Cms-p-0015a Mcbs

Enumeration Summary (ENS)
Variable Name
MR Screen Name
BOX ENSBEG

Question type
routing

ENSINT

ENSINTRO

no entry

BOX ENS1

routing

HHSTILL

ENS1

yes/no

HOUSEHOLD_NOT ENS2

roster

NAVIGATOR

instance navigator

ENS2_IN

NOTHHRSN

ENS2A

code 1

NOTHHROS

ENS2A
BOX ENS2

verbatim text
routing

HHNEW

ENS3

yes/no

HOUSEHOLD_ENS ENS4

roster

HHMISS

ENS4A

yes/no

HHPSEX

ENS5

grid

EHHDOBMM

ENS5

grid

Question text/description
GO TO ENSINTRO - ENSINT.
Now I’d like to [review with you who was living in the household/ask you a few questions about [your/(SP's)]
home and any other people who may live in the household.].
IF AT LEAST ONE PERSON LIVED IN THE HOUSEHOLD WITH THE SP AT THE TIME OF THE PREVIOUS ROUND
INTERVIEW, GO TO ENS1 - HHSTILL.
ELSE GO TO ENS3 - HHNEW.
From our last interview on (REFERENCE DATE), we have listed that [(READ NAME(S) LISTED BELOW)] lived in
the same household as [you/(SP)].
[As of (DATE OF DEATH/DATE OF INSTITUTIONALIZATION), did/Do/Does] [READ NAME(S) LISTED BELOW] still
live in the same household as [you/(SP)]?
[A SEPARATE QUESTION WILL ASK YOU IF ANYONE ELSE SHOULD BE ADDED. THIS QUESTION ONLY REFERS TO
THE LISTED PERSONS.]
PROBE FOR AND SELECT THOSE PEOPLE WHO ARE NO LONGER IN THE HOUSEHOLD.

Code list

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

(01) ITEM SELECTED IN INSTANCE NAVIGATOR
(02) CONTINUE INTERVIEW SELECTED

Why [is/was] (HOUSEHOLD MEMBER NAME) no longer in the household [as of (DATE OF DEATH/DATE OF
INSTITUTIONALIZATION)]?

OTHER REASON (SPECIFY)
GO TO ENS2_IN - NAVIGATOR.
[At the time of the last interview, [you were living by yourself/(SP)
was living by [himself/herself]]].

(01) DECEASED
(02) INSTITUTIONALIZED, HEALTH CARE FACILITY
(03) INSTITUTIONALIZED, OTHER
(04) PERSON MOVED
(05) SP MOVED
(06) PERSON NOT IN HOUSEHOLD - PREVIOUS ROUND
ERROR
(91) OTHER REASON
(-8) Don't Know
(-9) Refused

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

[Besides [you/(SP)], (is/was)/(Is/Was)] there anyone else living or staying in the household [as of (DATE OF
DEATH/DATE OF INSTITUTIONALIZATION)]? Remember to include people who
[are/were] temporarily absent and any children who [may live/may
have lived] in the household.
Who else [is/was] living or staying in the household?
SELECT OR ADD ALL PERSONS LIVING IN THE HOUSEHOLD.
Now I want to make sure I have everyone who [lives/lived] in the household [as of (DATE OF DEATH/DATE OF
(01) YES
INSTITUTIONALIZATION)]. I have listed (READ NAME(S) LISTED BELOW).
(02) NO
(-8) Don't Know
Have I missed any lodgers, boarders, or anyone else who usually [lives or stays/lived or stayed] in the
(-9) Refused
household but [is/was] away from home traveling or in the hospital?
(01) MALE
(02) FEMALE
Is (HOUSEHOLD MEMBER NAME) male or female?
(-8) Don't Know
(-9) Refused
(01) [Continuous answer.]
What is (HOUSEHOLD MEMBER NAME'S) date of birth?
(-8) Don't Know
[ENTER DATE.]
(-9) Refused

Enumeration Summary (ENS)
Variable Name
MR Screen Name

Question type

Question text/description

EHHDOBDD

ENS5

grid

What is (HOUSEHOLD MEMBER NAME'S) date of birth?
[ENTER DATE.]

EHHDOBYY

ENS5

grid

What is (HOUSEHOLD MEMBER NAME'S) date of birth?
[ENTER DATE.]

HHPAGE

ENS5

grid

How old is (HOUSEHOLD MEMBER NAME)?

