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pdf2022 MCBS Community Questionnaire
Variable Name
MR Screen Name
Question Type
ENS-ENUMERATION SUMMARY
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
HHSTILL
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.
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.]
roster
PROBE FOR AND SELECT THOSE PEOPLE WHO ARE NO LONGER IN THE HOUSEHOLD.
ENS1
HOUSEHOLD_NOT ENS2
NOTHHRSN
ENS2A
code 1
Why [is/was] (HOUSEHOLD MEMBER NAME) no longer in the household [as of (DATE OF DEATH/DATE OF
INSTITUTIONALIZATION)]?
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
ENS3
yes/no
BOX ENS1
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) ENS3 - HHNEW
(02) ENS2 - HOUSEHOLD_NOT
(-8) ENS3 - HHNEW
(-9) ENS3 - HHNEW
ENS2A - NOTHHRSN
(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
[Besides [you/(SP)], [is/was] there anyone else living or staying in the household [as of (DATE OF DEATH/DATE
(-8) Don't Know
OF INSTITUTIONALIZATION)]? Remember to include people who
(-9) Refused
[are/were] temporarily absent and any children who [may live/may
have lived] in the household.
(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) ENS4 - HOUSEHOLD_ENS
(02) BOX ENS4
(-8) BOX ENS4
(-9) BOX ENS4
Page 1 of 6
2022 MCBS Community Questionnaire
Variable Name
MR Screen Name
Question Type
ENS-ENUMERATION SUMMARY
Question Text/Description
Code List
Routing
HOUSEHOLD_ENS ENS4
roster
Who else [is/was] living or staying in the household?
SELECT OR ADD ALL PERSONS LIVING IN THE HOUSEHOLD.
DISPLAY PERSON ROSTER AS RESPONSE
OPTIONS:
1. [PERSON 1]
2. [PERSON 2]
…
(01-N) BOX ENS4
(01-N) LIST ALL PERSONS AS RESPONSE OPTIONS (N+1) HH-ROSTFNAM
(N+1) ADD ANOTHER
IF EXISTING PERSON SELECTED, GO TO BOX
DISPLAY:
ENS4.
1 First Name Display ROST.ROSTFNAM.
ELSE IF "ADD ANOTHER" SELECTED, GO TO HH2 Last Name Display ROST.ROSTLNAM.
ROSTFNAM.
3 Relationship to SP Display relationship:
If ROST.ROSTREL=91/OtherRelative or 92/OtherNonRelative, display ROST.ROSTREOS.
Else display ROST.ROSTREL relationship.
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
(02) SPOUSE
(56) PARTNER
(58) CHILD
(59) GRANDCHILD
(60) PARENT
(61) SIBLING
(91) OTHER
(-8) Don't Know
(-9) Refused
(01) DO NOT DISPLAY
(02) HHADD-HHADD
(56) HHADD-HHADD
(58) HHADD-HHADD
(59) HHADD-HHADD
(60) HHADD-HHADD
(61) HHADD-HHADD
(91) HH - ROSTREOS
(-8) HHADD-HHADD
(-9) HHADD-HHADD
ROSTREL
HH
code one
[What is the name of the person and relationship to (SP)?]
ROSTREOS
HH
verbatim text
[What is the name of the person and relationship to (SP)?]
HHADD
HHADD
code one
HHMISS
ENS4A
yes/no
BOX ENS3
routing
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).
(01) continuous reponse
(-8) Don't Know
(-9) Refused
ENS4A- HHMISS
(01) ADD ANOTHER
(02) ALL DONE
(01) ROSTFNAM- HH
(02) ENS4A- HHMISS
(01) YES
(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 household
(-9) Refused
but [is/was] away from home traveling or in the hospital?
(01) HH-ROSTFNAM
(02) BOX ENS3
(-8) BOX ENS3
(-9) BOX ENS3
IF ROSTSEX IS NOT MISSING, GO TO BOX ENS4A.
ELSE GO TO ENS5-HHPSEX.
Page 2 of 6
2022 MCBS Community Questionnaire
Variable Name
MR Screen Name
Question Type
ENS-ENUMERATION SUMMARY
Question Text/Description
Code List
Routing
ENS5 - EHHDOBMM
HHPSEX
ENS5
grid
Is (HOUSEHOLD MEMBER NAME) male or female?
(01) MALE
(02) FEMALE
(-8) Don't Know
(-9) Refused
EHHDOBMM
ENS5
grid
What is (HOUSEHOLD MEMBER NAME'S) [date/year] of birth?
[ENTER DATE.]
(01) [Continuous answer.]
(-8) Don't Know
(-9) Refused
ENS5 - EHHDOBDD
EHHDOBDD
ENS5
grid
What is (HOUSEHOLD MEMBER NAME'S) [date/year] of birth?
[ENTER DATE.]
(01) [Continuous answer.]
(-8) Don't Know
(-9) Refused
ENS5 - EHHDOBYY
EHHDOBYY
ENS5
grid
What is (HOUSEHOLD MEMBER NAME'S) [date/year] of birth?
[ENTER DATE.]
(01) [Continuous answer.]
(-8) Don't Know
(-9) Refused
(01) BOX ENS4
(-8) ENS5 -HHPAGE
(-9) ENS5-HHPAGE
HHPAGE
ENS5
grid
How old is (HOUSEHOLD MEMBER NAME)?
(01) [Continuous answer.]
(-8) Don't Know
(-9) Refused
BOX ENS4
(01)[Continuous answer.]
(-8) Don't Know
(-9) Refused
ENS10 - EHHDOBDD
(01)[Continuous answer.]
(-8) Don't Know
(-9) Refused
ENS10 - EHHDOBYY
(01)[Continuous answer.]
