Cms-p-0015a Mcbs

Medicare Current Beneficiary Survey (MCBS)

R69_RHF

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

OMB: 0938-0568

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Medicare Current Beneficiary Survey

Section Specifications for RHF

Round 69

RESIDENCE HISTORY

Created on 5/9/2014 6:13:37 PM

BOX RHBEG



Box Instructions

IF SP IS A CFR, GO TO RH2PRE - RH2PRECT.

ELSE GO TO RH1PRE - RH1PRECT.



Variable Name

Assignment Instructions

RH3CT

RH3CT=EMPTY

RHREFBEG

If SP IS A CFR and PERS.RHREFBEG = EMPTY or NULL, then PERS.RHREFBEG = date of previous interview.

SPDISP

SPDISP = EMPTY



RH1PRE Code 1



Question Text

Now, I would like to ask you about the places where (SP) stayed for one night or more between [January 1, (CURRENT YEAR)/(his/her) admission to this (facility/home)/(his/her) readmission to this (facility/home)] and today including staying in [other parts of (LARGER FACILITY),] hospitals or other places.

In answering these questions, it might be helpful for you to review records that show discharges or transfers from (FACILITY) to [other parts of (LARGER FACILITY),] hospitals or other places.

PRESS "1" TO CONTINUE.

Field 1: RH1PRECT

Field 1 Routing

Value

Label

Route

1

CONTINUE

BOX RH1





RH2PRE Code 1



Question Text

On my last visit on (REF DATE), (SP) was alive and a resident of (FACILITY).

Now, I would like to ask you about all the places (SP) has stayed since my last visit, including staying in [other parts of (LARGER FACILITY)], hospitals or other places.

PRESS "1" TO CONTINUE.

Field 1: RH2PRECT

Field 1 Routing

Value

Label

Route

1

CONTINUE

BOX RH1





Other Programming Instructions

Design Notes

Ref begin only set once, do not change on backup

BOX RH1



Box Instructions

If CFR, GO TO RH7 - RHALIVE.

ELSE IF SP IS EXPECTED SSM1, GO TO RH2 - ADMITMM1.

ELSE GO TO RH2A - ADMITMM2.

RH2 Date



Question Text

On what date was (SP) most recently admitted to (FACILITY)?

Field 1: ADMITMM1

MONTH

Field 1 Routing

Value

Label

Route

1

[Continuous answer.]

RH2 - ADMITDD1


Don't Know

RH3 - RH3CT


Refused

RH3 - RH3CT





Field 2: ADMITDD1

DAY

Field 2 Routing

Value

Label

Route

1

[Continuous answer.]

RH2 - ADMITYY1


Don't Know

RH3 - RH3CT


Refused

RH3 - RH3CT





Field 3: ADMITYY1

YEAR

Field 3 Routing

Value

Label

Route

1

[Continuous answer.]

BOX RH2


Don't Know

RH3 - RH3CT


Refused

RH3 - RH3CT





Other Programming Instructions

Background Variable Assignments

Variable Name

Assignment Instructions

ADMIT

If RH2-ADMITYY1 <> DK, RF, EMPTY or NULL, PERS.ADMIT = RH22-ADMITYY1 + RH22-ADMITMM1 + RH22-ADMITDD1

ORIGADMT

If RH2-ADMITYY1 <> DK, RF, EMPTY or NULL, PERS.ORIGADMT = ADMIT

RAD

PERS.RAD = ADMIT

SUPPTYPE

If RH2-ADMITYY1 = current year, then PERS.SUPPTYPE = 2/SSM2. Else PERS.SUPPTYPE = SSM1.

PREVADMT

If RH2-ADMITYY1 = current year, then PERS.PREVADMT = PERS.ADMIT. Else if RH2-ADMITYY1 <> DK, RF, EMPTY, NULL, or current year, then PERS. PREVADMT = current year + '0101'

RHREFBEG

PERS.RHREFBEG = PREVADMT



RH2A Date



Question Text

On what date [on or around (ADMISSION DATE REPORTED BY A PREVIOUS SOURCE),] do your records show (SP) was admitted to (FACILITY)?

IF SP NEVER ADMITTED, ENTER "DK" IN MONTH FIELD.

Field 1: ADMITMM2

MONTH

Field 1 Routing

Value

Label

Route

1

[Continuous answer.]

RH2A - ADMITDD2


Don't Know

RH3 - RH3CT


Refused

RH3 - RH3CT





Field 2: ADMITDD2

DAY

Field 2 Routing

Value

Label

Route

1

[Continuous answer.]

RH2A - ADMITYY2


Don't Know

RH3 - RH3CT


Refused

RH3 - RH3CT





Field 3: ADMITYY2

YEAR

Field 3 Routing

Value

Label

Route

1

[Continuous answer.]

BOX RH2A1


Don't Know

RH3 - RH3CT


Refused

RH3 - RH3CT





Other Programming Instructions

Background Variable Assignments

Variable Name

Assignment Instructions

ORIGADMT

If RH2A-ADMITYY2 <> DK, RF, EMPTY or NULL and PERSRNDC = current round, then ORIGADMT = RH2A-ADMITYY2 + RH2A-ADMITMM2 + RH2A-ADMITDD2

ADMIT

If PERSRNDC = current round, then ADMIT = ORIGADMT

PREVADMT

If CURRTYPE = 5/SSM and RH2A-ADMITYY2 <> RF, DK, EMPTY, or NULL and RH2A-ADMITYY2 <> CURRENT YEAR, then PREVADMT = CURRENT YEAR + '0101'. Else if PERSRNDC = current round, then PREVADMT = RH2A-ADMITYY2 + RH2A-ADMITMM2 + RH2A-ADMITDD2.

SUPPTYPE

If CURRTYPE = 5/SSM THEN
If RH2A-ADMITYY2 <> DK, RF, or EMPTY and RH2A-ADMITYY2 <> current year, then SUPPTYPE = 1/SSM1. Else SUPPTYPE = 2/SSM2.

