Event Roster (EV) Section

Fall 2021

BOX_00 (EV1000)

BOX_10 (EV1001)

BOX_20 (EV1005)

EV10 (EV1010)

BLAISE NAME: EvntPersRoster

Question Text:

{INTERVIEWER: SELECT CORRECT PERSON FOR THIS EVENT.}

{{Next I need to enter some basic information about the health care visits from the records you have for the people in this household.} Let’s {start/continue} with this {next} record. Please tell me who {(else)} this record is for.}

Responses: {FIRST NAME [MIDDLE NAME] LAST NAME}1 1

{FIRST NAME [MIDDLE NAME] LAST NAME}2 2

{FIRST NAME [MIDDLE NAME] LAST NAME}3 3

{FIRST NAME [MIDDLE NAME] LAST NAME}4 4

{FIRST NAME [MIDDLE NAME] LAST NAME}N 5

Programmer Instructions: Roster behavior:

1. Single select only.

If person selected at EV10 has NOT reported at least one ‘1’ (YES, HAS RECORD TYPE) at CA30_01 through CA30_08, go to EV15. Otherwise, go to EV20.

NOTE TO PROGRAMMER: For each person selected at EV10 without at least one value of 1 (YES, HAS RECORD TYPE) at CA30_01 through CA30_08, CAPI will display this person’s name at either PP10 or PP170 in a fill.

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

Roster definition:

Display the RU members-Roster for selection.

Roster filter:

No filter; display all RU members.

-Display “INTERVIEWER: SELECT CORRECT PERSON FOR THIS EVENT” if coming from the Off path route or the Event Follow-Up (EF) Section. Otherwise, use a null display.

Display paragraph “{Next I need … this record is for?}” if coming from Calendar (CA) Section.

Otherwise, use a null display.

-Display ‘Next I need to enter some basic information about the health care visits from the records you have for the people in this household.’ if first time going through LOOP_30 in CA section, otherwise, use null display.

-Display “start” if first time EV10 is being asked. Otherwise, display “continue.”

Display “next” if CA100 was coded ‘1’ (YES) to loop again. Otherwise, use a null display.

Display “(else)” if CA90 was coded ‘1’ (YES) to loop again for this record. Otherwise, use a null display.

EV15 (EV1015)

BLAISE NAME: ProbeReminder

Question Text:

At the moment, we‘re going to focus on {{you}/{and} {NAMES OF PEOPLE WITH RECORDS}} since you have records to help you report {your/their} health care. We’ll talk about health care for {you/{PERSON }} a little later in the interview. I will remind you when we get to that section.

PRESS 1 AND ENTER TO CONTINUE.

Responses: CONTINUE 1

Programmer Instructions: Go to BOX_160.

NOTE TO PROGRAMMERS: A person level variable needs to store the response to EV15. If EV15 has a value, the Provider Probes section (PP10 or PP170) will use the information to determine a fill display for a person in the family or non-family subunit

Display Instructions: Display the RU members’ names that have at least 1 record reported at CA30_01-CA30_08.

Display RU member’s name (or you for respondent) selected at EV10 who didn’t report at least one record ‘1’ (YES HAS RECORD) at CA30_01-CA30_08.

Display ‘you” if the respondent has reported at least 1 record at CA30_01-CA30_08.

Display “and” if both the respondent and another RU member has at least 1 record reported at CA30_01–CA30_08.

EV20 (EV1020)

BLAISE NAME: EvntTp

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME}

Question Text:

& EV-1{A/B}

{Looking at show card EV-1{A/B}, at what type of place did {you/{PERSON}} receive the care?/

Looking at show card EV-1{A/B}, tell me if {you/{PERSON}} received the care at {a hospital/a hospital emergency room/home/a residential or long term care facility} or at some other type of place listed on the card?}

REFER TO QUICK REFERENCE GUIDE FOR EVENT TYPE FOLLOW-UP PROBES.

HELP: F1

Responses: HOSPITAL INPATIENT STAY (HS) 1 BOX_30 (EV1030)

HOSPITAL EMERGENCY ROOM (ER) 2 BOX_30 (EV1030)

HOSPITAL OUTPATIENT DEPARTMENT (OP) 3 BOX_30 (EV1030)

DENTAL OFFICE (DN) 4 BOX_30 (EV1030)

MEDICAL PROVIDER OFFICE OR CLINIC (MV) 5 BOX_30 (EV1030)

CARE RECEIVED AT HOME (HH) 6 EV50 (EV1050)

RESIDENTIAL OR LONG TERM CARE FACILITY (IC) 7 BOX_30 (EV1030)

{GLASSES/CONTACT LENSES} 8

{OTHER MEDICAL EXPENSES} 9

TELEHEALTH (TH) 10 BOX_30 (EV1030)

Programmer Instructions: NOTE to programmers: if coming from Calendar (CA) or Event Follow-Up (EF) and coded ‘8’ (GLASSES/CONTACTS), a person level variable needs to store this response. If EV20=8, OM10 will use the information to determine a fill display for this person to verify purchase of glasses or contacts during the reference period and go to BOX_160.

If coming from Off Path Section (OF) and coded ‘8’ (GLASSES/CONTACTS), display the following message “RECORD THE PURCHASE OF GLASSES IN THE OM SECTION IF AT (OR BEFORE) THE OM SECTION FOR THIS PERSON.

OTHERWISE, MAKE A COMMENT.” and then go to BOX_160.

If coming from Calendar (CA) or Event Follow-Up (EF) and coded ‘9’ (OTHER MEDICAL EXPENSES), go to EV25.