(-8) Don't Know
(-9) Refused
ENS10 - HHPSEX
BOX ENS4
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
[(ROSTREL ^=02/SPOUSE OR 56/PARTNER) AND (EHHDOBYY IS MISSING)] OR [(ROSTREL= 02/SPOUSE
OR 56/PARTNER) AND (EHHDOBMM OR EHHDOBDD OR EHHDOBYY IS MISSING)] AND (ENS10 HAS
NEVER BEEN ASKED IN ANY PREVIOUS ROUND), GO TO ENS10 - EHHDOBMM.
ELSE, GO TO BOX ENS4A
EHHDOBMM
EHHDOBDD
EHHDOBYY
ENS10
ENS10
ENS10
grid
grid
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/YEAR] OF BIRTH.
[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.
(HOUSEHOLD MEMBER NAME'S) [DATE/YEAR] OF BIRTH.
[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.
(HOUSEHOLD MEMBER NAME'S) [DATE/YEAR] OF BIRTH.
[ENTER DATE.]
Page 3 of 6
2022 MCBS Community Questionnaire
Variable Name
HHPSEX
MR Screen Name
ENS10
Question Type
grid
ENS-ENUMERATION SUMMARY
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) 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
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.
BOX ENS4A
routing
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
BOX ENS4B
routing
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
HOUSEHOLD_OW
ENS10A
NS
BOX ENS4C
ASKWORK
ENS10AA
BOX ENS5
roster
Code List
Routing
(01)[Continuous answer.]
(-8) Don't Know
(-9) Refused
ENS10 - ROSTREL
(02) SPOUSE
(56) PARTNER
(58) CHILD
(59) GRANDCHILD
(60) PARENT
(61) SIBLING
(91) OTHER
(-8) Don't Know
(-9) Refused
ENS10 - HHPAGE
(01)[Continuous answer.]
(-8) Don't Know
(-9) Refused
BOX ENS4A
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.
routing
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
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.
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
BOX ENS5
Page 4 of 6
2022 MCBS Community Questionnaire
Variable Name
JOBSTAT
MR Screen Name
ENS11
BOX ENS5A
SPOUSJOB
ENS11A
BOX ENS6
BOX ENS7
SPAFEVER
ENS12
ENS-ENUMERATION SUMMARY
Question Type
Question Text/Description
routing
(01) YES
[Before I continue with the next set of questions, I need to collect information about [your/(SP’s)] job status.] [Are (02) NO
you/Is (SP)] currently working at a job or business?
(-8) Don't Know
(-9) Refused
BOX ENS5A
routing
IF ANOTHER PERSON WHO LIVES IN THE HOUSEHOLD WITH THE SP IS 02/SPOUSE OR 56/PARTNER
AND ((THIS PERSON IS A NEW HOUSEHOLD MEMBER IN THE CURRENT ROUND) OR (IT IS A FALL
ROUND)), GO TO ENS11A-SPOUSJOB.
ELSE GO TO BOX ENS7.
(01) ITEM SELECTED IN INSTANCE NAVIGATOR
(02) CONTINUE INTERVIEW SELECTED
(01) ENS11A - HHJBSTAT
(02) 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?
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
BOX ENS6
routing
IF ANOTHER PERSON WHO LIVES IN THE HOUSEHOLD WITH THE SP IS 02/SPOUSE OR 56/PARTNER
AND ((THIS PERSON IS A NEW HOUSEHOLD MEMBER IN THE CURRENT ROUND) OR (IT IS A FALL
ROUND)), GO TO ENS11A-SPOUSJOB.
ELSE GO TO 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.
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) ENS13 - SPAFTIME
(02) ENS14 - SPNGEVER
(-8) ENS14 - SPNGEVER
(-9) ENS14 - SPNGEVER
(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
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) ENS15 - SPNGALL
(02) BOX ENS14
(-8) BOX ENS14
(-9) BOX ENS14
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
ENS16 - SPNGDSBL
yes/no
Now we have a few questions about military service.
Did [you/(SP)] ever serve in the Armed Forces of the United States?
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
ENS14
yes/no
[Were you/Was (SP)] ever an active member of a National Guard or military reserve unit of the United States?
BOX ENS14
routing
IF ENS12 - SPAFEVER = 1/Yes, GO TO ENS16 - SPNGDSBL.
ELSE GO TO BOX ENSEND.
ENS15
yes/no
Was all of [your/(SP’s)] active duty related to National Guard or military reserve training?
Code List
Routing
Page 5 of 6
2022 MCBS Community Questionnaire
Variable Name
SPNGDSBL
MR Screen Name
ENS16
ENS-ENUMERATION SUMMARY
Question Type
Question Text/Description
yes/no
(01) YES
[Do you/Does (SP)/Did (SP)] have a disability related to service in the Armed Forces of the United States?
(02) NO
[PROBE: ‘Have you received a V.A. disability rating?’ IF THE RESPONDENT HAS A V.A. DISABILITY RATING,
(-8) Don't Know
SELECT "YES"; IF HE OR SHE DOES NOT, SELECT "NO"]
(-9) Refused
What [is [your/(SP’s)]/was (SP's)] (current) V.A. disability rating?
SPVARATE
ENS17
numeric
BOX ENSEND
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.
Code List
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
Routing
(01) ENS17 - SPVARATE
(02) BOX ENSEND
(-8) BOX ENSEND
(-9) BOX ENSEND
BOX ENSEND
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 6 of 6
File Type | application/pdf |
File Title | Medicare Current Beneficiary Survey Section Specifications for ENS |
Subject | Medicare beneficiaries, MCBS community questionnaire, 2022, Enumeration summary, ENS |
Author | NORC |
File Modified | 2022-08-15 |
File Created | 2022-08-12 |