Home Health (HH) Section

BOX_00 (HH1000)

BOX_10 (HH1001)

BOX_20 (HH1010)

HH10 (HH1015)

BLAISE NAME: CodeAllHcarWrkrProf

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {EVN-MO}

Question Text:

&HH-1

Please look at card HH-1. During {VISIT MONTH}, what types of health care workers from {PROVIDER} provided home care services for {you/{PERSON}}?

ENTER ALL THAT APPLY.

HELP: F1

Responses: CERTIFIED NURSING ASSISTANT (CNA) 1 HH20 (HH1020)

DIETITIAN/NUTRITIONIST 2 HH20 (HH1020)

I.V. OR INFUSION THERAPIST 3 HH20 (HH1020)

MEDICAL DOCTOR 4 HH20 (HH1020)

NURSE/NURSE PRACTITIONER 5 HH20 (HH1020)

OCCUPATIONAL THERAPIST 6 HH20 (HH1020)

PHYSICAL THERAPIST 7 HH20 (HH1020)

RESPIRATORY THERAPIST 8 HH20 (HH1020)

SOCIAL WORKER 9 HH20 (HH1020)

SPEECH THERAPIST 10 HH20 (HH1020)

NONE OF THESE 95 HH20 (HH1020)

REFUSED RF HH20 (HH1020)

DON'T KNOW DK HH20 (HH1020)

Programmer Instructions: For specifications purposes only (this check is automatic): CAPI does not allow ‘95’ (NONE OF THESE), 'RF' (REFUSED) or 'DK' (DON'T KNOW) in combination with any other code.

Display the following message if these codes are selected in combination with any other code “THIS CODE CANNOT BE SELECTED WITH OTHER OPTIONS. VERIFY AND RE-ENTER.”

MHOP NOTE: Codes 1-10 represented providers who are skilled.

Display Instructions:

HH20 (HH1020)

BLAISE NAME: CodeAllHcarWrkrOth

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {EVN-MO}

Question Text:

&HH-2

Please look at card HH-2. {Which/Other than what we have discussed, which} of these types of health care workers from {PROVIDER} provided home care services for {you/{PERSON}} during {VISIT MONTH}?

ENTER ALL THAT APPLY.

HELP: F1

Responses: COMPANION 1 HH30 (HH1025)

HOMEMAKER/HOUSE CLEANER 2 HH30 (HH1025)

HOME HEALTH AIDE/HOME CARE AIDE 3 HH30 (HH1025)

HOSPICE WORKER 4 HH30 (HH1025)

NURSE'S AIDE 5 HH30 (HH1025)

PERSONAL CARE ATTENDANT 6 HH30 (HH1025)

NONE OF THESE 95 HH30 (HH1025)

REFUSED RF HH30 (HH1025)

DON'T KNOW DK HH30 (HH1025)

Programmer Instructions: For specifications purposes only (this check is automatic): CAPI does not allow ‘95’ (NONE OF THESE), 'RF' (REFUSED) or 'DK' (DON'T KNOW) in combination with any other code.

Display the following message if these codes are selected in combination with any other code “THIS CODE CANNOT BE SELECTED WITH OTHER OPTIONS. VERIFY AND RE-ENTER.”

MHOP NOTE: Codes 1-6 represented providers who are unskilled. If HH10 and HH20 are only some combination of codes ‘95’ (NONE OF THESE), ‘RF’ (REFUSED), and ‘DK’ (DON’T KNOW), the provider is also unskilled.

Display Instructions: Display “Which” if HH10 is coded ‘95’ (NONE OF THESE), ‘RF’ (REFUSED) or ‘DK’ (DON'T KNOW). Otherwise, display “Other than what we have discussed, which”.

HH30 (HH1025)

BLAISE NAME: HHMPNum

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {EVN-MO}

Question Text:

How many people from {PROVIDER} provided home care services for {you/{PERSON}}?

