Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)

2024 MCBS Facility Instrument

Variable Name

IR-Interviewer Remarks

MR Screen Name Question Type

Question Text/Description

Code List

Routing

INTERVIEWER REMARKS SECTION SPECIFICATIONS
CRITERIA
(N/A)
PLACEMENT
(N/A)
BOX IRQBEG

routing

GO TO MULTMODE

MULTMODE

MULTMODE

code one

WHICH OF THE FOLLOWING MODES DID YOU USE TO COMPLETE THIS INTERVIEW? DO NOT INCLUDE
MODES USED FOR GAINING COOPERATION OR SETTING APPOINTMENTS.

(01) PHONE ONLY
(02) IN-PERSON ONLY
(03) PHONE AND IN-PERSON

(01) IRQ15 - MDSABST
(02) IRQ15 - MDSABST
(03) IRQ15 - MDSABST

MDSABST

IRQ15

yes/no

DID YOU USE INFORMATION FROM AN MDS FOR ANY PART OF THIS INTERVIEW?

(00) NO
(01) YES

(00) IRQ3 - FUTUREF
(01) IRQ3 - FUTUREF

FUTUREF

IRQ3

yes/no

ARE THERE ANY COMMENTS YOU WOULD LIKE TO MAKE ABOUT THE RESPONDENT(S) OR
INTERVIEWING SITUATION THAT COULD HELP THE NEXT INTERVIEWER COMPLETE THIS CASE?

(00) NO
(01) YES

(00) BOX IRQ1
(01) IRQ3OV - FUTURVB

FUTURVB

IRQ3OV

verbatim text

PLEASE RECORD THOSE NOTES HERE.

(01) Continuous Answer

(01) IRQ14 - ANYFIX

BOX IRQ1

routing

IF THERE ARE NO PREVIOUS ROUND DRIVING DIRECTIONS AVAILABLE, GO TO IRQ14B - DRIVE.
ELSE GO TO IRQ14C - DRIVCHNG.

DRIVE

IRQ14B

yes/no

ARE THERE ANY DRIVING INSTRUCTIONS THAT WOULD ASSIST AN INTERVIEWER NEXT ROUND IN
REACHING THE FACILITY?

(00) NO
(01) YES

(00) IRQEND - IRQENDCT
(01) IRQ14D - DRIVETXT

DRIVCHNG

IRQ14C

yes/no

DO YOU NEED TO UPDATE OR CHANGE THE FOLLOWING DRIVING DIRECTIONS RECORDED IN THE LAST
ROUND?
(01) YES, REPLACE
(02) NO, KEEP THE SAME
PLEASE REMEMBER WHEN UPDATING OR CHANGING DRIVING DIRECTIONS, THE NEW TEXT WILL
(03) REMOVE DRIVING DIRECTIONS
REPLACE THE PREVIOUS TEXT.

(01) IRQ14D - DRIVETXT
(02) IRQEND - IRQENDCT
(03) IRQEND - IRQENDCT

DRIVETXT

IRQ14D

verbatim text

ENTER THE DRIVING DIRECTIONS.

(01) Continuous Answer

(01) IRQEND - IRQENDCT

IRQENDCT

IRQEND

code one

YOU HAVE COMPLETED THE IRQ FOR (SP).
PRESS "1" TO RETURN TO NORCSUITE.

(01) Continue

(01) BOX IRQEND

BOX IRQEND

routing

GO TO NORCSUITE

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