BOX ENS4

routing

EHHDOBMM

ENS10

grid

EHHDOBDD

ENS10

grid

EHHDOBYY

ENS10

grid

HHPAGE

ENS10

grid

BOX ENS4A

routing

BOX ENS4B

routing

HOUSEHOLD_OWNSENS10A

ASKWORK

roster

BOX ENS4C

routing

ENS10AA

yes/no

Code list
(01) [Continuous answer.]
(-8) Don't Know
(-9) Refused
(01) [Continuous answer.]
(-8) Don't Know
(-9) Refused
(01) [Continuous answer.]
(-8) Don't Know
(-9) Refused

IF AT LEAST ONE PERSON LIVING IN THE HOUSEHOLD WITH THE SP IN THE CURRENT ROUND, WAS ALSO
LIVING IN THE HOUSEHOLD AT THE TIME OF THE PREVIOUS ROUND INTERVIEW AND (WAS MISSING ANY
PART OF THEIR DATE OF BIRTH IN THE PREVIOUS ROUND) AND (HAS NEVER BEEN ASKED ENS10 IN ANY
PREVIOUS ROUND), GO TO ENS10 - EHHDOBMM.
ELSE GO TO BOX ENS4A
ASK THE RESPONDENT TO PROVIDE INFORMATION FOR ALL "DK" AND "RF" ENTRIES LISTED BELOW. DO NOT
CHANGE THE ENTRIES IF THE RESPONDENT STILL DOES NOT KNOW THE INFORMATION.
(01)[Continuous answer.]
(-8) Don't Know
(HOUSEHOLD MEMBER NAME'S) DATE OF BIRTH.
(-9) Refused
[ENTER DATE.]
ASK THE RESPONDENT TO PROVIDE INFORMATION FOR ALL "DK" AND "RF" ENTRIES LISTED BELOW. DO NOT
CHANGE THE ENTRIES IF THE RESPONDENT STILL DOES NOT KNOW THE INFORMATION.
(01)[Continuous answer.]
(-8) Don't Know
(HOUSEHOLD MEMBER NAME'S) DATE OF BIRTH.
(-9) Refused
[ENTER DATE.]
ASK THE RESPONDENT TO PROVIDE INFORMATION FOR ALL "DK" AND "RF" ENTRIES LISTED BELOW. DO NOT
CHANGE THE ENTRIES IF THE RESPONDENT STILL DOES NOT KNOW THE INFORMATION.
(01)[Continuous answer.]
(-8) Don't Know
(HOUSEHOLD MEMBER NAME'S) DATE OF BIRTH.
(-9) Refused
[ENTER DATE.]
ASK THE RESPONDENT TO PROVIDE INFORMATION FOR ALL "DK" AND "RF" ENTRIES LISTED BELOW. DO NOT
(01)[Continuous answer.]
CHANGE THE ENTRIES IF THE RESPONDENT STILL DOES NOT KNOW THE INFORMATION.
(-8) Don't Know
(-9) Refused
(HOUSEHOLD MEMBER NAME'S) AGE.
IF (SP IS IN THE SUPPLEMENTAL SAMPLE) OR (SP'S PREVIOUS ROUND INTERVIEW WAS IN A FACILITY), GO TO
BOX ENS4B.
ELSE GO TO BOX ENS5
IF AT LEAST ONE PERSON LIVES IN THE HOUSEHOLD WITH THE SP, GO TO ENS10A - HOUSEHOLD_OWNS.
ELSE SET SP AS PERSON WHO OWNS/RENTS HOME AND GO TO BOX ENS4C
Who owns or rents [this/(SP’s)] home? (PROBE: Of the people living [here/there] now, who is the person
who is the head of the household?)
SELECT ONLY ONE.
IF (SP IS IN THE SUPPLEMENTAL SAMPLE) AND (SP'S AGE IS 16 OR OLDER, OR AGE = DK OR RF), GO TO
ENS10AA - ASKWORK.
ELSE GO TO BOX ENS5.
(01) YES
(02) NO
Since (REFERENCE DATE), did [you/(SP)] work at any time at a job or business?
(-8) Don't Know
(-9) Refused