Responses: 1

REFUSED RF

DON'T KNOW DK

Programmer Instructions: If Round 1, go to BOX_40.

Otherwise, go to HH70.

Display Instructions:

BOX_30 (HH1026)

HH40 (HH1027)

BLAISE NAME: HHProfTp

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {EVN-MO}

Question Text:

&HH-1

Please look at card HH-1. What type of health care worker is {PROVIDER} who provided home care services for {you/{PERSON}} during {VISIT MONTH} ?

HELP: F1

Responses: CERTIFIED NURSING ASSISTANT (CNA) 1

DIETITIAN/NUTRITIONIST 2

I.V. OR INFUSION THERAPIST 3

MEDICAL DOCTOR 4

NURSE/NURSE PRACTITIONER 5

OCCUPATIONAL THERAPIST 6

PHYSICAL THERAPIST 7

RESPIRATORY THERAPIST 8

SOCIAL WORKER 9

SPEECH THERAPIST 10

NONE OF THESE 95

REFUSED RF

DON'T KNOW DK

Programmer Instructions: If coded 95, ‘NONE OF THESE’ or ‘DK’ (DON’T KNOW), go to HH50.

If round 1, and coded 1-10, RF go to BOX_40.

Otherwise, go to HH70

Display Instructions:

HH50 (HH1030)

BLAISE NAME: HHProfTpOth

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {EVN-MO}

Question Text:

&HH-2

Please look at card HH-2. Which of these types of health care workers, if any, is {PROVIDER} who provided home care services for {you/{PERSON}} during {VISIT MONTH}?

HELP:F1

Responses: COMPANION 1

HOMEMAKER/HOUSE CLEANER 2

HOME HEALTH AIDE/HOME CARE AIDE 3

HOSPICE WORKER 4

NURSE'S AIDE 5

PERSONAL CARE ATTENDANT 6

NONE OF THESE 95

REFUSED RF

DON'T KNOW DK

Programmer Instructions: If round 1, go to BOX_40.

Otherwise, go to HH70.

Display Instructions:

BOX_40 (HH1032)

HH60 (HH1033)

BLAISE NAME: HHCareBefYr

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {EVN-MO}

Question Text:

Did {someone from} {PROVIDER} ever provide home care services for {you/{PERSON}} before January 1, {YEAR}?

Responses: YES 1 HH70 (HH1040)

NO 2 HH70 (HH1040)

REFUSED RF HH70 (HH1040)

DON'T KNOW DK HH70 (HH1040)

Display Instructions: Display ‘someone from’ if provider is flagged as 'AGENCY'. Otherwise, use a null display.

For specifications purposes only; CAPI handles automatically: ‘YEAR’ in question text is first calendar year of panel.

HH70 (HH1040)

BLAISE NAME: HHSpecCond

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {EVN-MO}

Question Text:

Thinking about all of the home care services {you/ {PERSON}} {have/has} received from {someone from} {PROVIDER} during {VISIT MONTH}, were any of these home care services related to any specific health problem?

IF OLD AGE MENTIONED, SELECT 'YES' AND ENTER ‘OLD AGE’ AS CONDITION

HELP: F1

Responses: YES 1 HH80 (HH1045)

NO 2 HH90 (HH1085)

REFUSED RF HH90 (HH1085)

DON'T KNOW DK HH90 (HH1085)

Display Instructions: Display ‘someone from’ if provider is flagged as ‘AGENCY’.

HH80 (HH1045)

BLAISE NAME: HHCondRoster

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {EVN-MO}

Question Text:

What health condition led {you/{PERSON}} to receive home health care services from {someone from} {PROVIDER} during {VISIT MONTH}?

PROBE: Any other health condition?

ENTER ALL THAT APPLY.