RAD

If RH2A-ADMITYY2 <> DK, RF, EMPTY or NULL, RAD = RH2A-ADMITYY2 + RH2A-ADMITMM2 + RH2A-ADMITDD2

RHREFBEG

If PERSRNDC = current round, then RHREFBEG = PREVADMT. Else RHREFBEG = RAD.



Design Notes

Design note: This item collects the first admit date for CFCs, SSM2s and first time to this facility FCFs and FFCs, and the RAD for FCFs and FFCs with previous interviews in this facility.

BOX RH2A1



Box Instructions

IF SP IS SSM OR RH2A DATE IS WITHIN +/- 7 DAYS OF ADMISSION DATE REPORTED BY A PREVIOUS SOURCE, GO TO BOX RH2.

ELSE GO TO RH2AVB - WHYADDIS.

Other Programming Instructions

Background Variable Assignments

If PERSRNDC <> current round, create next sequential stay with the following field values:

Variable Name

Assignment Instructions

STAYNUM

STAYNUM = Create STAY where STAYNUM = next sequential STAYNUM

STAYRNDC

STAYRNDC = current round

STAYACCS

STAYACCS = current round

RHPROBTY

STAY.RHPROBTY = 9/DPStay

XSTPLAC

STAY.XSTPLAC = 000

DPSTAY

STAY.DPSTAY = 1/Indicated

STAYLAST

PERS.STAYLAST = STAYNUM for newly created
STAY

STAYSYY

STAY.STAYSYY = Year of Previous Interview

STAYSMM

STAY.STAYSMM = Month of Previous Interview

STAYSDD

STAY.STAYSDD = Day of Previous Interview

STAYEYY

STAY.STAYEYY = ADMITYY2

STAYEMM

STAY.STAYEMM = ADMITMM2

STAYEDD

STAY.STAYEDD = ADMITDD2

STAYORD

STAY.STAYORD = next sequential STAYORD

LASTSTAY

PERS.LASTSTAY = STAY.STAYNUM of newly created stay

STAYCLASS

STAY.STAYCLAS = 6/OutsideThisFac



RH2AVB Verbatim Text



Question Text

DESCRIBE WHY THERE IS A DISCREPANCY BETWEEN THE ADMISSION DATE REPORTED BY A PREVIOUS SOURCE AND THE ADMISSION DATE ENTERED DURING THIS INTERVIEW.

Field 1: WHYADDIS

Field 1 Routing

Value

Label

Route

1

[Continuous answer.]

BOX RH2





BOX RH2



Box Instructions

IF SSM, GO TO RH6 - RHSEX.

ELSE GO TO RH7 - RHALIVE.

Other Programming Instructions

Variable Name

Assignment Instructions

STAYNUM

If PERSRNDC = current round, create first STAY with STAYNUM = 001. Else create STAY with next sequential STAYNUM.

STAYRNDC

STAYRNDC = current round

STAYACCS

STAYACCS = current round

RHPROBTY

If PERSRNDC = current round, STAY.RHPROBTY = 0. Else STAY.RHPROBTY = 8.

XSTPLAC

STAY.XSTPLAC = 001

STAYSYY

Year portion of RHREFBEG

STAYLAST

PERS.STAYLAST = STAYNUM

STAYSMM

Month portion of RHREFBEG

STAYSDD

Day portion of RHREFBEG

STAYORD

STAY.STAYORD = next sequential STAYORD

LASTSTAY

PERS.LASTSTAY = STAY.STAYNUM of newly created stay

STAYCLASS

STAY.STAYCLAS = 1/EligibleLTC



Design Notes

Must reassign any global SSM1/SSM2 displays based on assignments at RH2 or RH2A.

RH3 Code 1



Question Text

Please tell me the name and title of someone in (FACILITY) who could give me that information.

RECORD RESPONDENT INFORMATION ON PERSON ROSTER AND SELECT ENTRY WHEN RH IS RESTARTED.


PRESS "1" TO CONTINUE.

Field 1: RH3CT

Field 1 Routing

Value

Label

Route

1

CONTINUE

BOX RHEND





RH6 Code 1



Question Text

ASK IF NOT OBVIOUS.

Is (SP) male or female?

Field 1: RHSEX

Field 1 Routing

Value

Label

Route

1

MALE

RH7 - RHALIVE

2

FEMALE

RH7 - RHALIVE





Other Programming Instructions

Design Notes

Global displays for sex must be updated if RHSEX does not match preload.

RH7 Yes/No



Question Text

Is (SP) alive?

Field 1: RHALIVE

Field 1 Routing

Value

Label

Route

0

NO

RH8 - RHDODMM

1

YES

BOX RH7


Don't Know

BOX RH7


Refused

BOX RH7





RH8 Date



Question Text

On what date did (SP) die?

Field 1: RHDODMM

MONTH

[IF RESPONDENT ANSWERS "DK", PROBE: Do you know what month (SP) died?]

Field 1 Routing

Value

Label

Route

1

[Continuous answer.]

RH8 - RHDODDD


Don't Know

BOX RH6


Refused

BOX RH6





Field 2: RHDODDD

DAY

Field 2 Routing

Value

Label

Route

1

[Continuous answer.]

RH8 - RHDODYY


Don't Know

RH8 - RHDODYY


Refused

RH8 - RHDODYY





Field 3: RHDODYY

YEAR

Field 3 Routing

Value

Label

Route

1

[Continuous answer.]

BOX RH6


Don't Know

BOX RH6


Refused

BOX RH6





BOX RH6



Box Instructions

IF SP IS SSM, GO TO RH3B - RHINEL.

ELSE IF MONTH OR YEAR OF DEATH IS DK OR RF, GO TO RH3 - RH3CT.

ELSE, GO TO BOX RH7.

Other Programming Instructions

Background Variable Assignments

IF DAY IS DK OR RF:
SET DATE OF DEATH TO LAST DAY OF MONTH OR TODAY'S DATE IF MONTH OF DEATH = DATE OF INTERVIEW (DOI) MONTH.