Enumeration Summary (ENS)
Variable Name
MR Screen Name
BOX ENS5

JOBSTAT

NAVIGATOR
HHJBSTAT

Question type
routing

ENS11

routing

BOX ENS5A

routing

ENS11A_IN

instance navigator

ENS11A

yes/no

BOX ENS6

routing

BOX ENS7

routing

Question text/description
IF (SP IS IN THE SUPPLEMENTAL SAMPLE AND ENS10AA - ASKWORK = 1/Yes) OR (IF SP IS NOT IN THE
SUPPLEMENTAL SAMPLE AND ((IT IS A FALL ROUND) AND (SP IS ALIVE AND NOT INSTITUTIONALIZED) AND
(SP'S AGE IS 16 OR OLDER, OR AGE = DK OR RF))), GO TO ENS11 - JOBSTAT.
ELSE GO TO BOX ENS5A.

(01) YES
[Before I continue with the next set of questions, I need to collect information about [your/(SP’s)] job status.] (02) NO
[Are you/Is (SP)] currently working at a job or business?
(-8) Don't Know
(-9) Refused
IF AT LEAST ONE PERSON WHO LIVES IN THE HOUSEHOLD WITH THE SP IS AGE 16 OR OLDER, OR AGE = DK OR
RF AND ((THIS PERSON IS A NEW HOUSEHOLD MEMBER IN THE CURRENT ROUND) OR (IT IS A FALL ROUND)), (01) ITEM SELECTED IN INSTANCE NAVIGATOR
GO TO ENS11A_IN - NAVIGATOR.
(02) CONTINUE INTERVIEW SELECTED
ELSE GO TO BOX ENS7.
([Before I continue with the next set of questions, I need to update information about [your/(HOUSEHOLD
MEMBER NAME'S)] job status.)] [Are you/Is (HOUSEHOLD MEMBER NAME)] currently working at a job or
business?

ENS12

yes/no
Did [you/(SP)] ever serve in the Armed Forces of the United States?

SPAFTIME

SPNGEVER

SPNGALL

SPNGDSBL

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

GO TO ENS11A_IN - NAVIGATOR.
IF ((SP IS IN THE SUPPLEMENTAL SAMPLE) OR (SP IS NEW FROM THE FACILITY)) AND SP'S AGE IS 17 OR OLDER
OR AGE = DK OR RF, GO TO ENS12 - SPAFEVER.
ELSE GO TO BOX ENSEND.
Now we have a few questions about military service.

SPAFEVER

Code list

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

code all

SHOW CARD ENS1
Looking at this card, in which of these time periods did [you/(SP)]
serve in the Armed Forces?
CHECK ALL THAT APPLY.

(07) IRAQ OR AFGHANISTAN CONFLICT (2001-present)
(06) PERSIAN GULF WAR/OPERATION DESERT STORM
(Aug 1990 - March 1991)
(01) VIETNAM ERA (Aug 1964 - May 1975)
(02) KOREAN CONFLICT (June 1950 - Jan 1955)
(03) WORLD WAR II (Sept 1940 - July 1947)
(04) WORLD WAR I (1917 - 1918)
(05) PEACE TIME (ALL OTHER TIMES)
(-8) Don't Know
(-9) Refused

ENS14

yes/no

[Were you/Was (SP)] ever an active member of a National Guard or
military reserve unit of the United States?

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

BOX ENS14

routing

IF ENS12 - SPAFEVER = 1/Yes, GO TO ENS16 - SPNGDSBL.
ELSE GO TO BOX ENSEND.

ENS13

ENS15

ENS16

yes/no

Was all of [your/(SP’s)] active duty related to National Guard or
military reserve training?

yes/no

[Do you/Does (SP)/Did (SP)] have a disability related to service in the Armed Forces of the United States?
[PROBE: ‘Have you received a V.A. disability rating?’ IF THE RESPONDENT HAS A V.A. DISABILITY RATING,
SELECT "YES"; IF HE OR SHE DOES NOT, SELECT "NO"]

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

Enumeration Summary (ENS)
Variable Name
MR Screen Name

SPVARATE

Question type

ENS17

numeric

BOX ENSEND

routing

Question text/description
What [is [your/(SP’s)]/was (SP's)] (current) V.A. disability rating?
THE VA DISABILITY RATING IS A PERCENTAGE IN MULTIPLES
OF 10 (I.E., 10%, 20%, ETC.). ENTER THE NUMBER AS A
WHOLE NUMBER. YOU DO NOT NEED TO ENTER THE "%"
SIGN.
GO TO NEXT SECTION

Code list
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused