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Introduction to the 1996 MEPS Nursing Home Component Data Collection Instrument: Rounds 1–3




Overview of the 1996 MEPS-NHC 

The MEPS NHC Nursing Home Component is sponsored by the Agency for Health Care Research and Quality (AHRQ). The (NHC) is a panel survey of nursing homes and persons resident in or admitted to nursing homes during calendar year 1996. The NHC panel design consists of three rounds conducted by in-person interviewing, in the nursing home, using Computer Assisted Personal Interview (CAPI) technology. Round 1 was conducted from May-July 1996; Round 2 was conducted from August-December, 1996. The last round was conducted from April-August 1997 The primary objective of the NHC is to estimate, for persons who are residents in nursing homes anytime during 1996, their use of and expenses for nursing home services and other health care expenses during their periods of residence. Other major objectives are to provide estimates of
  • Sources of payments, and changes in sources of payment for nursing home services
  • Annual use of in-patient hospital services for nursing home residents during 1996
  • Use, expenditures, and sources of payment for physician services provided during periods of nursing home residence
  • Characteristics of facilities, including structure, size, certification, services typically provided, staffing, revenues and expenses
  • Use of prescribed medications by nursing home residents
  • Functional health status of nursing home residents at selected points in time
  • Diagnostic data
  • Family characteristics, income and assets

For a discussion of the design and methods and a complete list of acronyms used in the questionnaire of the NHC, see Potter DEB. Design and Methods of the 1996 Medical Expenditure Panel Survey Nursing Home Component. Rockville (MD): Agency for Health Care Policy and Research; 1998. MEPS Methodology Report No.3. AHCPR Pub. No. 98-0041.

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Questionnaires used in Rounds 1–3 

Each round of the MEPS-NHC collected information on facilities and persons sampled within the facilities. Each round of data collection also includes different sections of the overall MEPS NHC data collection instrument. Some sections are included only during one round of data collection, some are included once but are updated during subsequent rounds. An overview of the data collection activities for the MEPS NHC can be found in collect.pdf.

Navigating through the NHC questionnaire using nav-v#-v1.pdf

The MEPS-NHC is a large-scale and comprehensive data collection effort. To accommodate the extensive array of questions covered, yet minimize the number of questions asked of each respondent, CAPI technology structures the design of the data collection instrument as an intricate system of skip patterns. Since data are collected using CAPI, rather than hard-copy questionnaire, the data collection instrument actually consists of a series of computer programming notes embedded along with each data item. Any single question must be considered within the context of the skip patterns incorporated into the questionnaire. Residents are sampled during each round only in the sampled facilities. Those sampled in Round 1 are referred to as Current Residents; those sampled in Round 2 are referred to as Round 2 First Admits; those sampled in Round 3 are referred to as Round 3 First Admits. In addition, these sampled persons may transfer to another sampled facility; others may transfer to new facilities. These combinations yield seven different resident/facility types. NAV-V3-V1.PDF can be used in conjunction with the survey instrument to identify which facilities and sampled residents are eligible for all or selected portions of the questionnaire for each round and to determine reference periods for those facilities and residents who were administered the questionnaire.

A brief description of the questionnaire sections is provided below. On the attached files, detailed information regarding the objectives and the general structure of that section precede each section of the questionnaire. It is recommended that the documentation preceding each section be read carefully.

Facility questionnaires: Round 1

The Round 1 facility-level questionnaire was administered to all sampled, cooperating, eligible facilities. It is divided into five sections that were collected using CAPI and a sixth section which utilized a self- administered questionnaire (SAQ). The names of the sections, the code identifying each section, the files that identify the section, and the page numbers are listed below, followed by a brief description of each section. The section code can be used to identify the questionnaire section when navigating through the instrument. For example, the first question of the Facility Structure and Characteristics Section is FA1, the second question of the Facility Rate Schedule is FR2, the fifth question of the Self-Administered Questionnaire is SAQ5, and so forth.

The page numbers shown below reflect the electronic page number. When this instrument is printed the page number on the hard copy will not always match the electronic page number.

Code

Section

File name

Page#

  

