Cms-p-0015a Mcbs

Home Health Summary (HHS)
Variable Name
MR Screen Name
BOX HHS1

PROFPROB

FRNDPROB

OTHMEALS

Question type
routing

BOX HHS1A

routing

HHS1

yes/no

BOX HHS2

routing

BOX HHS2A

routing

HHS2

yes/no

BOX HHS3

routing

HHS3

yes/no

BOX HHS5

routing

BOX HHS6

routing

Question text/description
IF SP RECEIVED CARE FROM AT LEAST ONE HOME HEALTH PROFESSIONAL DURING THE PREVIOUS ROUND,
GO TO BOX HHS1A.
ELSE GO TO BOX HHS2
CREATE CURRENT ROUND HERO RECORD FOR HH PROVIDER BEING ASKED ABOUT
GO TO HHS1 - PROFPROB.
We recorded that [you/(SP)] had been helped at home by (someone from) [READ PROVIDER BELOW]
between (SUMMARY REFERENCE DATE) and (REFERENCE DATE). Has (anyone from) [READ PROVIDER
BELOW] helped [you/(SP)] at home [since (REFERENCE DATE/UTILDATE)/between (REFERENCE DATE) and
(DATE OF DEATH)/ (DATE OF INSTITUTIONALIZATION/ENDUTILD)]?

Code list

(01) YES
(02) NO
(03) HOME HEALTH ENTERED IN ERROR IN PREVIOUS
ROUND
(-8) Don't Know
[IF THE RESPONDENT SAYS "SOMEONE ELSE CAME," PROBE TO DETERMINE IF THE PERSON WORKED FOR THE (-9) Refused
AGENCY SHOWN ON THE SCREEN.]
IF SP RECEIVED HOME HEALTH CARE FROM AT LEAST ONE FRIEND OR RELATIVE DURING THE PREVIOUS
ROUND, GO TO BOX HHS2A.
ELSE GO TO BOX HHS6.
CREATE CURRENT ROUND HERO RECORD FOR HH PROVIDER BEING ASKED ABOUT
GO TO HHS2 - FRNDPROB.
We recorded that [you/(SP)] had received personal care or help with daily needs at home from (someone
(01) YES
from) [READ PROVIDER BELOW] between (SUMMARY REFERENCE DATE) and (REFERENCE DATE). [Have
(02) NO
you/Has (SP)] received personal care or help with daily needs at home from (anyone from) [READ PROVIDER (03) HOME HEALTH ENTERED IN ERROR IN PREVIOUS
BELOW] [since (REFERENCE DATE/UTILDATE)/between (REFERENCE DATE) and (DATE OF DEATH)/ (DATE OF ROUND
INSTITUTIONALIZATION/ENDUTILD]?
(-8) Don't Know
(-9) Refused
[IF THE RESPONDENT SAYS "SOMEONE ELSE CAME," PROBE TO DETERMINE IF THE PERSON WORKED FOR THE
AGENCY SHOWN ON THE SCREEN.]
IF TYPE OF HOME HEALTH PROVIDER ORGANIZATION IS A MEAL PROGRAM, GO TO HHS3 - OTHMEALS.
ELSE GO TO BOX HH1BB
Since (REFERENCE DATE/UTILDATE), has (PROVIDER NAME) provided any services to [you/(SP)] other than
(01) YES
delivering meals?
(02) NO
(-8) Don't Know
(-9) Refused
IF ASKING ABOUT HOME HEALTH PROFESSIONALS FROM THE PREVIOUS ROUND, THEN
IF SP RECEIVED CARE FROM ANOTHER HOME HEALTH PROFESSIONAL DURING THE PREVIOUS ROUND, GO
TO BOX HHS1A.
ELSE GO TO BOX HHS2.
ELSE IF ASKING ABOUT HOME HEALTH CARE FROM A FRIEND OR RELATIVE FROM THE PREVIOUS ROUND,
THEN
IF SP RECEIVED HOME HEALTH CARE FROM ANOTHER FRIEND OR RELATIVE DURING THE PREVIOUS
ROUND, GO TO BOX HHS2A.
ELSE GO TO BOX HHS6.
ELSE GO TO BOX HHS6.
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