Variable Name

Assignment Instructions

DOD

If RH8-RHDODYY ^= RF, DK, NULL or EMPTY:
If RH8-RHDODDD ^= RF, DK THEN DOD = RH8-RHDODYY + RH8-RHDODMM + RH8-RHDODDD.
ELSE IF RH8-RHDODDD = RF or DK, then DOD = RH8-RHDODYY + RH8-RHDODMM + Last day of month in RH8-RHDODMM

SPDISP

If SP is SSM, SPDISP = 11/FinalNonResp



BOX RH7



Box Instructions

IF SP IS SSM, GO TO RH9 - RHDOBMM.

ELSE GO TO BOX RH9A.

Variable Name

Assignment Instructions

RHREFEND

If RH7-RHALIVE = 0/No, RHREFEND = DOD.
Else If PERS.RHDOI <> EMPTY, RHREFEND = PERS.RHDOI.
Else RHREFEND = CURRENT DATE.



RH9 Date



Question Text

What (is/was) (SP's) date of birth?

ENTER A 4-DIGIT YEAR.

Field 1: RHDOBMM

MONTH

Field 1 Routing

Value

Label

Route

1

[Continuous answer.]

RH9 - RHDOBDD


Don't Know

RH9 - RHDOBDD


Refused

RH9 - RHDOBDD





Field 2: RHDOBDD

DAY

Field 2 Routing

Value

Label

Route

1

[Continuous answer.]

RH9 - RHDOBYY


Don't Know

RH9 - RHDOBYY


Refused

RH9 - RHDOBYY





Field 3: RHDOBYY

YEAR

Field 3 Routing

Value

Label

Route

1

[Continuous answer.]

BOX RH9A


Don't Know

RH10 - RHAGE


Refused

RH10 - RHAGE





Other Programming Instructions

Background Variable Assignments

Variable Name

Assignment Instructions

DOBYY

DOBYY = RHDOBYY

DOBMM

DOBMM = RHDOBMM

DOBDD

DOBDD = RHDOBDD



RH10 Numeric



Question Text

Approximately how old is (SP)?

Field 1: RHAGE

Field 1 Routing

Value

Label

Route

1

[Continuous answer.]

BOX RH9A


Don't Know

BOX RH9A


Refused

BOX RH9A





BOX RH9A



Box Instructions

IF SP IS A CFR, GO TO RH11A - RHPROBE1.

ELSE GO TO RH11B - RHPROBE2.

Other Programming Instructions

Background Variable Assignments

Open last chronological STAY for CFRs.

Variable Name

Assignment Instructions

AGE

If DOB <> DK, RF, EMPTY or NULL, then AGE = difference between DOB and RHREFEND in years. Else if RHAGE <> DK, RF, EMPTY or NULL, then PERS.AGE = RHAGE. Else AGE = difference between PreloadSP.DOB and RHREFEND in years.



RH11A Yes/No



Question Text

Between (REF DATE), (the date of my last visit), and (RH END OF REFERENCE PERIOD) has (SP) been in (FACILITY) the whole time or has (he/she) spent one or more nights [in another part of (LARGER FACILITY),] in a hospital, or in some other place?

Field 1: RHPROBE1

Field 1 Routing

Value

Label

Route

0

NO, OTHER PLACE

BOX RH13A

1

YES, WHOLE TIME

BOX RH10


Refused

BOX RH10





Other Programming Instructions

Background Variable Assignments

Variable Name

Assignment Instructions

STAYACCS

STAYACCS = CURRRND

STAYEYY

If RH11A-RHPROBE1 = 1/YesWholeTime and RH7-RHALIVE ^= 0/No, then STAYEYY = Year portion of RHREFEND.

STAYEMM

If RH11A-RHPROBE1 = 1/YesWholeTime and RH7-RHALIVE ^= 0/No, then STAYEMM = Month portion of RHREFEND.

STAYEDD

If RH11A-RHPROBE1 = 1/YesWholeTime and RH7-RHALIVE ^= 0/No, then STAYEDD = Day portion of RHREFEND.

RHPROBE

STAY.RHPROBE = RH11A-RHPROBE1



RH11B Yes/No



Question Text

Between (REF DATE) and (RH END OF REFERENCE PERIOD) has (SP) been in (FACILITY) the whole time or has (she/he) spent one or more nights [in another part of (LARGER FACILITY),] in a hospital, or in some other place?

Field 1: RHPROBE2

Field 1 Routing

Value

Label

Route

0

NO, OTHER PLACE

BOX RH13A

1

YES, WHOLE TIME

BOX RH10


Refused

BOX RH10





Other Programming Instructions

Background Variable Assignments

Variable Name

Assignment Instructions

STAYEYY

If RH11B-RHPROBE2 = 1/YesWholeTime and RH7-RHALIVE ^= 0/No, then STAYEYY = Year portion of RHREFEND.

STAYEMM

If RH11B-RHPROBE2 = 1/YesWholeTime and RH7-RHALIVE ^= 0/No, then STAYEMM = Month portion of RHREFEND.

STAYEDD

If RH11B-RHPROBE2 = 1/YesWholeTime and RH7-RHALIVE ^= 0/No, then STAYEDD = Day portion of RHREFEND.

RHPROBE

STAY.RHPROBE = RH11B-RHPROBE2



RH12 Yes/No



Question Text

Between (CURRENT START DATE) and (END OF RH REFERENCE PERIOD) was (SP) in (CURRENT PLACE) the whole time?

Field 1: RHPROBE3

Field 1 Routing

Value

Label

Route

0

NO, LEFT

BOX RH13A

1

YES, WHOLE TIME

BOX RH10


Don't Know

BOX RH10


Refused

BOX RH10





Other Programming Instructions

Background Variable Assignments

Variable Name

Assignment Instructions

RHPROBE

If RH12-RHPROBE3 = 0/NoLeft, then STAY.RHPROBE = 0/NoOtherPlace.
Else STAY.RHPROBE = RH12-RHPROBE3.

