CMS-P-0015A Residence History Missing Data

2021 MCBS Facility Instrument

Variable Name

MR Screen Name

RHM-Residence History Missing Data

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

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.

RHMISSNG

BOX RHMBEG

routing

RHMISS1

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

RHMALIVE

RHM2

routing

code one

BOX RHM3

routing

RHM3

date

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?
ENTER "95" IF RESPONDENT NEVER WILL KNOW.

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

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

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

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.

STAYEMM

RHM6

date

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

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

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.

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

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2021 MCBS Facility Instrument

Variable Name

MR Screen Name

RHM-Residence History Missing Data

Question Type

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

STAYNITE

RHM6B

numeric

ENTER "995" IF RESPONDENT NEVER WILL KNOW.

STAYCNTC

RHMSTCNT

code one

PRESS "1" TO CONTINUE.

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

BOX RHMEND

routing

# OF NIGHTS

RHMENDC

YOU HAVE COMPLETED THE MISSING RESIDENCE HISTORY ITEMS FOR THIS SP.
THANK RESPONDENT AND PRESS "1" TO RETURN TO THE NAVIGATION SCREEN.

Code List

Routing

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

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

(01) CONTINUE

(01) BOX RHM7

(01) CONTINUE

(01) BOX RHMEND

GO TO NAVIGATOR

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