If coming from Off Path Section (OF) and coded ‘9’ (OTHER MEDICAL EXPENSES), display the following message “RECORD THE PURCHASE OF OTHER MEDICAL EXPENSES IN THE OM SECTION IF AT (OR BEFORE) THE OM SECTION FOR

Display Instructions: If coming from Off Path Route, Calendar (CA) or Event Follow-Up (EF) sections, display ‘B’.

Otherwise, display ‘A’. If coming from Off Path Route, Calendar (CA) or Event Follow-Up (EF) sections, display response options for “GLASSES/CONTACT LENSES” and “OTHER MEDICAL EXPENSES” Otherwise, use a null display.

Display “Looking at show card EV-1{A/B}, tell me if {you/{PERSON}} received the care at…”

If the event is coming from PP10, PP170, PP20, PP180, PP140, PP300, PP150, PP310, or if coming from the EE section and EE30=1 and the instance of EE is launched from any of those questions (PP10, PP170, PP20, PP180, PP140, PP300, PP150, PP310) AND

Display “a hospital” if coming from PP10 or PP170, or if coming from EE30, and EE30=1 and instance of EE was launched from PP10 or PP170.

Display “a hospital emergency room” if coming from PP20 or PP180 or if coming from EE30 and EE30=1 and instance of EE was launched from PP20 or PP180.

Display “at home” if coming from PP140 or PP300 or if coming from EE30 and EE30=1 and instance of EE was launched from PP140 or PP300.

Display “a residential or long term care facility” if coming from PP150 or PP310 or if coming from EE30 and EE30=1 and instance of EE was launched from PP150 or PP310.

Otherwise, display "Looking at show card EV-1{A/B}, at what type of place did {you/{PERSON}} receive the care?}

EV25 (EV1025)

BLAISE NAME: OMReminder

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME}

Question Text:

At this time we are just recording care received from health care providers. I have recorded this information and will remind you to tell me about {your/{PERSON}’s} medical purchases at a later point in the interview.

PRESS 1 AND ENTER TO CONTINUE.

Responses: CONTINUE 1

Programmer Instructions: Go to BOX_160.

NOTE TO PROGRAMMERS: A person level variable needs to store the response to EV25. If EV25 has a value, the Other Medical Expenses (OM) Section will use the information to determine a question display for the person being cycled on through the

Display Instructions:

BOX_30 (EV1030)

BOX_40 (EV1035)

EV30 (EV1040)

BLAISE NAME: HSICDatePicker

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME}{STR-DT}{END-DT}{EV} {NAME OF MEDICAL CARE PROVIDER......}

Question Text:

When {were/was} {you/{PERSON}} admitted to and discharged from {PROVIDER}? If {you/he/she} went more than once, please tell me all stays between {START DATE} and {END DATE}.

PRESS 1 AND ENTER TO LAUNCH DATE PICKER.

HELP: F1

Responses: CONTINUE 1 BOX_60 (EV1070)

EMPTY Empt BOX_60 (EV1070)

Programmer Instructions: Launch range date picker when ‘1’ (CONTINUE) is selected. CAPI will copy the dates selected at this instance of EV and move it into the Event Array. Control Variables must be set so that the dates selected at this instance are saved, to be used later in the EV section. Set a variable (e.g. CurrEventsIDs) to a dash delimited string with all EventIDs created at this EV30 instance.

Ideally, although these dates will be saved to the event array once FI moves past this screen, if FI was to back up, we would like for the dates that were selected during this instance to display as active and editable, with the option of “cancel” to move away and keep backing up or going forward without making any changes. If an FI backs-up over EV30, the ‘1’ (CONTINUE) should be emptied out so that the FI must select ‘1’ again to launch the datepicker. The datepicker should not automatically display during back-up and moving forward.

Hard Check: Before an interviewer moves off EV30 for the first time during this instance, there should be a check to determine that at least 1 event date was added at the datepicker. If at least one date was not added, display the datepicker and the message “At least one stay must be added.”

Edit check: If round 1 only, allow an admit date of one year prior to the start of the person's reference period begin date (BegRefM, BegRefD, BegRefY).

At completion of date picker, go to BOX_60.

Display Instructions:

EV40 (EV1045)

BLAISE NAME: OthEvntDatePicker

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME}{STR-DT}{END-DT} {EV} {NAME OF MEDICAL CARE PROVIDER......}-{DOC or DEPT}

Question Text:

When was {your/{PERSON's}} visit with {PROVIDER} - {DOC or DEPT}? Please tell me all the dates between {START DATE} and {END DATE}.

PRESS 1 AND ENTER TO LAUNCH DATE PICKER.

HELP: F1

Responses: CONTINUE 1 BOX_60 (EV1070)

EMPTY Empt BOX_60 (EV1070)

Programmer Instructions: Launch standard date picker when ‘1’ (CONTINUE) is selected. CAPI will copy the dates selected at this instance of EV and move it into the Event Array. Control Variables must be set so that the dates selected at this instance are saved, to be used later in the EV section. Set a variable (e.g. CurrEventsIDs) to a dash delimited string with all EventIDs created at this EV40 instance.

Setting a Recurrence Counter (gblDatePickRecurCnt): Each time event dates are added through the recurrence feature, across the length of the interview, implement a Recurrence counter. At the end of the interview, the counter should reflect the total number of times during the interview the recurrence feature was used. Deletion of any subset or even all of the dates added via the recurrence feature should not change the counter value. The counter value should be saved at the point the dates are saved in that instance of the date picker. If the interviewer uses the recurrence feature more than once during the same instance of the date picker (i.e., has not returned to main CAPI instrument since launching the date picker for a person-provider pair within a single event type), the counter should increment each time the recurrence feature is used.