STAYEYY

If RH12-RHPROBE3 = 1/YesWholeTime and RH7-RHALIVE ^= 0/No, then STAYEYY = Year portion of RHREFEND.

STAYEMM

If RH12-RHPROBE3 = 1/YesWholeTime and RH7-RHALIVE ^= 0/No, then STAYEMM = Month portion of RHREFEND.

STAYEDD

If RH12-RHPROBE3 = 1/YesWholeTime and RH7-RHALIVE ^= 0/No, then STAYEDD = Day portion of RHREFEND.



BOX RH10



Box Instructions

(IF RH11A-RHPROBE1 = 1/YesWholeTime, OR
RH11B-RHPROBE2 = 1/YesWholeTime, OR
RH12-RHPROBE3 = 1/YesWholeTime) AND SP IS ALIVE OR VITAL STATUS IS NOT KNOWN, GO TO BOX RH24.

(IF RH11A-RHPROBE1 = RF, OR
RH11B-RHPROBE2 = RF, OR
RH12-RHPROBE3 = DK or RF) AND SP IS ALIVE OR VITAL STATUS IS NOT KNOWN, GO TO RH12B - CURSTIL.

ELSE GO TO RH12A - CURDIED.

RH12A Code 1



Question Text

Was (he/she) in (CURRENT PLACE) when (he/she) died on (DATE OF DEATH) or somewhere else?

Field 1: CURDIED

Field 1 Routing

Value

Label

Route

0

SOMEWHERE ELSE

BOX RH13A

1

IN (FACILITY)

BOX RH24


Don't Know

BOX RH24


Refused

BOX RH24





Other Programming Instructions

Background Variable Assignments

Variable Name

Assignment Instructions

STAYEYY

If RH12A-CURDIED = 1/InCurrPlace, DK, or RF, then STAYEYY = Year portion of RHREFEND.

STAYEMM

If RH12A-CURDIED = 1/InCurrPlace, DK, or RF, then STAYEMM = Month portion of RHREFEND.

STAYEDD

If RH12A-CURDIED = 1/InCurrPlace, DK, or RF, then STAYEDD = Day portion of RHREFEND.



RH12B Yes/No



Question Text

Is (he/she) still at (CURRENT PLACE)?

Field 1: CURSTIL

Field 1 Routing

Value

Label

Route

0

NO

BOX RH13A

1

YES

BOX RH24


Don't Know

BOX RH24


Refused

BOX RH24





Other Programming Instructions

Background Variable Assignments

RH12B-CURSTIL = 1/Yes, DK, or RF set stay end date to end of reference period.

Variable Name

Assignment Instructions

STAYEYY

If RH12B-CURSTIL = 1/Yes, DK, or RF, then STAYEYY = Year portion of RHREFEND.

STAYEMM

If RH12B-CURSTIL = 1/Yes, DK, or RF, then STAYEMM = Month portion of RHREFEND.

STAYEDD

If RH12B-CURSTIL = 1/Yes, DK, or RF, then STAYEDD = Day portion of RHREFEND.



BOX RH13A



Box Instructions

GO TO RH13 - STAYEMM.

RH13 Date



Question Text

When did (SP) leave (CURRENT PLACE)?

Field 1: STAYEMM

MONTH

Field 1 Routing

Value

Label

Route

1

[Continuous answer.]

RH13 - STAYEDD


Don't Know

RH13 - STAYEDD


Refused

RH13 - STAYEDD





Field 2: STAYEDD

DAY

Field 2 Routing

Value

Label

Route

1

[Continuous answer.]

RH13 - STAYEYY


Don't Know

RH13 - STAYEYY


Refused

RH13 - STAYEYY





Field 3: STAYEYY

YEAR

Field 3 Routing

Value

Label

Route

1

[Continuous answer.]

BOX RH11


Don't Know

BOX RH11


Refused

BOX RH11





Other Programming Instructions

Background Variable Assignments

Create the next STAY with the following field values:

Variable Name

Assignment Instructions

STAYRNDC

STAYRNDC for newly created STAY = current round

STAYACCS

STAYACCS for newly created STAY = current round

RHPROBTY

IF RH12A-CURDIED = 0/SomewhereElse, DK, or RF, then RHPROBTY = 4. Else if RH12B-CURSTIL = 0/No, DK, or RF, then RHPROBTY = 5. Else RHPROBTY = 3.

STAYLAST

PERS.STAYLAST = STAYNUM for newly created STAY

STAYSYY

RH13-STAYEYY

STAYSMM

RH13-STAYEMM

STAYSDD

RH13-STAYEDD

STAYEYY

If (RH12A-CURDIED = 0/SomewhereElse) or (RH12B-CURSTIL = 0/No), then STAYEYY = Year portion of RHREFEND. Else STAYEYY = EMPTY.

STAYEMM

If (RH12A-CURDIED = 0/SomewhereElse) or (RH12B-CURSTIL = 0/No), then STAYEMM = Month portion of RHREFEND. Else STAYEMM = EMPTY.

STAYEDD

If (RH12A-CURDIED = 0/SomewhereElse) or (RH12B-CURSTIL = 0/No), then STAYEDD = Day portion of RHREFEND. Else STAYEDD = EMPTY.

STAYORD

STAY.STAYORD = next sequential STAYORD

LASTSTAY

PERS.LASTSTAY = STAY.STAYNUM of newly created stay



BOX RH11



Box Instructions

IF ANY PART OF RH13 DATE IS MISSING, GO TO RH14 - STAYNITE.

ELSE GO TO RH21 - XSTPLACS.

RH14 Numeric



Question Text

About how many nights did (he/she) spend there?

Field 1: STAYNITE

Field 1 Routing

Value

Label

Route

1

[Continuous answer.]

