CMS-P-0015A Enumeration Summary

2018 MCBS Community Questionnaire

Variable Name

MR Screen Name

ENS-ENUMERATION SUMMARY

Question Type

Question Text/Description

Code List

Routing

ENUMERATION SUMMARY SPECIFICATIONS
CRITERIA
INTTYPE=C001, C002, C003, C004, C005, C006, C007, C010
SPALIVE=ALL
SEASON=ALL
SPPROXY=SP or PROXY
Other: N/A
PLACEMENT
If INTTYPE in(C001, C002, C003, C004, C005, C006, C007, C010), administer after INQ.

ENSINT

BOX ENSBEG

routing

GO TO ENSINTRO - ENSINT.

ENSINTRO

no entry

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.].

BOX ENS1

routing

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.

BOX ENS1

HHSTILL

ENS1

yes/no

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.]

HOUSEHOLD_NOT

ENS2

roster

PROBE FOR AND SELECT THOSE PEOPLE WHO ARE NO LONGER IN THE HOUSEHOLD.

ENS2A - NOTHHRSN

(01) BOX ENS2
(02) BOX ENS2
(03) BOX ENS2
(04) BOX ENS2
(05) BOX ENS2
(06) BOX ENS2
(91) ENS2A - NOTHHROS
(-8) BOX ENS2
(-9) BOX ENS2
BOX ENS2

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

NOTHHRSN

ENS2A

code 1

(01) DECEASED
(02) INSTITUTIONALIZED, HEALTH CARE FACILITY
(03) INSTITUTIONALIZED, OTHER
(04) PERSON MOVED
Why [is/was] (HOUSEHOLD MEMBER NAME) no longer in the household [as of (DATE OF DEATH/DATE OF (05) SP MOVED
INSTITUTIONALIZATION)]?
(06) PERSON NOT IN HOUSEHOLD - PREVIOUS
ROUND ERROR
(91) OTHER REASON
(-8) Don't Know
(-9) Refused

NOTHHROS

ENS2A

verbatim text

OTHER REASON (SPECIFY)

BOX ENS2

routing

IF ANOTHER HH MEMBER IS SELECTED AT ENS2-HOUSEHOLD_NOT, GO TO ENS2A-NOTHHRSN.
ELSE GO TO ENS3-HHNEW.
[At the time of the last interview, [you were living by yourself/(SP)
was living by [himself/herself]]].

HHNEW

HOUSEHOLD_ENS

ENS3

ENS4

yes/no

roster

[Besides [you/(SP)], [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.

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

DISPLAY PERSON ROSTER AS RESPONSE
OPTIONS:
1. [PERSON 1]
2. [PERSON 2]
…
(01-N) LIST ALL PERSONS AS RESPONSE
OPTIONS
(N+1) ADD ANOTHER
DISPLAY:
1 First Name Display ROST.ROSTFNAM.
2 Last Name Display ROST.ROSTLNAM.
3 Relationship to SP Display relationship:
If ROST.ROSTREL=91/OtherRelative or 92/OtherNonRelative, display ROST.ROSTREOS.
Else display ROST.ROSTREL relationship.

(01) ENS3 - HHNEW
(02) ENS2 - HOUSEHOLD_NOT
(-8) ENS3 - HHNEW
(-9) ENS3 - HHNEW

(01) ENS4 - HOUSEHOLD_ENS
(02) BOX ENS4
(-8) BOX ENS4
(-9) BOX ENS4

(01-N) BOX ENS4
(N+1) HH-ROSTFNAM
IF EXISTING PERSON SELECTED, GO TO BOX
ENS4.
ELSE IF "ADD ANOTHER" SELECTED, GO TO HHROSTFNAM.

ROSTFNAM

HH

text

[What is the name of the person and relationship to (SP)?]

(01) continuous answer

HH-ROSTLNAM

ROSTLNAM

HH

text

[What is the name of the person and relationship to (SP)?]