Setting Recurrence Type (DatePickRecurType): There are 3 Recurrence Types –

RWK: Identifies when FI selects Recurrence method of “Daily/Weekly”

RMY: Identifies when FI selects Recurrence method of “Monthly by Day”

RMT: Identifies when FI selects Recurrence method of “Monthly by Date/Day Number”

Any event dates created as a result of selecting one of these recurrence methods should have the associated Recurrence Type (DatePickRecurType) saved to the corresponding event records.

Saving Recurrence Information to the Event Record: CAPI should write the following information about the method of event date selection to the event record in the event datamodel (MEPSSpring2019.EV_Main) for each date selected in an instance of the date picker for a person & provider pair within a single event type:

gblDatePickRecurCnt

DatePickRecurType

Both of these variables will hold the same value for each event date/record created as a result of a recurrence selection. If the interviewer uses the recurrence more than once in the same instance of the date picker (e.g., after launching the date picker for a person & provider pair within a single event type and before returning to main CAPI) the gblDatePickRecurCnt will have a different value for the second selection of the recurrence feature within that instance of the date picker than the first, and so on. If the recurrence feature is only selected once in that instance of the date picker, all event dates/records created as a result of that recurrence selection will have the same value for gblDatePickRecurCnt and the same value for DatePickRecurType.

Individual event dates selected without use of the Recurrence feature will have the gblDatePickRecurCnt=0 and DatePickRecurType=NoR on the event record.

Ideally, although these dates will be saved to the event array once FI moves past this screen, if the FI was to back up, we would like for the dates that were selected during this instance to display as active and editable, with the option of “cancel” to move away and keep backing up or going forward without making any changes. If an FI backs-up over EV40, the ‘1’ (CONTINUE) should be emptied out so that the FI must select ‘1’ again to launch the datepicker. The datepicker should not automatically display during back-up and moving forward.

Hard Check: Before an interviewer moves off EV40 for the first time during this instance, there should be a check to determine that at least 1 event date was added at the datepicker. If at least one date was not added, display the datepicker and the message “At least one visit must be added.”

Note: The datepicker will only display the dates within the person's reference period.

At completion of date picker go to BOX_60.

Display Instructions:

EV50 (EV1050)

BLAISE NAME: HHEvntTp

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME}{STR-DT}{END-DT}

Question Text:

Thinking about the health care {you/{PERSON}} received at home, was the person who provided the care a friend or neighbor, a relative, a volunteer, or some type of provider who was paid? Please do not include health care received from friends or relatives living here.

PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

NOTE: SELECT ONLY ONE TYPE OF PROVIDER AT THIS TIME.

HELP: F1

Responses: FRIEND/NEIGHBOR 1 EV70_01 (EV1065)

RELATIVE 2 EV70_01 (EV1065)

VOLUNTEER 3 EV70_01 (EV1065)

OTHER - PAID 4 EV60 (EV1055)

VOLUNTEER: MEAL DELIVERY 5 BOX_160 (EV1235)

Programmer Instructions: If coded ‘1’ (FRIEND/NEIGHBOR):

-Add ‘FRIEND(S) OR NEIGHBOR(S)’ to the RU-medical-providers-roster, person-

type-provider name column. No address information is necessary.

If coded ‘2’ (RELATIVE):

-Add ‘RELATIVE(S)’ to the RU-medical-providers-roster, person-type-provider name column. No address information is necessary.

If coded ‘3’ (VOLUNTEER):

-Add ‘VOLUNTEER(S)’ to the RU-medical-providers-roster, person-type-provider name column. No address information is necessary.

If coded ‘5’ (VOLUNTEERED: MEAL DELIVERY SERVICE), create an event record with HH as the event type and the only attribute for this record is VOLUNTEERED:

MEAL DELIVERY SERVICE. No other information is necessary.

If EV50 is coded '1' (FRIEND/NEIGHBOR), '2' (RELATIVE), or '3' (VOLUNTEER), flag provider as ‘INFORMAL’ for PROV.HHTYPE (this will have to be replaced when we know what variable it is being stored as).

Display Instructions:

EV60 (EV1055)

BLAISE NAME: EvntAgencySelf

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}{END-DT}

Question Text:

Did this person work for a home health agency, hospital, or nursing home or did they work for themselves?

PROBE: Do you have a brochure, folder, binder of papers, telephone listing, or anything which might help?

Responses: WORKED FOR AGENCY, HOSPITAL, OR NURSING HOME 1 BOX_50 (EV1060)

WORKED FOR SELF 2 BOX_50 (EV1060)

REFUSED RF BOX_50 (EV1060)

DON'T KNOW DK BOX_50 (EV1060)

Display Instructions:

BOX_50 (EV1060)

EV70_01 (EV1065)

BLAISE NAME: HHMth1

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}{STR-DT}{END-DT} {EV}{NAME OF MEDICAL CARE PROVIDER…}

Question Text:

Did {someone from} {PROVIDER} provide home care services for {you/{PERSON}}……during the month of {MONTH_1}?

Responses: YES 1

NO 2

REFUSED RF

DON'T KNOW DK

Programmer Instructions: Preloaded Grid Type 1- forced navigation including EV70_01, EV70_02, EV70_03, EV70_04…, EV70_N.