RH21 - XSTPLACS


Don't Know

RH21 - XSTPLACS


Refused

RH21 - XSTPLACS





Other Programming Instructions

Background Variable Assignments

MINEND:
If RH14-STAYNITE <> DK,RF & RH13-STAYEMM <> DK, RF & RH13-STAYEYY <> DK,RF.
If RH13-STAYEDD <> DK,RF then MINEND = RH13-STAYEYY + RH13-STAYEMM + RH13-STAYEDD.
Else if RH13-STAYEMM <> RH14STARTMM then MINEND = RH13-STAYEYY + RH13-STAYEMM + ‘01’.
Else if RH13-STAYEMM = RH14STARTMM and day from MINSTART = last day of the month for RH14STARTMM then MINEND = RH13-STAYEYY + RH13-STAYEMM + last day of the month for RH13-STAYEMM.
Else MINEND = MINSTART + 1 day.

MAXEND:
If RH14-STAYNITE <> DK,RF & RH13-STAYEMM <> DK, RF & RH13-STAYEYY <> DK,RF.
If RH13-STAYEDD <> DK,RF then MAXEND = RH13-STAYEYY + RH13-STAYEMM + RH13-STAYEDD.
Else if RH14STARTYY = RH8-RHDODYY and RH14STARTMM = RH8-RHDODMM, then MAXSTART = PERS.DOD.
Else If RH14STARTYY = current year and RH14STARTMM = RH8-RHDODMM, then MAXSTART = RHREFEND.
Else MAXEND = RH13-STAYEYY + RH13-STAYEMM + last day of the month for RH13-STAYEMM.

Variable Name

Assignment Instructions

MAXALLOW

If RH14-STAYNITE <> DK,RF and MAXSTART <> EMPTY and MAXEND <> EMPTY then MAXALLOW = MAXEND – MAXSTART.

MINALLOW

If RH14-STAYNITE <> DK, RF and MINSTART <> EMPTY and MINEND <> EMPTY then MINALLOW = MINEND - MINSTART.

STAYEYY

If RH14-STAYNITE <> DK, RF, then STAYEYY = Year portion of date calculated as RHSTARTDATE + RH14-STAYNITE days.

STAYEMM

If RH14-STAYNITE <> DK, RF, then STAYEMM = Month portion of date calculated as RHSTARTDATE + RH14-STAYNITE days.

STAYEDD

If RH14-STAYNITE <> DK, RF, then STAYEDD = Day portion of date calculated as RHSTARTDATE + RH14-STAYNITE days.

RH14STARTMM

If STAYRNDC = current round, then RH14STARTMM = STAYSMM.
Else RH14STARTMM = month portion of RHREFBEG.

RH14STARTDD

If STAYRNDC = current round, then RH14STARTDD = STAYSDD.
Else RH14STARTDD = day portion of RHREFBEG.

RH14STARTYY

If STAYRNDC = current round, then RH14STARTYY = STAYSYY.
Else RH14STARTYY = year portion of RHREFBEG.

MINSTART

If RH14-STAYNITE <> DK,RF and RH14-STARTMM <> DK,RF & RH14STARTYY <> DK,RF:
If RH14STARTDD <> DK,RF then MINSTART = RH14STARTYY + RH14STARTMM + RH14STARTDD.
Else MINSTART = RH14STARTYY + RH14STARTMM + last day of the month for RH14STARTMM.

MAXSTART

If RH14-STAYNITE <> DK, RF and RH14STARTMM <> DK, RF and RH14STARTYY <> DK,RF:
If RH14STARTDD <> DK, RF then MAXSTART = RH14STARTYY + RH14STARTMM + RH14-STARTDD.
Else MAXSTART = RH14STARTYY + RH14STARTMM + ‘01’.

RH14STARTDATE

RH14STARTDATE = RH14STARTYY + RH14STARTMM +
RH14STARTDD.



RH21 Roster



Question Text

[Where did (he/she) go on (START DATE)?/Where is (he/she) living now?/Where was (he/she) staying when (he/she) died on (DATE OF DEATH)?]

SELECT NAME FROM LIST OR SELECT "[NEED TO ADD PLACE]".

Field 1: XSTPLACS

Field 1 Routing

Value

Label

Route

1

[Continuous answer.]

BOX RH12





Other Programming Instructions

Roster/Grid Instructions

Display all place names on the STAY roster except the place name for the place where the SP stayed during the last sequential STAY.

BOX RH12



Box Instructions

IF RH21-XSTPLACS = "[NEED TO ADD PLACE]", GO TO RH21A - XSTPLACN.

ELSE GO TO BOX RH13.

Other Programming Instructions

Background Variable Assignments

Create next sequential PLAC and assign the following:

Variable Name

Assignment Instructions

PLACNUM

PLAC.PLACNUM = next sequential PLAC record number

PLACRNDC

PLAC.PLACRNDC = CURRENT ROUND

PLCREATE

PLAC.PLCREATE = 50/ResidenceHistory

XSTPLAC

STAY.XSTPLAC = PLACNUM



RH21A Text



Question Text

ENTER THE NAME OF THE PLACE.

Field 1: XSTPLACN

Field 1 Routing

Value

Label

Route

1

[Continuous answer.]

BOX RH13





Other Programming Instructions

Background Variable Assignments

Variable Name

Assignment Instructions

PLACNAME

PLAC.PLACNAME = XSTPLACN



BOX RH13



Box Instructions

IF PLACE ADDED AT RH21A-XSTPLACN AND FACILITY IS PART OF A LARGER PLACE, GO TO RH21B - LOCTEMP.

ELSE IF PLACE ADDED AT RH21A-XSTPLACN, GO TO RH22 - PLACKIRH.

ELSE IF PLACE SELECTED IS A HOSPITAL, GO TO RH25 - SNFWING.

ELSE GO TO BOX RH18.

Variable Name

Assignment Instructions

XSTPLAC

STAY.XSTPLAC = PLACNUM of place added/selected

STAYCLAS

If PLAC.PLACKIND of place selected <> (3/CcrcRetirementHomeCenter or 4/Hospital), then STAY.STAYCLAS = STAY.STAYCLAS of previous STAY for this PLAC.



RH21B Yes/No



Question Text

Is (ADDED PLACE NAME) part of (LARGER FACILITY NAME)?