Objectives, structure,
and concepts

fac-lvl.pdf

1-11

FA

Facility Structure
and Characteristics

fac-lvl.pdf

12-67

FR

Facility Rate Schedule

fac-lvl.pdf

68-69

FG

Facility Records
Organization Grid

fac-lvl.pdf

70-71

SS

Sampling Section

fac-lvl.pdf

72-86

MD

Facility Missing Data

fac-lvl.pdf

87-102

Card Info/Help Screens

fac-lvl.pdf

103-118

SAQ

Self-Administered
Questionnaire

fac-lvl.pdf

119-123


FA - The Facility Structure and Characteristics Section is the largest and most complex of the sections and needs to be read carefully to determine whether the questions are directed toward the sampled facility, larger facility, a special care unit of the nursing home, or a unit of the larger facility. Its primary purpose is to define the facility's eligibility, determine its structure, enumerate and classify all the parts (or units) of a facility, collect data on the number of beds by Medicaid and Medicare certification status, state licensing status, and whether or not 24-hour a day, on-site supervision is provided by an RN or LPN seven days a week. Subsequent questions about the facility will exclude non-certified or unlicensed units.
FR - This is a vehicle for collecting a copy of the facility's rate schedule and contains four questions. It is designed to assist analysis of expenditure data at the sample person level.
FG - Facility Records Organization Grid identifies the various records the facility maintains with resident data and the facility staff members in charge of the records.
SS - This section is used to select a random sample of facility residents from eligible nursing home units. It directs the interviewer to list all current residents (i.e., residents of the nursing home unit at 12:00 a.m., December 31,1995).
MD - If data could not be ascertained from the first respondent, or during the initial interview, the Facility Missing Data Module is the CAPI instrument used to collect these data from alternative nursing home staff.
SAQ - The Self-Administered Questionnaire collects information on the wage rates and number of nursing staff employees by type, and the number of admissions in 1995.

Facility questionnaires: Round 2

The Round 2 facility instrument consist of the sampled facility questionnaire (updates information collected in Round 1) and the new facility questionnaire (collects information on eligible facilities to which some residents sampled in Round 1 were transferred). The Round 2 sampled facility-level questionnaire is divided into three sections. The names of the sections, the code identifying each section, the files that identify the section, and the page numbers are listed below, followed by a brief description of each section.

Sampled facility-level questionnaire Round 2


Code

Section

File name

Page#

  

Objectives, structure,
and concepts

sam-fac2.pdf

1-12

FB

Facility Structure
and Characteristics

sam-fac2.pdf

13-47

SS

Sampling Section

sam-fac2.pdf

48-59

FR

Facility Rate Schedule

sam-fac2.pdf

60-72

  

Facility Missing Data
Card Info/Help Screens

sam-fac2.pdf

73-86


FB - Updates data collected in FA in Round 1.
SS - This section is used to select a random sample of residents admitted since January 1, 1996 and the Round 2 interview.
FR - Updates information collected in the Round 1 FR.

The Round 2 new facility-level questionnaire was administered to all cooperating, eligible facilities to which residents sampled in round 1 were transferred. The content is similar to that of the facility-level instrument used in Round 1 for sampled facilities.

New facility-level instrument: Round 2


Code

Section

File name

Page#

  

Objectives, structure,
and concepts

new-fac.pdf

1-6

FA

Facility Structure
and Characteristics

new-fac.pdf

7-67

FR

Facility Rate Schedule

new-fac.pdf

68-69

FG

Facility Records
Organization Grid

new-fac.pdf

70-72

MD

Facility Missing Data

new-fac.pdf

73-89

 

Card Info/Help Screens

new-fac.pdf

90-100

FA - Similar to the FA section used to collect data for sampled facilities in Round 1.
FR - Similar to the FR section used to collect data for sampled facilities in Round 1.
FG - Similar to the FG section used to collect data for sampled facilities in Round 1.
MD- Similar to the MD section used to collect data for sampled facilities in Round 1.

Facility questionnaires: Round 3

The Round 3 facility instrument consist of the sampled facility questionnaire (updates information collected on facilities sampled in Round 1) and the continuing new facility /new facility questionnaire (collects information on eligible facilities to which some residents sampled in Rounds 1 or 2 were transferred).

Sampled facility questionnaire: Round 3

Code

Section

File name

Page#

  

Objectives, structure,
and concepts

sam-fac3.pdf

1-10

FC

Facility Cost Report

sam-fac3.pdf

11-41

SS

Sampling Section

sam-fac3.pdf

42-53

MD

Facility Missing Data

sam-fac3.pdf

54-75

SAQ

Self-Administered
Questionnaire

sam-fac3.pdf

76-87

FC - The Facility Cost Report collects revenue data.
SS - This section is used to select a random sample of residents admitted since Round 2 interview and December 31, 1996.
MD - Collects facility missing data; similar to the MD section used in Rounds 1 and 2.
SAQ - Updates information collected in earlier SAQ.

Continuing new and new facility questionnaire: Round 3


Code

Section

File name

Page#

  

Objectives, structure,
and concepts

cnf-nffq.pdf

1-12

FA

Facility Structure and
Characteristics

cnf-nffq.pdf

13-66

FB

Facility Structure and
Characteristics

cnf-nffq.pdf

67-75

SAQ

Self-Administered
Questionnaire

cnf-nffq.pdf

76-82

MD

Facility Missing Data

cnf-nffq.pdf

82-97

  

Show Cards and
Help Screens

cnf-nffq.pdf

98-101

FA - Similar to the FA section used to collect data for sampled facilities in Round 1.
FB - Updates information collected in FB during Round 2 for continuing new facilities.
SAQ - Similar to the SAQ used for sampled facilities in Round 1. Collects data for new facilities and updates information for continuing new facilities.
MD - Collects facility missing data; similar to the MD section used in Rounds 1 and 2.

Person-level questionnaire: Rounds 1–3

The person-level questionnaire collects data on a random sample of persons who were residents in the cooperating, eligible nursing homes on January 1, 1996 and on a random sample of persons admitted to sampled facilities between January 1 and December 31, 1996.

Person-level data include demographic information, measures of health status and psychosocial well-being, diagnoses/conditions, insurance information, key dates for residents, and family relationships.

The table below lists each sample-person questionnaire section by section code, section name, page numbers, and the name of the corresponding computer file by which each section is identified.

The page numbers shown below reflect the electronic page number. When this instrument is printed the page number on the hard copy will not always match the electronic page number.


Code

Section

File name

Page#

  

RH structure and
concepts

res-his.pdf

1-8

RH

Residency History

res-his.pdf

9-52

  

RH help screens
and show cards

res-his.pdf

53-58

  

PM structure

pmed.pdf

1-3

PM

Prescription Medicines

pmed.pdf

4-40

  

IN structure and concepts

fb-hi.pdf

1-2

BQ

Background Questionnaire

fb-hi.pdf

3-19

IN

Insurance

fb-hi.pdf

20-31

  

IN show cards and help
screens

fb-hi.pdf

32-35

  

Health status structure and
concepts

hlthstat.pdf

1-13

HA

Health Status-A

hlthstat.pdf

14-58

HB

Health Status-B

hlthstat.pdf

56-65

HC

Health Status-C

hlthstat.pdf

66-67

  

Show cards/Help screens

hlthstat.pdf

68-82

 

EX structure and concepts

expend.pdf

1-7

EX

Expenditures

expend.pdf

8-51

 

EX help screens and
show cards

expend.pdf

52-53

  

US structure and concepts

services.pdf

1-8

 

Blank Pages

services.pdf

9-14

US

Use of services

services.pdf

15-34

 

US help screens and
show cards

services.pdf

35-40

  

CI structure and concepts

communty.pdf

1-7

CI

Community interview structure
and concepts

communty.pdf

8-77

  

CI help screens and
show cards

communty.pdf

78-79

RH - Residency History collects key reference dates, information about all stays in eligible facilities, ineligible long-term care places, hospitals, and the community from the date of most recent community stay prior to January 1, 1996, to the date of interview.
PM - The data collected in the Prescribed Medicine section include the name of the medicine, the form, strength, and dosage in which it was prescribed, the number of times it was prescribed each month, and when it was discontinued.
BQ - The Background Questionnaire collects demographic information, lifetime use of long-term care and information about the sample person's immediate family, typically from nursing staff who use medical records.
IN - The Insurance Section collects information about the person's insurance coverage.
HA - This section gathers information that is usually contained in the residents Minimum Data Set (MDS) assessment, the Quarterly Review forms, and other medical records. It includes data on diagnoses/conditions, ADL status, cognition, and behavior. *
HB - The HB collects information on incident conditions and hospital stays and diagnoses.*
HC - This last section of the Health Status Questionnaire ascertains the source of data for the HA and HB sections. *
EX - The overall objective of the Expenditure instrument across Rounds 2 and 3 is to collect billing and payment information data for all sampled residents during the 1996 period of time they were residing in an eligible nursing home. In both rounds insurance missing data is also administered in EX for those sampled residents who had missing items in IN or HA from the previous round. In round 3, questions about income from Social Security, pensions, and home ownership are asked for all sampled residents who have expenditure data collected from the facilities in which they were sampled.
US - The Use of Services instrument collects information about the types and frequency of services, such as physician, occupational therapy, physical therapy mental health services, podiatry, emergency room, and so forth used by sampled residents.
CI - The Community Interview is used to collect information in areas where the community respondent should have a better knowledge about the sampled resident. Conducted by telephone, it includes resident history (RH), demographic information (BQ), insurance information (IN), care giver information (CQ), and income and assets (IA) information.

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Accessing the questionnaires using Adobe Acrobat 

The data collection instrument for Rounds 1-3 of the MEPS Nursing Home Component is provided for public use in 12 separate computer files. These files are stored in portable document format (PDF) for easy translation and printing. To view and print PDF files, you need Adobe Acrobat Reader®, a free software program you can download from the Adobe Web site.

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Suggested Citation:
Introduction to the 1996 MEPS Nursing Home Component Data Collection Instrument. January 2001. Agency for Healthcare Research and Quality, Rockville, MD. http://www.meps.ahrq.gov/data_stats/nhc_ data_collection.shtml