If the current round interview month is coded ‘1’ (YES), the HH utilization section will not be asked this round and set the status of this event to ‘95’ (OPEN HH EVENT) to be followed up on in the next round.

Grid must accommodate at least 12 months.

‘RF’ (REFUSED) and ‘DK’ (DON’T KNOW) are allowed for EV70_01, EV70_02, EV70_03, EV70_04…, EV70_N. However, they will be treated as a ‘NO’ when creating events.

For each month that is coded '1' (YES), CAPI will create one event for that person-provider pair.

Display Instructions: Roster 1 Report.

Display Months

Col#1 Header: Months

Instructions: Display months according to specifications in roster filter.

Roster Filter:

Display all months in person’s reference period including the previous round interview month.

If, however, the previous round interview month was already coded ‘YES’ during the previous interview do not display here. Display the subsequent month. Display the following variable question text wording in person’s reference period for the months following the first:

EV70_02. How about in {MONTH_2}?

EV70_03. How about in {MONTH_3}?

EV70_04. …during the month of {MONTH_4}?

EV70_N. How about in {MONTH_N}?

Repeat variable question text for EV70_01-EV70_N for months beyond.

Display “Did {someone from} {PROVIDER} provide home care services for…” in black bold text for every fourth question in this grid, otherwise, display in lighter grayed-out text.

Display ‘someone from’ if provider is a facility. Otherwise, use a null display.

BOX_60 (EV1070)

EV80 (EV1075)

BLAISE NAME: HSFollowER

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {EV} {NAME OF MEDICAL CARE PROVIDER…}

Question Text:

Did {any of} {your/PERSON}’s} {visit/visits} to the emergency room lead to an admission to the hospital on the same day or the next day?

Responses: YES 1

NO 2 BOX_160 (EV1235)

REFUSED RF BOX_160 (EV1235)

DON'T KNOW DK BOX_160 (EV1235)

Programmer Instructions: Use the variable CurrEventIDs created at EV40. If CurrEventIDs consists of exactly one EventID then use a null display for the first fill and display "visit" for the second fill. If

CurrEventIDs consists of more than one EventID, then display "any of" for the first fill and display "visits" for the second fill.

If EV80 is coded ‘1’ (YES) and more than one emergency room (ER) event record at EV40 in this pass through the EV section, continue with EV90.

If EV80 is coded ‘1’ (YES) and exactly one emergency room (ER) event record at EV40 in this pass through the EV section, auto-code that ER event at EV90 and then go to LOOP_10.

If EV80 is coded ‘1’ (YES), create another event record for the person currently looping on this instance of the EV section and the type is an HS event. The provider and date

Display Instructions: Display “any of” if more than 1 ER event record at EV40 in this pass through the EV section. Otherwise, use a null display.

Display “visit” if exactly 1 ER event record at EV40 in this pass through the EV section. Otherwise, display “visits”.

EV90 (EV1080)

BLAISE NAME: ERLinkRoster1

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {EV} {NAME OF MEDICAL CARE PROVIDER…}

Question Text:

Which emergency room visit or visits were followed by a hospital stay?

ENTER ALL THAT APPLY.

Date Provider

Responses: {MONTH, DAY, YEAR} {MONTH, DAY, YEAR} {PROVIDER}1 1

{MONTH, DAY, YEAR} {MONTH, DAY, YEAR} {PROVIDER}2 2

{MONTH, DAY, YEAR} {MONTH, DAY, YEAR} {PROVIDER}3 3

{MONTH, DAY, YEAR} {MONTH, DAY, YEAR} {PROVIDER}4 4

{MONTH, DAY, YEAR} {MONTH, DAY, YEAR} {PROVIDER}N 5

Programmer Instructions: Use the variable CurrEventIDs created at EV40 to be able to list the correct response options for event dates and provider names.

For each ER visits selected at EV90, create another event record. The event type is HS, and the person is the RU member in the context header. The two events are linked in BOX_90.

Go to LOOP_10.

Roster Behavior:

Multiple select allowed.

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

Roster definition:

Display only ER events that were just recorded at EV40 in this current pass through the EV section.

The headings Date and Provider should appear in the response pane located directly above the {MONTH, DAY, YEAR} and {PROVIDER} displayed in two columns.

Roster Filter:

Display only those events with the following characteristics:

Event was created this round.

Event is for this person.

Event has event type of ‘ER’

4. Event recorded at EV40 in this current pass through the EV section.

5. Event does not have DeleteFlg=Yes.

LOOP_10 (EV1085)

BOX_70 (EV1090)

EV100 (EV1093)

BLAISE NAME: HSLinkRoster1

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}{END-DT} {EV} {NAME OF MEDICAL CARE PROVIDER…}

Question Text:

Which hospital stay followed {your/{PERSON}’s} emergency room visit to {PROVIDER} on {VISIT DATE}?

Admit date Discharge date Provider

Responses: HOSPITAL STAY NOT YET 0

{MONTH, DAY, YEAR} {MONTH, DAY,YEAR} {PROVIDER} 1 1

{MONTH, DAY, YEAR} {MONTH, DAY,YEAR} {PROVIDER} 2 2

{MONTH, DAY, YEAR} {MONTH, DAY,YEAR} {PROVIDER} 3 3

{MONTH, DAY, YEAR} {MONTH, DAY,YEAR} {PROVIDER} 4 4

{MONTH, DAY, YEAR} {MONTH, DAY,YEAR} {PROVIDER} N 5

Programmer Instructions: Roster behavior:

Single select allowed.

If HS event selected, go to BOX_90. If EV100 is coded ‘0’ (HOSPITAL STAY NOT LISTED) go to EV110.