(01) continuous answer

HH-ROSTREL

Page 1 of 4

2018 MCBS Community Questionnaire

Variable Name

ROSTREL

ROSTREOS

HHMISS

MR Screen Name

HH

HH

ENS-ENUMERATION SUMMARY

Question Type

code one

verbatim text

ENS4A

yes/no

BOX ENS3

routing

Question Text/Description

[What is the name of the person and relationship to (SP)?]

[What is the name of the person and relationship to (SP)?]
Now I want to make sure I have everyone who [lives/lived] in the household [as of (DATE OF DEATH/DATE
OF INSTITUTIONALIZATION)]. I have listed (READ NAME(S) LISTED BELOW).
Have I missed any lodgers, boarders, or anyone else who usually [lives or stays/lived or stayed] in the
household but [is/was] away from home traveling or in the hospital?

ENS5

grid

Is (HOUSEHOLD MEMBER NAME) male or female?

EHHDOBMM

ENS5

grid

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

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)?

routing

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

EHHDOBMM

ENS10

grid

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.
(HOUSEHOLD MEMBER NAME'S) DATE OF BIRTH.
[ENTER DATE.]

EHHDOBDD

ENS10

grid

(02) SPOUSE
(03) SON
(04) DAUGHTER
(05) BROTHER
(06) SISTER
(07) FATHER
(08) MOTHER
(09) SON-IN-LAW
(10) DAUGHTER-IN-LAW
(11) GRANDSON
(12) GRANDDAUGHTER
(13) NEPHEW
(14) NIECE
(51) FRIEND/NEIGHBOR
(52) BOARDER
(53) NURSE/NURSE'S AIDE
(54) LEGAL/FINANCIAL OFFICER
(55) GUARDIAN
(56) PARTNER
(57) ROOMMATE
(91) OTHER
(-8) Don't Know
(-9) Refused

Routing
(01) DO NOT DISPLAY
(02) ENS4A-HHMISS
(03) ENS4A-HHMISS
(04) ENS4A-HHMISS
(05) ENS4A-HHMISS
(06) ENS4A-HHMISS
(07) ENS4A-HHMISS
(08) ENS4A-HHMISS
(09) ENS4A-HHMISS
(10) ENS4A-HHMISS
(11) ENS4A-HHMISS
(12) ENS4A-HHMISS
(13) ENS4A-HHMISS
(14) ENS4A-HHMISS
(50) DO NOT DISPLAY
(51) ENS4A-HHMISS
(52)ENS4A-HHMISS
(53)ENS4A-HHMISS
(54) ENS4A-HHMISS
(55) ENS4A-HHMISS
(56) ENS4A-HHMISS
(57) ENS4A-HHMISS
(91) HH - ROSTREOS
(-8) ENS4A-HHMISS
(-9) ENS4A-HHMISS

(01) continuous reponse
(-8) Don't Know
(-9) Refused

ENS4A- HHMISS

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

(01) ENS4 - HOUSEHOLD_ENS
(02) ENS5 - HHPSEX
(-8) ENS5 - HHPSEX
(-9) ENS5 - HHPSEX

(01) MALE
(02) FEMALE
(-8) Don't Know
(-9) Refused

ENS5 - EHHDOBMM

IF ROSTSEX IS NOT MISSING, GO TO BOX ENS4A.
ELSE GO TO ENS5-HHPSEX.

HHPSEX

BOX ENS4

Code List

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.
(HOUSEHOLD MEMBER NAME'S) DATE OF BIRTH.
[ENTER DATE.]

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

ENS5 - EHHDOBDD

ENS5 - EHHDOBYY
(01) BOX ENS4
(-8) ENS5 -HHPAGE
(-9) ENS5-HHPAGE
BOX ENS4

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

ENS10 - EHHDOBDD

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

ENS10 - EHHDOBYY

Page 2 of 4

2018 MCBS Community Questionnaire

Variable Name

EHHDOBYY

MR Screen Name

ENS10

ENS-ENUMERATION SUMMARY

Question Type

grid

Question Text/Description
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.
(HOUSEHOLD MEMBER NAME'S) DATE OF BIRTH.
[ENTER DATE.]

