Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)

Statement OM Edit Roster Pop-Up
Item #:

OMEDISP
Cheshire Name:

STC1005

TEMP
OME Type display fill:

If EVNT.STOMTYPE = 91/Other, set and display OMEDISP =

Other Specify Text, EVOS.EVOSTEXT, on EVOS where

EVOS.EVOSEVNT = this EVNT.EVNTNUM.

Else set and display OMEDISP = EVNT.STOMTYPE

response text.

Do not allow updates to field.

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

String
TSTOMDisp

1

No
No

Number Label
1 [Continuous answer.]

11:22:19 AM Thursday, December 20, 2007

FieldSize:
Min Value:

Max Value:
Mask:

30

Route
STOMEdit - RENTDISP ( STC1010 )

Page 1 of 8

Statement OM Edit Roster Pop-Up
Item #:

RENTDISP
Cheshire Name:

STC1010

TEMP
Purchased/Rental Status display fill:

If EVNT.RENTPROB = 1/Buy, set and display RENTDISP =

“Purchased”.

Else if EVNT.RENTPROB = 2/Rent and EVNT.RENTSTIL =

2, DK, RF, set and display RENTDISP = “Rental Complete”.

Else set and display RENTDISP = “Still Renting”.

Do not allow updates to field.

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

String
TSTOMDisp

1

No
No

Number Label
1 [Continuous answer.]

11:22:20 AM Thursday, December 20, 2007

FieldSize:
Min Value:

Max Value:
Mask:

30

Route
STOMEdit - EVBEGMM ( STC1015 )

Page 2 of 8

Statement OM Edit Roster Pop-Up
Item #:

EVBEGMM
Cheshire Name:

Field Type:

Type Name:

Answers Allowed:

Drop Down List:

Lookup File:

Lookup File Name:

STC1015

EVNT.EVBEGMM
Integer
TMonthInt
1
No
No

Number Label
1 [Continuous answer.]
Attribute
Don't know

Route
STOMEdit - EVBEGDD ( STC1020 )

Refusal

STOMEdit - EVBEGDD ( STC1020 )

11:22:22 AM Thursday, December 20, 2007

FieldSize:
Min Value:
Max Value:
Mask:

2
01
12

Route
STOMEdit - EVBEGDD ( STC1020 )

Page 3 of 8

Statement OM Edit Roster Pop-Up
Item #:

EVBEGDD
Cheshire Name:

Field Type:

Type Name:

Answers Allowed:

Drop Down List:

Lookup File:

Lookup File Name:

STC1020

EVNT.EVBEGDD
Integer
TDayDKRF
1
No
No

Number Label
1 [Continuous answer.]
Attribute
Don't know

Route
STOMEdit - EVBEGYY ( STC1025 )

Refusal

STOMEdit - EVBEGYY ( STC1025 )

11:22:24 AM Thursday, December 20, 2007

FieldSize:
Min Value:
Max Value:
Mask:

2
1
31

Route
STOMEdit - EVBEGYY ( STC1025 )

Page 4 of 8

Statement OM Edit Roster Pop-Up
Item #:

EVBEGYY
Cheshire Name:

Field Type:

Type Name:

Answers Allowed:

Drop Down List:

Lookup File:

Lookup File Name:

STC1025

EVNT.EVBEGYY
Integer
TYearDKRF
1
No
No

Number Label
1 [Continuous answer.]
Attribute
Don't know

Route
STOMEdit - EVENDMM ( STC1030 )

Refusal

STOMEdit - EVENDMM ( STC1030 )

11:22:26 AM Thursday, December 20, 2007

FieldSize:
Min Value:
Max Value:
Mask:

0
99

Route
STOMEdit - EVENDMM ( STC1030 )

Page 5 of 8

Statement OM Edit Roster Pop-Up
Item #:

EVENDMM
Cheshire Name:

STC1030

EVNT.EVENDMM
If (EVNT.RENTSTIL = 2/No, DK, or RF) and
(EVNT.RENT2BUY ^= 2/PurchasedRentToBuy), allow
updates to field.
Else disallow updates.

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
STOMEdit - EVENDDD ( STC1035 )

Refusal

STOMEdit - EVENDDD ( STC1035 )

11:22:28 AM Thursday, December 20, 2007

FieldSize:
Min Value:
Max Value:
Mask:

2
01
12

Route
STOMEdit - EVENDDD ( STC1035 )

Page 6 of 8

Statement OM Edit Roster Pop-Up
Item #:

EVENDDD
Cheshire Name:

STC1035

EVNT.EVENDDD
If (EVNT.RENTSTIL = 2/No, DK, or RF) and
(EVNT.RENT2BUY ^= 2/PurchasedRentToBuy), allow
updates to field.
Else disallow updates.

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
STOMEdit - EVENDYY ( STC1040 )

Refusal

STOMEdit - EVENDYY ( STC1040 )

11:22:29 AM Thursday, December 20, 2007

FieldSize:
Min Value:
Max Value:
Mask:

2
1
31

Route
STOMEdit - EVENDYY ( STC1040 )

Page 7 of 8

Statement OM Edit Roster Pop-Up
Item #:

EVENDYY
Cheshire Name:

STC1040

EVNT.EVENDYY
If (EVNT.RENTSTIL = 2/No, DK, or RF) and
(EVNT.RENT2BUY ^= 2/PurchasedRentToBuy), allow
updates to field.
Else disallow updates.

Field Type:

Type Name:

Answers Allowed:

Drop Down List:

Lookup File:

Lookup File Name:

Integer
TYearDKRF
1
No
No

Number Label
1 [Continuous answer.]

FieldSize:

Min Value:
Max Value:
Mask:

0

99

Route
Exit Pop-Up Window.

Attribute
Don't know

Route
Exit Pop-Up Window.

Refusal
Exit Pop-Up Window.

11:22:30 AM Thursday, December 20, 2007

Page 8 of 8