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

Roster definition:

This item displays all HS events reported for this person during this round.

The headings Admit Date, Discharge date, and Provider should appear in the response pane located directly above the {MONTH, DAY, YEAR} {MONTH, DAY, YEAR} and {PROVIDER} displayed in three columns.

Roster Filter:

Display only those events with the following characteristics:

Event was created this round or was created in the immediate previous round and had a discharge date of ‘95’ (STILL IN HOSPITAL).

Event is for this person.

3. Event has event type of ‘HS’.

4. Event has an admit date after the ER visit date selected at EV90 that is currently being looped on.

5. Event does not have DeleteFlg=Yes.

EV110 (EV1095)

BLAISE NAME: ERHSSameProv1

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}{END-DT}

{EV}{NAME OF MEDICAL CARE PROVIDER…}

Question Text:

Was the hospital stay that followed {your/{PERSON}’s} emergency room visit on {VISIT DATE} also to {PROVIDER}?

Responses: YES 1 EV120 (EV1110)

NO 2 BOX_80 (EV1105)

REFUSED RF EV120 (EV1110)

DON'T KNOW DK EV120 (EV1110)

Programmer Instructions: If coded ‘1’ (YES), ‘RF’ (REFUSED), or ‘DK’ (DON’T KNOW), link the HS event record in process of being created to the same provider as the ER event being looped on.

Display Instructions: Display the "VISIT DATE" selected at EV90.

BOX_80 (EV1105)

EV120 (EV1110)

BLAISE NAME: HSBegDate

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}

Question Text:

What date {were/was} {you/{PERSON}} admitted to and discharged from {HS EVENT PROVIDER} after {your/{PERSON}’s} emergency room visit on {VISIT DATE} {also} to {ER EVENT PROVIDER}?

ENTER ADMIT DATE:

Responses: 1 EV130 (EV1115)

Programmer Instructions: Hard check: The HS admittance date entered at EV120 should be on or within 5 days after the ER visit date selected at EV90 and currently being cycled on. If the admittance date for the hospital stay is >6 days after the ER visit, display the following message:

"HOSPITAL STAY FOLLOWING THIS ER VISIT ON {VISIT DATE} MUST HAVE BEEN ON OR WITHIN 5 DAYS AFTER THE {VISIT DATE}. CORRECT DATE ON BACK-UP TO EV80 (HSFollowER) AND DO NOT LINK THIS HOSPITAL STAY TO THIS ER VISIT. THE HOSPITAL STAY SHOULD BE ENTERED AS A STAND-ALONE EVENT."

Hard check: The admittance date entered at EV120 should be after the ER visit selected at EV90, and is currently being cycled on. If the admittance date entered is before the ER visit, display the following message: HOSPITAL STAY THAT FOLLOWED THE EMERGENCY ROOM VISIT ON {VISIT DATE} CANNOT BEGIN BEFORE {VISIT DATE}. HOSPITAL STAY THAT FOLLOWED THE ER VISIT MUST HAVE BEEN ON OR WITHIN 5 DAYS AFTER {VISIT DATE}. CORRECT DATE OR BACK-UP TO EV90 (ERLinkRoster1) AND DO NOT LINK THIS HOSPITAL STAY TO THE ER VISIT. THE HOSPITAL STAY SHOULD BE ENTERED AS A STAND-ALONE EVENT."

Hard check: If date entered is before the RU member's reference period, display the

Display Instructions: Display EV120, EV130, and EV140 on the same form pane.

Display “also” if EV110 is coded ‘1’ (YES), otherwise use null display. Display “VISIT DATE” if looping on more than one date in LOOP_10.

For {HS EVENT PROVIDER} display the provider name of the HS event currently looping on selected or added at EV100.

For {ER EVENT PROVIDER} display the provider name of the ER event selected at EV90.

Display the date field for the Admit date here.

EV130 (EV1115)

BLAISE NAME: StillInHS

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {EV} {NAME OF MEDICAL CARE PROVIDER….}

Question Text:

[What date {were/was} {you/{PERSON}} admitted to and discharged from {HS EVENT PROVIDER} after {your/{PERSON}’s}emergency room visit on {VISIT DATE} {also} to {ER EVENT PROVIDER}?]

PRESS 1 AND ENTER TO SELECT A DISCHARGE DATE. PRESS 95 TO INDICATE PERSON IS STILL IN THE HOSPITAL.

Responses: DISCHARGE DATE 1 EV140 (EV1117)

STILL IN THE HOSPITAL 95 BOX_90 (EV1120)

Display Instructions: Display EV120, EV130, and EV140 on the same form pane.

For {HS EVENT PROVIDER} display the provider name of the HS event currently looping on selected or added at EV100.

For {ER EVENT PROVIDER} display the provider name of the ER event selected at EV90.

Display “What date were…” in brackets and lighter grayed out text.

EV140 (EV1117)

BLAISE NAME: HSEndDate

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {EV} {NAME OF MEDICAL

Question Text:

[What date {were/was} {you/{PERSON}} admitted to and discharged from {HS EVENT PROVIDER} after

{your/{PERSON}’s}emergency room visit on {VISIT DATE} {also} to {ER EVENT PROVIDER}?]

DISCHARGE DATE:

Responses: 1 BOX_90 (EV1120)

Programmer Instructions: Hard check: Discharge date must be on or after Admit date. If the FI selects a date before the Admit date display: DISCHARGE DATE MUST ON OR AFTER ADMITTANCE DATE. CONFIRM DATES WITH RESPONDENT.