HHPSEX

ENS10

grid

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.
(HOUSEHOLD MEMBER NAME'S) SEX

ROSTREL

ENS10

grid

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.
(HOUSEHOLD MEMBER NAME'S) RELATIONSHIP

HHPAGE

ENS10

grid

BOX ENS4A

routing

BOX ENS4B

routing

HOUSEHOLD_OWNS ENS10A

roster

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.
(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

Code List

Routing

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

ENS10 - HHPSEX

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

ENS10 - ROSTREL

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

ENS10 - HHPAGE

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

BOX ENS4A

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.

BOX ENS4C

IF THE HOME IS JOINTLY OWNED BY THE RESPONDENT AND ANOTHER PERSON SELECT THE
RESPONDENT AS THE OWNER.
BOX ENS4C

ASKWORK

ENS10AA

SPAFEVER

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

BOX ENS5

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

BOX ENS5A

Since (REFERENCE DATE), did [you/(SP)] work at any time at a job or business?

routing

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.

routing

[Before I continue with the next set of questions, I need to collect information about [your/(SP’s)] job status.]
[Are you/Is (SP)] currently working at a job or business?

routing

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 (01) ITEM SELECTED IN INSTANCE NAVIGATOR
(IT IS A FALL ROUND)), GO TO ENS11A-HHJBSTAT.
(02) CONTINUE INTERVIEW SELECTED
ELSE GO TO BOX ENS7.

yes/no

[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?

BOX ENS6

routing

IF ANOTHER 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)), GO TO ENS11A-HHJBSTAT.
ELSE GO TO BOX ENS7.

BOX ENS7

routing

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.

ENS11

BOX ENS5A

HHJBSTAT

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.

yes/no

BOX ENS5

JOBSTAT

routing

ENS11A

ENS12

yes/no

Now we have a few questions about military service.
Did [you/(SP)] ever serve in the Armed Forces of the United States?

(01) ENS11A - HHJBSTAT
(02) BOX ENS7

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

BOX ENS6

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

(01) ENS13 - SPAFTIME
(02) ENS14 - SPNGEVER
(-8) ENS14 - SPNGEVER
(-9) ENS14 - SPNGEVER

Page 3 of 4

2018 MCBS Community Questionnaire

Variable Name

MR Screen Name

ENS-ENUMERATION SUMMARY

Question Type

Question Text/Description

SHOW CARD ENS1
SPAFTIME

ENS13

code all

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

SPNGEVER

SPNGALL

SPNGDSBL

Routing

(07) IRAQ OR AFGHANISTAN CONFLICT (2001present)
(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)
(05) PEACE TIME (ALL OTHER TIMES)
(-8) Don't Know
(-9) Refused

ENS14 - SPNGEVER

ENS14

yes/no

(01) YES
(02) NO
[Were you/Was (SP)] ever an active member of a National Guard or military reserve unit of the United States?
(-8) Don't Know
(-9) Refused

BOX ENS14

routing

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

ENS15

ENS16

ENS17

BOX ENSEND

(01) ENS15 - SPNGALL
(02) BOX ENS14
(-8) BOX ENS14
(-9) BOX ENS14

yes/no

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

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

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) ENS17 - SPVARATE
(02) BOX ENSEND
(-8) BOX ENSEND
(-9) BOX ENSEND

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

BOX ENSEND

What [is [your/(SP’s)]/was (SP's)] (current) V.A. disability rating?
SPVARATE

Code List

numeric

routing

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.

ENS16 - SPNGDSBL

IF SEASON=FALL, GO TO HAQ.
IF (SEASON=WINTER OR SUMMER) AND INTTYPE in(C001, C002, C003, C004, C005, C006, C007, C010),
GO TO HIQ.

Page 4 of 4