CTRL-A: ADD

CTRL-E: EDIT

CTRL-D: DELETE

HELP: F1

Responses: {MEDICAL CONDITION} 1 1 HH90 (HH1085)

{MEDICAL CONDITION} 2 2 HH90 (HH1085)

{MEDICAL CONDITION} 3 3 HH90 (HH1085)

{MEDICAL CONDITION} 4 4 HH90 (HH1085)

{MEDICAL CONDITION}N 5 HH90 (HH1085)

Programmer Instructions: Roster Behavior:

1. Multiple select allowed.
   
   
2. Multiple add allowed.
   
   
3. Limited delete allowed. Interviewer may delete a condition added at this item until CAPI creates the link between this condition and the event. The link is created when the collection of utilization and/or charge/payment data is complete.
   
   
4. Limited edit allowed. Interviewer may edit a condition name newly added at this item until CAPI creates the link between this condition and the event.

The link is created when the collection of utilization and/or charge/payment data is complete.

Display Instructions: Roster 3 - Add/Edit/Delete Allowed

Roster Definition:

Display the Person's-Medical-Conditions Roster for the selection and/or addition of one or more medical condition (s) associated with this event. Display name of medical condition (COND.CONDNAM).

Roster Filter:

Display all conditions on person's roster; no filter.

Display ‘someone from’ if provider is flagged as ‘AGENCY’.

HH90 (HH1085)

BLAISE NAME: HHFreq

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {EVN-MO}

Question Text:

During {VISIT MONTH}, did {someone from} {PROVIDER} usually come to the home to help {you/ {PERSON}} every week, only some weeks, or did they come only once during {VISIT MONTH}?

Responses: EVERY WEEK 1 HH100 (HH1090)

SOME WEEKS 2 HH110 (HH1095)

ONLY CAME ONCE 3 BOX_50 (HH1125)

REFUSED RF BOX_50 (HH1125)

DON'T KNOW DK BOX_50 (HH1125)

Display Instructions: Display ‘someone from’ if provider is flagged as ‘AGENCY’.

HH100 (HH1090)

BLAISE NAME: HHDaysWeek

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {EVN-MO}

Question Text:

During {VISIT MONTH}, about how many days per week did {someone from} {PROVIDER} come?

PROBE: We just need to know in general.

ENTER DAYS PER WEEK

Responses: 1 BOX_50 (HH1125)

REFUSED RF BOX_50 (HH1125)

DON'T KNOW DK BOX_50 (HH1125)

Programmer Instructions: Hard range: 1-7.

Display the following message if an out of range response is entered: “THE VALUE MUST BE BETWEEN 1 AND 7. VERIFY WITH RESPONDENT AND RE-ENTER.”

Display Instructions: Display ‘someone from’ if provider is flagged as ‘AGENCY’.

HH110 (HH1095)

BLAISE NAME: HHDaysMth

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {EVN-MO}

Question Text:

About how many days during {VISIT MONTH} did {someone from} {PROVIDER} come?

PROBE: We just need to know in general.

ENTER 1-{28/29/30/31} DAYS PER MONTH

Responses: 1 BOX_50 (HH1125)

REFUSED RF BOX_50 (HH1125)

DON'T KNOW DK BOX_50 (HH1125)

Programmer Instructions: Hard range: 1-31.

Range Check:

CAPI will display an error message and force the interviewer to rectify the data if any of the following situations occur:

If (VISIT MONTH) is: January, March, May, July, August, October or December: 1-31 for number of days.

If (VISIT MONTH) is: April, June, September or November: 1-30 for number of days.

If (VISIT MONTH) is: February: 1-29 for leap years.

Otherwise, 1-28 for number of days.

Display Instructions: Display ‘someone from’ if provider is flagged as ‘AGENCY’.

Display ‘28’ if HH visit month is February and event year is not a leap year.

Display ‘29’ if HH visit month is February and event year is a leap year.

Display ‘30’ if HH visit month is April, June, September or November.

Display ‘31’ if HH visit month is January, March, May, July, August, October or December.