Hard check: If date entered is after the RU member's reference period, display the following message: 'YOU MUST SELECT A DISCHARGE DATE WITHIN THE REFERENCE PERIOD'.

Hard check: Beginning in Spring 2019, MEPS does not allow the entry of a zero night stay for any HS or IC event. Only stays of at least one night are allowed. If the discharge date entered is the same date as the admission date (EvntEndDate/HSEndDate=EvntBegDate/HSBegDate), display the following message:

“You have entered a stay with the same admit and discharge date. MEPS defines hospital and institutional stays as requiring at least one night in the facility.” Verify dates with respondent.

If the person stayed in the hospital/facility overnight:

Correct the admit/discharge dates.

If the person was seen on this day for outpatient treatment or did not stay at least one night:

Back-up to ED20.

Delete this event.

Re-add event as an OP event.

Display Instructions: Display EV120, EV130, and EV140 on the same form pane.

For {HS EVENT PROVIDER} display the provider name of the HS event currently looping on selected or added at EV100.

For {ER EVENT PROVIDER} display the provider name of the ER event selected at EV90.

Display the date field for the discharge date here. Display “What date were…” in brackets and lighter grayed out text.

BOX_90 (EV1120)

END_LP10 (EV1125)

EV150 (EV1130)

BLAISE NAME: ERLeadHS

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT} {EV} {NAME OF MEDICAL CARE PROVIDER…}

Question Text:

Did a visit to the emergency room lead to {any of} {your/{PERSON}’s} admission{s} to the hospital that began on {ADMIT

DATE}?

Responses: YES 1

NO 2 BOX_160 (EV1235)

REFUSED RF BOX_160 (EV1235)

DON'T KNOW DK BOX_160 (EV1235)

Programmer Instructions: If EV150 is coded ‘1’ (YES) and more than 1 HS event recorded at EV30 in this pass through of the EV section, continue with EV160.

If EV150 is coded ‘1’ (YES) and exactly 1 HS event recorded at EV30 in this pass through the EV section, auto-code that HS event at EV160 and go to LOOP_20.

If EV150 is coded ‘1’ (YES), create another event record for the person currently looping on this instance of the EV section and the type is an ER event. The provider and date will be collected in LOOP_20 for this newly created linked ER event.

Display Instructions: Use the variable CurrEventIDs created at EV30. If CurrEventIDs consists of exactly one EventID then use a null display for the first fill and display “admission” for the second fill. If CurrEventIDs consists of more than one EventID, then use "any of" for the first fill and display “admissions” for the second fill.

EV160 (EV1135)

BLAISE NAME: HSLinkRoster2

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT} {EV} {NAME OF MEDICAL CARE PROVIDER…}

Question Text:

Which hospital stay(s) were preceded by a visit to the emergency room?

ENTER ALL THAT APPLY.

Admit Date Discharge Date Provider

Responses: {MONTH, DAY, YEAR} {MONTH, DAY, YEAR} {PROVIDER}1 1

{MONTH, DAY, YEAR} {MONTH, DAY, YEAR} {PROVIDER}2 2

{MONTH, DAY, YEAR} {MONTH, DAY, YEAR} {PROVIDER}3 3

{MONTH, DAY, YEAR} {MONTH, DAY, YEAR} {PROVIDER}4 4

{MONTH, DAY, YEAR} {MONTH, DAY, YEAR} {PROVIDER}N 5

Programmer Instructions: Use the variable CurrEventIDs created at EV30 to be able to list the correct response options for event dates and provider names.

For each HS stay selected at EV160, create another event record. The event type is ER, and the person is the RU member in the context header. The two events are linked in BOX_120.

Go to LOOP_20.

Roster behavior:

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

Roster definition:

This item displays all HS events reported for this person during this round.

The headings Admit Date, Discharge Date, and Provider should appear in the response pane located directly above the {MONTH, DAY, YEAR} {MONTH, DAY, YEAR} and {PROVIDER} displayed in three columns.

Roster filter:

Display only those events with the following characteristics:

Event was created this round.

Event is for this person.

Event has event type “HS”.

4. Event recorded at EV30 in this current pass through the EV section.

5. Event does not have DeleteFlg=Yes.

LOOP_20 (EV1140)

BOX_100 (EV1145)

EV170 (EV1150)

BLAISE NAME: ERLinkRoster2

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}

Question Text:

Which emergency room visit led to {your/{PERSON}’s} admission on {ADMIT DATE}?

Date Provider

Responses: ER VISIT NOT YET RECORDED 0

{MONTH, DAY, YEAR} {PROVIDER} 1 1

{MONTH, DAY, YEAR} {PROVIDER} 2 2

{MONTH, DAY, YEAR} {PROVIDER} 3 3

{MONTH, DAY, YEAR} {PROVIDER} 4 4

{MONTH, DAY, YEAR} {PROVIDER} 5

Programmer Instructions: Roster behavior:

Single select only.

If ER event is selected, go to BOX_120. If EV170 is coded ‘0’ (EMERGENCY ROOM VISIT NOT LISTED), go to EV180.

Display Instructions: Roster 2 – No add/edit/delete allowed

Roster definition:

Display all ER events reported for this person in this round.

The headings Date and Provider should appear in the response pane located directly above the {MONTH, DAY, YEAR} and {PROVIDER} displayed in two columns.

Roster filter:

Display only those events with the following characteristics.

Event was created this round.

Event is for this person.

3. Event has event type of ‘ER’.

4. Event visit date is not after the HS admit date selected at EV160.

5. Event does not have DeleteFlg=Yes.

EV180 (EV1155)

BLAISE NAME: ERHSSameProv2

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT} {EV}

{NAME OF MEDICAL CARE PROVIDER…}

Question Text:

Was the emergency room visit that led to {your/{PERSON}’s} hospital stay that started on {ADMIT DATE} also to {PROVIDER}?

Responses: YES 1 EV190 (EV1165)

NO 2 BOX_110 (EV1160)

REFUSED RF EV190 (EV1165)

DON'T KNOW DK EV190 (EV1165)

Programmer Instructions: If coded ‘1’ (YES), ‘RF’ (REFUSED), or ‘DK’ (DON’T KNOW), link event in process of being created to the same provider as the HS event being looped on.

Display Instructions: Display the {ADMIT DATE} of the HS event selected at EV160.

BOX_110 (EV1160)

EV190 (EV1165)

BLAISE NAME: ERDate

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}

Question Text:

What date did {you/{PERSON}} visit the emergency room at {ER EVENT PROVIDER} that led to {your/his/her} hospital stay on {ADMIT DATE} {also} to {HS EVENT PROVIDER}?

Responses: 1 BOX_120 (EV1170)

Programmer Instructions: Hard check: The emergency room visit date entered at EV190 should be <=5 days prior to the admit date of the hospital stay selected at EV160 and is currently being cycled on. If the visit date entered is >6 days prior to the admit date of this HS stay, display the following message: "EMERGENCY ROOM VISIT LEADING TO THIS HOSPITAL STAY ON {ADMIT DATE} MUST HAVE BEEN ON OR WITHIN 5 DAYS BEFORE {ADMIT DATE}. CORRECT DATE OR BACK-UP TO EV150 (ERLeadHS) AND DO NOT LINK THIS ER VISIT TO THE HOSPITAL STAY.

THE ER VISIT SHOULD BE ENTERED AS A STAND-ALONE EVENT."

Hard check: The emergency room visit date entered at EV190 should be before the admit date of the hospital stay selected at EV160 and is currently being looped on. If the visit date entered is after the admit date of the HS stay, display the following message:

"EMERGENCY ROOM VISIT LEADING TO HOSPITAL STAY ON {ADMIT DATE} CANNOT BEGIN AFTER {ADMIT DATE}. ER VISIT LEADING TO HS STAY MUST HAVE BEEN ON OR WITHIN 5 DAYS BEFORE {ADMIT DATE}. CORRECT DATE OR BACK-UP TO EV150 (ERLeadHS) AND DO NOT LINK THIS ER VISIT TO THE HOSPITAL STAY. THE ER VISIT SHOULD BE ENTERED AS A STAND-ALONE EVENT."

Hard check: If date entered is before the RU member's reference period, display the following message: 'YOU MUST SELECT A VISIT DATE WITHIN THE

Display Instructions: Display “also” if EV180 is coded ‘1’ (YES), otherwise use null display.

Display the date field for the visit date here.

For {ER EVENT PROVIDER} display the provider name of the ER event currently looping on selected or added at EV170.

For {HS EVENT PROVIDER} display the provider name for the HS event selected at EV160.

BOX_120 (EV1170)

END_LP20 (EV1175)

EV200 (EV1180)

BLAISE NAME: ICFollowHS

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}{EV}{NAME OF MEDICAL CARE PROVIDER…}

Question Text:

Did an admission to the hospital lead to {any of} {your/{PERSON}’s}} stay{s} at {PROVIDER}?

Responses: YES 1

NO 2 BOX_160 (EV1235)

REFUSED RF BOX_160 (EV1235)

DON'T KNOW DK BOX_160 (EV1235)

Programmer Instructions: Use the variable CurrEventIDs created at EV30. If CurrEventIDs consists of exactly one EventID then use a null display for the first fill and display "stay" for the second fill. If CurrEventIDs consists of more than one EventID, then display "any of" for the first fill and display "visits" for the second fill.

If EV200 is coded ‘1’ (YES) and more than 1 IC event recorded at EV30 in this pass through the EV section, continue with EV210.

If EV200 is coded ‘1’ (YES) and exactly 1 IC event recorded at EV30 in this pass through the EV section, auto-code that IC event at EV210 and go to LOOP_30.

If EV200 is coded ‘1’ (YES), create event record for person currently looping on where the event type is HS. Provider and date will be collected in LOOP_30 for this newly created linked HS event.

Display Instructions: Display “any of” and “s” on stays if more than 1 IC event record at EV30 in this pass through the EV section. Otherwise, use a null display.

For {PROVIDER} display the name of the IC provider currently being looped on.

EV210 (EV1185)

BLAISE NAME: ICLinkRoster

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {EV} {NAME OF MEDICAL CARE PROVIDER…}

Question Text:

Which stay(s) at {PROVIDER} was preceded by a hospital stay?

ENTER ALL THAT APPLY.

Admit Date Discharge Date Provider

Responses: {MONTH, DAY, YEAR} {MONTH, DAY, YEAR} {PROVIDER}1 1

{MONTH, DAY, YEAR} {MONTH, DAY, YEAR} {PROVIDER}2 2

{MONTH, DAY, YEAR} {MONTH, DAY, YEAR} {PROVIDER}3 3

{MONTH, DAY, YEAR} {MONTH, DAY, YEAR} {PROVIDER}4 4

{MONTH, DAY, YEAR} {MONTH, DAY, YEAR} {PROVIDER}N 5

Programmer Instructions: Use the variable CurrEventIDs created at EV30 to be able to list the correct response options for event dates and provider names.

