CMS-P-0015A Fac2017R79RHM

2017 MCBS Facility Instrument

Variable Name

RHM-Residence History Missing Data

MR Screen Name Question Type

Question Text/Description

Code List

Routing

(01) CONTINUE

(01) BOX RHM2

(00) NO
(01) YES
(95)NEVER WILL KNOW
(-8) Don't Know
(-9) Refused

(00) RHM3 - RHMDODMM
(01) BOX RHM3
(95) BOX RHM3
(-8) BOX RHM3
(-9) BOX RHM3

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

(01) RHM3 - RHMDODDD
(-8) RHM3 - RHMDODDD
(-9) RHM3 - RHMDODDD

(01) RHM3 - RHMDODYY
(-8) RHM3 - RHMDODYY
(-9) RHM3 - RHMDODYY

RESIDENCE HISTORY MISSING DATA SECTION SPECIFICATIONS
CRITERIA
SAMPLE TYPE= ALL and at least one key RH variable is DK, RF, or NULL
SEASON=ALL
PLACEMENT
Administered in flexible order after FQ and RH sections are completed.
BOX RHMBEG

RHMISSNG

RHMISS1

routing

code one

GO TO RHMISS1 - RHMISSNG.
THE FOLLOWING ITEMS ARE MISSING FROM RH. CONFIRM THAT RESPONDENT CAN ANSWER AT LEAST
ONE OF THESE ITEMS.
PRESS "1" TO CONTINUE.

BOX RHM2

routing

If (RH7 - RHALIVE = DK OR RF) AND (RHM2 - RHMALIVE = DK, RF, EMPTY OR NULL), GO TO RHM2 RHMALIVE.
ELSE GO TO BOX RHM3.

Is (SP) alive?
RHMALIVE

RHM2

code one
ENTER "95" IF RESPONDENT NEVER WILL KNOW.

BOX RHM3

routing

If (RHM2-ALIVE = 0 or RH7-RHALIVE = 0) AND ((RH8 - RHDODMM = DK OR RF OR RH8 - RHDODDD = DK OR
RF OR RH8 - RHDODYY = DK OR RF OR RHM2 - RHMALIVE = 0/No) AND (RHM3 - RHMDODMM = DK, RF,
EMPTY OR NULL OR RHM3 - RHMDODDD = DK, RF, EMPTY OR NULL OR RHM3 - RHMDODYY = DK, RF,
EMPTY OR NULL)), GO TO RHM3 - RHMDODMM.
ELSE GO TO BOX RHM6A.
On what date did (SP) die?

RHMDODMM

RHM3

date

ENTER "95" IN MONTH , DAY, AND YEAR IF RESPONDENT NEVER WILL KNOW DATE.
MONTH

RHMDODDD

RHM3

date

DAY

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

RHMDODYY

RHM3

date

YEAR

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

(01) BOX RHM6A
(-8) BOX RHM6A
(-9) BOX RHM6A

BOX RHM6A

routing

IF THERE IS A CURRENT ROUND STAY WITH A MISSING END DATE AND (RHM6B - STAYNITE = DK, RF,
EMPTY OR NULL), GO TO RHM6 - STAYEMM.
ELSE GO TO RHMEND - RHMENDC.

RHM6

date

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

(01) RHM6 - STAYEDD
(-8) RHM6 - STAYEDD
(-9) RHM6 - STAYEDD

When did (SP) leave (CURRENT PLACE)?
STAYEMM

MONTH

STAYEDD

RHM6

date

DAY

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

(01) RHM6 - STAYEYY
(-8) RHM6 - STAYEYY
(-9) RHM6 - STAYEYY

STAYEYY

RHM6

date

YEAR

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

(01) BOX RHM6B
(-8) BOX RHM6B
(-9) BOX RHM6B

BOX RHM6B

routing

IF ANY PART OF RHM6 DATE = DK OR RF AND RHM6B - STAYNITE = DK, RF, EMPTY OR NULL, GO TO
RHM6B - STAYNITE.
ELSE GO TO RHMSTCNT - STAYCNTC.

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

(01) RHMSTCNT - STAYCNTC
(-8) RHMSTCNT - STAYCNTC
(-9) RHMSTCNT - STAYCNTC

(01) CONTINUE

(01) BOX RHM7

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

RHM6B

numeric

ENTER "995" IF RESPONDENT NEVER WILL KNOW.
# OF NIGHTS

STAYCNTC

RHMSTCNT

code one

PRESS "1" TO CONTINUE.

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2017 MCBS Facility Instrument

Variable Name

RHM-Residence History Missing Data

MR Screen Name Question Type

Question Text/Description

BOX RHM7

routing

IF THERE IS ANOTHER CURRENT ROUND STAY WITH A MISSING END DATE, GO TO RHM6 - STAYEMM.
ELSE GO RHMEND - RHMENDC.

RHMEND

code one

Code List

Routing

(01) CONTINUE

(01) BOX RHMEND

YOU HAVE COMPLETED THE MISSING RESIDENCE HISTORY ITEMS FOR THIS SP.
RHMENDC

THANK RESPONDENT AND PRESS "1" TO RETURN TO THE NAVIGATION SCREEN.
BOX RHMEND

routing

GO TO NAVIGATOR

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