Field 1: LOCTEMP

Field 1 Routing

Value

Label

Route

0

NO

RH22 - PLACKIRH

1

YES

RH22 - PLACKIRH


Don't Know

RH22 - PLACKIRH


Refused

RH22 - PLACKIRH





RH22 Code 1



Question Text

SHOW CARD RH1

Please look at this card and tell me what kind of place (ADDED PLACE NAME) is:

PRESS F1 FOR DEFINITIONS.

Field 1: PLACKIRH

Field 1 Routing

Value

Label

Route

1

NURSING HOME/REHAB CENTER

BOX RH15

2

PERSONAL CARE HOME/RESIDENTIAL CARE FACILITY

BOX RH15

3

CCRC/RETIREMENT HOME/CENTER

BOX RH15

4

HOSPITAL

BOX RH15

5

PRIVATE HOME OR APARTMENT

BOX RH15

7

OTHER LTC FACILITY

BOX RH15

91

OTHER

RH22 - PLKIRHOS





Field 2: PLKIRHOS

OTHER (SPECIFY)

Field 2 Routing

Value

Label

Route

1

[Continuous answer.]

BOX RH15





Other Programming Instructions

Report Display

Display report above question text.
Display all stays where STAY.XSTPLAC <> 000 that were reported for this SP in
chronological order by start date of the stay.
Report header: STAY TIMELINE
Report layout:
Column 1, header="Place Name", display PLAC.PLACNAME of
PLAC where PLAC.PLACNUM = STAY.XSTPLAC.
Column 2, header="Start Date", display
STAY.STAYSMM+STAY.STAYSDD+STAY.STAYSYY in month, day
year format.
Column 3, header="End Date", display
STAY.STAYEMM+STAY.STAYEDD+STAY.STAYEYY in month, day
year format.
Column 4, header="Stay Type", display STAY.STAYCLAS.

Background Variable Assignments

Variable Name

Assignment Instructions

RHPLACTY

If RH22-PLACKIRH = 1/NursingHomeRehabCenter, 2/PersonalCareHome, 3/CcrcRetirementHomeCenter or 7/OtherLtcFacility, then PLAC.RHPLACTY = 5/OtherFacLTC.
Else if RH22-PLACKIRH = 4/Hospital, PLAC.RHPLACTY = 3/Hospital.
Else PLAC.RHPLACTY = 4/Community.

PLACKIND

PLAC.PLACKIND = PLACKIRH

PLACKIOS

PLAC.PLACKIOS = PLKIRHOS

LOCCODE

If RH21B-LOCTEMP = 1/Yes then PLAC.LOCCODE = 5/PartOfLarger. Else PLAC.LOCCODE = 7/Other.



BOX RH15



Box Instructions

IF RH22 - PLACKIRH = 1/NursingHomeRehabCenter, 2/PersonalCareHome, OR 7/OtherLtcFacility, GO TO BOX RH24.

ELSE IF RH22 - PLACKIRH = 3/CcrcRetirementHomeCenter, GO TO BOX RH18.

ELSE IF RH22 - PLACKIRH = 4/Hospital, GO TO RH25 - SNFWING.

ELSE GO TO RH30A - LALONE.

Variable Name

Assignment Instructions

STAYCLAS

If RH22-PLACKIRH = 1/NursingHomeRehabCenter, 2/PersonalCareHome, 3/CcrcRetirementHomeCenter or 7/OtherLtcFacility, then STAYCLAS = 5/OtherFacLTC.
Else If RH22-PLACKIRH = 4/Hospital, then STAYCLAS = 3/Hospital.
Else STAYCLAS = 4/Community.



RH25 Yes/No



Question Text

Was (SP) staying in a SNF wing or SNF unit of (CURRENT PLACE)?

Field 1: SNFWING

Field 1 Routing

Value

Label

Route

0

NO

BOX RH24

1

YES

BOX RH24


Don't Know

BOX RH24


Refused

BOX RH24





Other Programming Instructions

Background Variable Assignments

Variable Name

Assignment Instructions

SNFWING

STAY.SNFWING = RH25 - SNFWING

STAYCLASS

If RH25 - SNFWING = 1/Yes, then STAY.STAYCLAS = 5/OtherFacLTC



BOX RH18



Box Instructions

IF PLACKIND OF PLACE ADDED OR SELECTED = 1/NursingHomeRehabCenter, 2/PersonalCareHomeResidentialCareFacility, OR 7/OtherLtcFacility AND RH12-RHPROBE3 = 1/Yes AND SP IS ALIVE OR VITAL STATUS IS NOT KNOWN, GO TO BOX RH31.

ELSE IF PLACKIND OF PLACE ADDED OR SELECTED = 1/NursingHomeRehabCenter, 2/PersonalCareHomeResidentialCareFacility, OR 7/OtherLtcFacility AND (RH11A-RHPROBE1 = 0/No, DK, or RF, OR RH11B-RHPROBE2 = 0/No, DK, or RF, OR RH12-RHPROBE3 = 0/No, DK, or RF) OR SP IS DECEASED AND PLACE SELECTED IS TARGET FACILITY, GO TO BOX RH24.

IF PLACKIND = 5/PrivateHomeOrApartment OR 91/Other, GO TO RH30A - LALONE.

ELSE IF PLACKIND = 3/CcrcRetirementHomeCenter, GO TO RH27 - NURWING.

Variable Name

Assignment Instructions

STAYCLAS

If PLACKIND = 5/PrivateHomeOrApartment or 91/Other, then STAYCLAS = 4/Community



RH27 Yes/No



Question Text

Was (he/she) staying in a nursing wing, nursing unit, assisted living unit, or personal care unit of (CURRENT PLACE)?

Field 1: NURWING

Field 1 Routing

Value

Label

Route

0

NO

BOX RH19

1

YES

BOX RH19


Don't Know

BOX RH19


Refused

BOX RH19





Other Programming Instructions

Background Variable Assignments

Variable Name

Assignment Instructions

NURWING

STAY.NURWING = RH27 - NURWING



BOX RH19



Box Instructions

IF RH27-NURWING = 1/Yes, GO TO RH28 - NAMNWING.

ELSE GO TO RH29 - PRIVHOME.

RH28 Text



Question Text

[INTERVIEWER: ASK THE FOLLOWING QUESTIONS AND RECORD THE INFORMATION, AS AVAILABLE. SELECT "DON'T KNOW" FOR ANY ITEM THAT IS NOT AVAILABLE.]

What is the name of this nursing wing, nursing unit, assisted living unit or personal care unit?

Field 1: NAMNWING

Field 1 Routing

Value

Label

Route

1

[Continuous answer.]

RH28 - NWINGCIT


Don't Know

RH28 - NWINGCIT


Refused

RH28 - NWINGCIT





Field 2: NWINGCIT

In what city is this place located?

Field 2 Routing

Value

Label

Route

1

[Continuous answer.]

RH28 - NWINGSTA


Don't Know

RH28 - NWINGSTA


Refused

RH28 - NWINGSTA





Field 3: NWINGSTA

In what state is this place located?

Field 3 Routing

Value

Label

Route

1

[Continuous answer.]

BOX RH21


Don't Know

BOX RH21


Refused

BOX RH21





Other Programming Instructions

Design Notes

STORE ALL FIELDS IN RH28 ON THE STAY BLOCK.

RH29 Yes/No



Question Text

Was (he/she) staying in a private home or apartment at (CURRENT PLACE)?

Field 1: PRIVHOME

Field 1 Routing

Value

Label

Route

0

NO

BOX RH21

1

YES

BOX RH21


Don't Know

BOX RH21


Refused

BOX RH21





Other Programming Instructions

Background Variable Assignments

Variable Name

Assignment Instructions

STAYCLAS

If RH29-PRIVHOME = 1/Yes, then STAY.STAYCLAS = 4/Community.

RHPLACTY

If RH29A-PRIVHOME = 1/Yes, then STAY.RHPLACTY = 4/Community.

PRIVHOME

STAY.PRIVHOME = RH29 - PRIVHOME



BOX RH21



Box Instructions

IF RH29-PRIVHOME = 1/Yes, GO TO RH30A - LALONE.

ELSE GO TO BOX RH24.

RH30A Yes/No



Question Text

(Did/Does) (SP) live there alone?

Field 1: LALONE

Field 1 Routing

Value

Label

Route

0

NO

RH30 - LWITH

1

YES

BOX RH24


Don't Know

BOX RH24


Refused

BOX RH24





RH30 Code All



Question Text

Who (lived/lives) with (him/her) there?

SELECT ALL THAT APPLY.
SEPARATE RESPONSES BY USING THE SPACEBAR.

Field 1: LWITH

Field 1 Routing

Value

Label

Route

1

SPOUSE

BOX RH24

2

DAUGHTER

BOX RH24

3

SON

BOX RH24

4

MOTHER

BOX RH24

5

FATHER

BOX RH24

6

SISTER

BOX RH24

7

BROTHER

BOX RH24

8

GUARDIAN

BOX RH24

9

OTHER FEMALE RELATIVE

BOX RH24

10

OTHER MALE RELATIVE

BOX RH24

11

OTHER NONRELATIVE

BOX RH24


Don't Know

BOX RH24


Refused

BOX RH24





BOX RH24



Box Instructions

IF ALL DAYS IN REFERENCE PERIOD ACCOUNTED FOR AND SP'S LAST STAY IS IN A PLACE OTHER THAN THE TARGET FACILITY, GO TO BOX RH36.

IF ALL DAYS IN REFERENCE PERIOD ACCOUNTED FOR AND SP IS STILL A RESIDENT OF THE TARGET FACILITY, GO TO RH49A - CNSNTREQ.

ELSE GO TO RH12 - RHPROBE3.

BOX RH31



Box Instructions

IF (SP IS ALIVE OR SP'S VITAL STATUS IS NOT KNOWN ) AND NOT A RESIDENT OF TARGET FACILITY, GO TO BOX RH36.

ELSE GO TO RH49A - CNSNTREQ.

BOX RH36



Box Instructions

GO TO RH36 - FORMDIS.

RH36 Yes/No



Question Text

Earlier you told me (SP) had been discharged to (DISCHARGE PLACE).

Was (SP) formally discharged from (FACILITY) for the stay at (LAST PLACE NAME FROM RH21) that began on (DISCHARGE DATE)?

PRESS F1 FOR DEFINITION OF FORMAL DISCHARGE.

Field 1: FORMDIS

Field 1 Routing

Value

Label

Route

0

NO

RH49A - CNSNTREQ

1

YES

RH48 - CONTNAME


Don't Know

RH49A - CNSNTREQ


Refused

RH49A - CNSNTREQ





RH48 Text



Question Text

Please tell me the name, address, and telephone number of someone we could contact regarding (SP) at (DISCHARGE PLACE).

Field 1: CONTNAME

NAME

Field 1 Routing

Value

Label

Route

1

[Continuous answer.]

RH48 - CONTADDR


Don't Know

RH48 - CONTADDR


Refused

RH48 - CONTADDR





Field 2: CONTADDR

ADDRESS

Field 2 Routing

Value

Label

Route

1

[Continuous answer.]

RH48 - CONTCITY


Don't Know

RH48 - CONTCITY


Refused

RH48 - CONTCITY





Field 3: CONTCITY

CITY

Field 3 Routing

Value

Label

Route

1

[Continuous answer.]

RH48 - CONTSTAT


Don't Know

RH48 - CONTSTAT


Refused

RH48 - CONTSTAT





Field 4: CONTSTAT

STATE

Field 4 Routing

Value

Label

Route

1

[Continuous answer.]

RH48 - CONTZIP


Don't Know

RH48 - CONTZIP


Refused

RH48 - CONTZIP





Field 5: CONTZIP

ZIPCODE

Field 5 Routing

Value

Label

Route

1

[Continuous answer.]

