value:
Mask:
2
00
99
Route
IU7 - IUMORE ( IUQ1150 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
Edit #1
If dates entered at IU4 do not have missing data, EVBEGMM,
EVBEGDD, EVBEGYY, EVENDMM, EVENDDD, EVENDYY ^= DK
and EVBEGMM, EVBEGDD, EVBEGYY, EVENDMM, EVENDDD,
EVENDYY ^= RF, then Admission date,
EVBEGMM/EVBEGDD/EVBEGYY, and Discharge date,
EVENDMM/EVENDDD/EVENDYY, should not match.
If not true, display message "VERIFY THAT SP WAS ADMITTED
AND DISCHARGED ON THE SAME DATE."
HARD EDIT CHECKS
Edit #1:
Admission date, EVBEGMM/EVBEGDD/EVBEGYY, must be on or
between (REFERENCE DATE) and (TODAY/DATE OF
DEATH/DATE OF INSTITUTIONALIZATION).
If not true, display message "INVALID DATE. ADMISSION DATE
MUST BE ON OR BETWEEN (REFERENCE DATE) AND
(TODAY/DATE OF DEATH/DATE OF INSTITUTIONALIZATION)".
INVOLVES EVBEGMM, EVBEGDD, EVBEGYY.
Edit #2:
11:30:57 AM Thursday, February 26, 2009
Page 16 of 22
IU4
Discharge date, EVENDMM/EVENDDD/EVENDYY, must be on or
between (ADMISSION DATE) and (TODAY/DATE OF DEATH/DATE
OF INSTITUTIONALIZATION).
If not true, display message "INVALID DATE. DISCHARGE DATE
MUST BE ON OR BETWEEN (ADMISSION DATE) AND
(TODAY/DATE OF DEATH/DATE OF INSTITUTIONALIZATION)".
INVOLVES EVENDMM, EVENDDD, EVENDYY.
Edit #3
If SPALIVE=2/AliveAndInstitute and date of institutionalization
colllected at INS2 does not have any missing data, SPINSTMM,
SPINSTDD, SPINSTYY ^= DK and SPINSTMM, SPINSTDD,
SPINSTYY ^= RF, then admission date,
EVBEGMM/EVBEGDD/EVBEGYY, and discharge date,
EVENDMM/EVENDDD/EVENDYY, cannot match date of
institutionalization collected at INS2,
SPINSTMM/SPINSTDD/SPINSTYY.
If not true, display message "INVALID DATE. THIS DATE
MATCHES THE CURRENT INSTITUTIONALIZATION DATE".
Edit #4:
Admission date, EVBEGMM/EVBEGDD/EVBEGYY, cannot match
an existing IU stay admission date for the same provider. If the
Admission date does not have missing data, EVBEGMM,
EVBEGDD, EVBEGYY ^= DK and EVBEGMM, EVBEGDD,
EVBEGYY ^= RF, then check this date against other IU stay
admission dates for this provider.
The following must be true for the IU stay added at IU4 to be a
duplicate of an existing IU stay:
Both EVNTDFLG ^= 1/Yes,
Both EVNTTYPE=IU,
Both EVNTRNDC=current round,
EVNTPROV matches,
EVBEGMM matches,
EVBEGDD matches,
EVBEGYY matches.
The Admission date added at IU4 cannot match an existing IU stay
admission date for the same provider.
If not true, display message "INVALID DATE. THE ADMISSION
DATE MATCHES AN EXISTING ADMISSION DATE TO (FACILITY
NAME)."
Display instructions: Display facility name, PROV.PROVNAME,
selected at IU2.
Edit #5:
Discharge date, EVENDMM/EVENDDD/EVENDYY, cannot match an
existing IU stay discharge date for the same provider. If the
Discharge date does not have missing data, EVENDMM, EVENDDD,
EVENDYY ^= DK and EVENDMM, EVENDDD, EVENDYY ^= RF,
then check this date against other IP stay discharge dates for this
provider.
The following must be true for the IU stay added at IU4 to be a
duplicate of an existing IU stay:
Both EVNTDFLG ^= 1/Yes,
Both EVNTRNDC=current round,
Both EVNTTYPE=IU,
EVNTPROV matches,
EVENDMM matches,
EVENDDD matches,
11:30:57 AM Thursday, February 26, 2009
Page 17 of 22
IU4
EVENDYY matches.
The Discharge date added at IU4 cannot match an existing IU stay
discharge date for the same provider.
If not true, display message "INVALID DATE. THE DISCHARGE
DATE MATCHES AN EXISTING DISCHARGE DATE TO (FACILITY
NAME)."
Display instructions: Display facility name, PROV.PROVNAME,
selected at IU2.
See General specifications for duplicate date logic.
TECHNICAL NOTES
DESIGN NOTES
11:30:57 AM Thursday, February 26, 2009
Page 18 of 22
IU7
IU7
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
IUMORE
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
100
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
If SP is deceased or institutionalized, display "did (SP) have".
Else if proxy interview, display "has (SP) had".
Else display "have you had".
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
IF RESPONDENT HAS ALREADY MENTIONED ANOTHER STAY
AT A NURSING HOME, ENTER “YES” WITHOUT ASKING.
OTHERWISE, ASK:
Question Text:
[Since (REFERENCE DATE)/Between (REFERENCE DATE) and
(DATE OF DEATH/DATE OF INSTITUTIONALIZATION)], [have you
had/has (SP) had/did (SP) have] any other stays in this or any other
nursing home or similar place that provides long-term care?
Int. Instr II:
11:31:00 AM Thursday, February 26, 2009
Page 19 of 22
IU7
INPUT FIELDS / ROUTING
( IUQ1150 )
IUMORE
Field1:
Cheshire Name:
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TYesNoDKRF
1
No
No
Number Label
1 Yes
2
FieldSize:
Min Value:
Max Value:
Mask:
Route
IU2 - PROVIDER_IU ( IUQ1030 )
English text: YES
No
English text: NO
BOX IU3 - (IUQ1155 )
Attribute
Don't know
Route
BOX IU3 - (IUQ1155 )
Refusal
BOX IU3 - (IUQ1155 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
4
Respondent
On MRES where MRES.MRESRND = current round:
A Proxy interview (respondent is a proxy) =
MRES.SPPROXY=2/Proxy.
MRES.RROSTNUM=ROST.ROSTNUM of respondent.
An SP interview (respondent is the SP) =
MRES.SPPROXY=1/SP.
11:31:06 AM Thursday, February 26, 2009
Page 20 of 22
IU7
MRES.RROSTNUM='01'.
DESIGN NOTES
11:31:06 AM Thursday, February 26, 2009
Page 21 of 22
BOX IU3
BOX IU3
Page Order # :
110
BOX INSTRUCTIONS
( IUQ1155 )
GO TO NEXT SECTION .
ASSIGNMENTS
TECHNICAL NOTES
DESIGN NOTES
11:31:06 AM Thursday, February 26, 2009
Page 22 of 22
| File Type | application/pdf |
| File Modified | 2010-04-05 |
| File Created | 0000-00-00 |