BOX_50 (HH1125)

HH120 (HH1130)

BLAISE NAME: HHFreqOthMth

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {EVN-MO}

Question Text:

I have recorded that {you/{PERSON}} received services from {PROVIDER} during other months. In the other months, did {PROVIDER} visit {only once/the same number of times/{FREQUENCY OF SERVICES…}}?

Responses: YES 1 HH130 (HH1135)

NO 2 BOX_60 (HH1145)

REFUSED RF BOX_60 (HH1145)

DON'T KNOW DK BOX_60 (HH1145)

Display Instructions: Display ‘only once’ if HH90 was coded ‘3’ (ONLY CAME ONCE). Display ‘the same number of times’ if HH90, HH100 or HH110 was coded 'RF' (REFUSED) or 'DK' (DON'T KNOW). Otherwise, display ‘{FREQUENCY OF SERVICES}’.

For 'FREQUENCY OF SERVICES':

Display number entered at HH100 and the phrase ‘days per week’ if a response was recorded at HH100.

Display number entered at HH110 and the phrase ‘days per month’ if a response was recorded at HH110.

HH130 (HH1135)

BLAISE NAME: HHMthRoster

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {EVN-MO}

Question Text:

During which of the following months did {PROVIDER} visit {only once/the same number of times/{FREQUENCY OF SERVICES}}?

PROBE: Any other months with the same number of visits?

ENTER ALL THAT APPLY.

Responses: {SELECT ALL EVENTS} 0 HH140 (HH1140)

{MONTH,YEAR}1 1 HH140 (HH1140)

{MONTH,YEAR}2 2 HH140 (HH1140)

{MONTH,YEAR}3 3 HH140 (HH1140)

{MONTH,YEAR}4 4 HH140 (HH1140)

{MONTH,YEAR}N 5 HH140 (HH1140)

Programmer Instructions: If coded '0' SELECT ALL EVENTS, CAPI should automatically select all of the events displayed on the roster and flag as being part of the repeat visit group.

Flag each month selected at HH130 as a repeat visit related to the event being asked about. (NOTE: The event being cycled on through this HH section administration is the “stem” repeat visit. The events selected at HH130 are each a “leaf”. The event driver (ED) section will not serve these repeat visits for the HH section.)

Assign next repeat visit number at the household level. (NOTE: Each repeat visit grouping, whether OP, MV, or HH is assigned this number at a household level. The number will start over every round.)

Roster Behavior:

1. Multiple select allowed.
   
   
2. Add, delete, and edit disallowed.

Display Instructions: Roster 2 - no add/edit/delete

Roster definition:

Display the person's Medical-Events-Roster for selection.

Roster filter:

Display only those events that meet the following criteria:

- Have event type 'HH'.

- Created this round, excluding the interview month. (If round 5, do not exclude Dec.)

- Are associated with the same provider as the event asked about during this round.

- Have not been processed through utilization.

Display ‘only once’ if HH90 was coded ‘3’ (ONLY CAME ONCE). Display ‘the same number of times’ if HH90, HH100 or HH110 was coded 'RF' (REFUSED) or 'DK' (DON'T KNOW).

Otherwise, display ‘{FREQUENCY OF SERVICES}’.

For 'FREQUENCY OF SERVICES':

Display number entered at HH100 and the phrase ‘days per week’ if a response was recorded at HH100.

Display number entered at HH110 and the phrase ‘days per month’ if a response was recorded at HH110.

For "MONTH,YEAR" in the response option area, display visit dates as "MON, YYYY". Abbreviate the month name as three letters.

Display the response option '0' SELECT ALL EVENTS when there is more than one event to display on the roster, otherwise use a null display.

HH140 (HH1140)

BLAISE NAME: HHVstGrp

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {EVN-MO}

Question Text:

INTERVIEWER: RECORD ‘NAME OF REPEAT VISIT GROUP’ FOR MONTHS SELECTED IN PREVIOUS QUESTION.

Responses: 1 BOX_60 (HH1145)

Display Instructions:

BOX_60 (HH1145)

BOX_70 (HH1150)

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