RH48 - CONTAREA


Don't Know

RH48 - CONTAREA


Refused

RH48 - CONTAREA





Field 6: CONTAREA

AREACODE

Field 6 Routing

Value

Label

Route

1

[Continuous answer.]

RH48 - CONTEXCH


Don't Know

RH48 - CONTEXCH


Refused

RH48 - CONTEXCH





Field 7: CONTEXCH

EXCHANGE

Field 7 Routing

Value

Label

Route

1

[Continuous answer.]

RH48 - CONTLOCL


Don't Know

RH48 - CONTLOCL


Refused

RH48 - CONTLOCL





Field 8: CONTLOCL

LOCAL

Field 8 Routing

Value

Label

Route

1

[Continuous answer.]

RH49 - CONTREL


Don't Know

RH49 - CONTREL


Refused

RH49 - CONTREL





Other Programming Instructions

Design Notes

STORE ALL FIELDS IN RH48 ON THE PERS BLOCK.

RH49 Code 1



Question Text

What is the relationship of (CONTACT NAME FROM RH48) to (SP)?

Field 1: CONTREL

Field 1 Routing

Value

Label

Route

1

SP

RH49A - CNSNTREQ

2

SPOUSE

RH49A - CNSNTREQ

3

DAUGHTER

RH49A - CNSNTREQ

4

SON

RH49A - CNSNTREQ

5

MOTHER

RH49A - CNSNTREQ

6

FATHER

RH49A - CNSNTREQ

7

SISTER

RH49A - CNSNTREQ

8

BROTHER

RH49A - CNSNTREQ

9

DAUGHTER-IN-LAW

RH49A - CNSNTREQ

10

SON-IN-LAW

RH49A - CNSNTREQ

11

GRANDDAUGHTER

RH49A - CNSNTREQ

12

GRANDSON

RH49A - CNSNTREQ

13

NIECE

RH49A - CNSNTREQ

14

NEPHEW

RH49A - CNSNTREQ

15

FRIEND/NEIGHBOR

RH49A - CNSNTREQ

16

NURSE/NURSE'S AIDE

RH49A - CNSNTREQ

17

BOARDER

RH49A - CNSNTREQ

18

GUARDIAN

RH49A - CNSNTREQ

91

OTHER FEMALE RELATIVE

RH49 - CONTRFOS

92

OTHER MALE RELATIVE

RH49 - CONTRMOS

93

OTHER NONRELATIVE

RH49 - CONTNROS


Don't Know

RH49A - CNSNTREQ


Refused

RH49A - CNSNTREQ





Field 2: CONTRFOS

OTHER FEMALE RELATIVE (SPECIFY)

Field 2 Routing

Value

Label

Route

1

[Continuous answer.]

RH49A - CNSNTREQ





Field 3: CONTRMOS

OTHER MALE RELATIVE (SPECIFY)

Field 3 Routing

Value

Label

Route

1

[Continuous answer.]

RH49A - CNSNTREQ





Field 4: CONTNROS

OTHER NON-RELATIVE (SPECIFY)

Field 4 Routing

Value

Label

Route

1

[Continuous answer.]

RH49A - CNSNTREQ





RH49A Yes/No



Question Text

WAS "CONSENT" REQUIRED AND OBTAINED FOR THIS SP?

PRESS F1 FOR A DEFINITION OF "CONSENT".

Field 1: CNSNTREQ

Field 1 Routing

Value

Label

Route

0

NO

RH50 - DIDABRH

1

YES

RH49B - WRITVERB





Other Programming Instructions

Background Variable Assignments

Variable Name

Assignment Instructions

RHDOI

If PERS.RHDOI = EMPTY, PERS.RHDOI = current date.



RH49B Yes/No



Question Text

WAS THE "CONSENT" WRITTEN OR VERBAL (BY TELEPHONE)?

Field 1: WRITVERB

Field 1 Routing

Value

Label

Route

1

WRITTEN

RH50 - DIDABRH

2

VERBAL

RH50 - DIDABRH





RH50 Code 1



Question Text

DID YOU ABSTRACT?

Field 1: DIDABRH

Field 1 Routing

Value

Label

Route

1

ALL

RH51 - WHYABRH

2

MAJORITY

RH51 - WHYABRH

3

HALF

RH51 - WHYABRH

4

SOME

RH51 - WHYABRH

5

NONE

RHEND - RHENDCNT





RH51 Code 1



Question Text

WHY DID YOU ABSTRACT?

Field 1: WHYABRH

Field 1 Routing

Value

Label

Route

1

NO KNOWLEDGEABLE RESPONDENT AVAILABLE

RHEND - RHENDCNT

2

NO TIME/STAFF BURDEN TOO GREAT

RHEND - RHENDCNT

3

REFUSAL--UNWILLING TO COOPERATE

RHEND - RHENDCNT

91

OTHER

RH51 - WHYABROS





Field 2: WHYABROS

OTHER (SPECIFY)

Field 2 Routing

Value

Label

Route

1

[Continuous answer.]

RHEND - RHENDCNT





RH3B Code 1



Question Text

Thank you. Those are all the questions I have for you at the moment. Someone from my office may call you to verify some of the data I have collected. We appreciate your help on this important study.

PRESS "1" TO CONTINUE.

Field 1: RHINEL

Field 1 Routing

Value

Label

Route

1

CONTINUE

BOX RHEND





RHEND Code 1



Question Text

THANK THE RESPONDENT.

PRESS "1" TO RETURN TO THE NAVIGATION SCREEN.

Field 1: RHENDCNT

Field 1 Routing

Value

Label

Route

1

CONTINUE

BOX RHEND





Other Programming Instructions

Background Variable Assignments

Variable Name

Assignment Instructions

RHDISP

If RH3-RH3CT = 1/Continue, then RHDISP = 92/ReadyToInterview.
Else if missing RHDATA, then RHDISP = 94/MissingData.
Else RHDISP = 96/Complete.



BOX RHEND



Box Instructions

GO TO NAVIGATOR




File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorRyan Hubbard
File Modified0000-00-00
File Created2021-01-22

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