For each IC stay selected at EV210, create another event record. The event type is HS, and the person is the RU member in the context header. The two events are linked in BOX_150.

Go to LOOP_30.

Roster Behavior:

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

Roster definition: This item displays the IC events that were just recorded at EV30 in this current pass through of the EV section.

The headings Admit Date, Discharge date, and Provider should appear in the response pane located directly above the {MONTH, DAY, YEAR} {MONTH, DAY, YEAR} and {PROVIDER} displayed in three columns.

Roster filter: Display only those events with the following characteristics.

Event was created this round.

Event was created for this person.

Event has event type ‘IC’.

4. Event recorded at EV30 in this current pass through the EV section.

5. Event does not have DeleteFlg=Yes.

For {PROVIDER} display the name of the IC provider currently being looped on.

LOOP_30 (EV1190)

BOX_130 (EV1195)

EV220 (EV1200)

BLAISE NAME: HSLinkRoster3

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}{EV} {NAME OF MEDICAL CARE PROVIDER…}

Question Text:

Which hospital stay led to {your/{PERSON}’s} admission to {PROVIDER} on {ADMIT DATE}?

Admit Date Discharge Date Provider

Responses: HOSPITAL STAY NOT YET 0

{MONTH, DAY, YEAR} {MONTH, DAY,YEAR} {PROVIDER} 1 1

{MONTH, DAY, YEAR} {MONTH, DAY,YEAR} {PROVIDER} 2 2

{MONTH, DAY, YEAR} {MONTH, DAY,YEAR} {PROVIDER} 3 3

{MONTH, DAY, YEAR} {MONTH, DAY,YEAR} {PROVIDER} 4 4

{MONTH, DAY, YEAR} {MONTH, DAY,YEAR} {PROVIDER} N 5

Programmer Instructions: Roster behavior:

Single select only.

If HS event is selected, go to BOX_150. If EV220 is coded ‘0’ (HOSPITAL STAY NOT LISTED), go to EV230.

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

The headings Admit Date, Discharge date, and Provider should appear in the response pane located directly above the {MONTH, DAY, YEAR} {MONTH, DAY, YEAR} and {PROVIDER} displayed in three columns.

Roster definition:

Display all HS events linked to this person.

Roster filter:

Display only those events with the following characteristics.

Event was created this round or was created in the immediate previous round and had a discharge date of ‘95’ (STILL IN HOSPITAL).

Event is for this person.

3. Event has event type of ‘HS’.

4. Event has an admit date that does not take place after the admit date of the IC event selected at

EV210 currently looping on.

5. Event does not have DeleteFlg=Yes.

For {PROVIDER} display the name of the IC provider currently being looped on.

EV230 (EV1205)

BLAISE NAME: HSICSameProv

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}{EV} {NAME OF MEDICAL CARE PROVIDER…}

Question Text:

Was the hospital stay that led to {your/{PERSON}’s} admission to {PROVIDER} on {ADMIT DATE} also to

{PROVIDER}?

Responses: YES 1 EV240 (EV1215)

NO 2 BOX_140 (EV1210)

REFUSED RF EV240 (EV1215)

DON'T KNOW DK EV240 (EV1215)

Programmer Instructions: If coded ‘1’ (YES), ‘RF’ (REFUSED) or ‘DK’ (DON’T KNOW), link event in process of being created as to the same provider as the IC event being looped on.

Display Instructions: Display the “ADMIT DATE” for the IC event currently being looped on.

For {PROVIDER} display the name of the IC provider currently being looped on in both the question text fill and also the context header.

BOX_140 (EV1210)

EV240 (EV1215)

BLAISE NAME: HSBegDate2

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}

Question Text:

What date {were/was} {you/{PERSON}} admitted to and discharged from {HS EVENT PROVIDER} that led to {your/his/her} stay on {ADMIT DATE} {also} to {IC EVENT PROVIDER}?

ENTER ADMIT DATE:

Responses: 1 EV250 (EV1220)

Programmer Instructions: Hard check: The admittance date entered at EV240 should be before the IC visit selected at EV210, and is currently being cycled on. If the HS admittance date entered is after the IC visit, display the following message: IT IS UNLIKELY THAT THE HOSPITAL ADMISSION DATE IS AFTER THE STAY AT {PROVIDER} ON {ADMIT DATE}. RESPONDENT SAID THEY HAD A HOSPITAL ADMISSION BEFORE THEIR STAY AT {PROVIDER} VISIT. CHECK TO MAKE SURE THE DATE IS CORRECT AND MAKE THE NECESSARY CORRECTIONS.

Display the IC provider currently being looped on for {PROVIDER} for the hard check message.

Hard check: If date entered is before the RU member's reference period, display the following message: 'YOU MUST SELECT AN ADMITTANCE DATE WITHIN THE REFERENCE PERIOD'.

Display Instructions: Display “also” if EV230 is coded ‘1’ (YES), otherwise use null display.

For {HS EVENT PROVIDER} display the provider name of the HS event selected at EV220.

For {IC EVENT PROVIDER} display the provider name of the IC event selected or added at EV220.

Display EV240, EV250, and EV260 on the same form pane.

Display the date field for the Admit date here.

EV250 (EV1220)

BLAISE NAME: StillInHS2

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}

Question Text:

[What date {were/was} {you/{PERSON}} admitted to and discharged from {HS EVENT PROVIDER} that led to {your/his/her} stay on {ADMIT DATE} {also} to {IC EVENT PROVIDER}?]

PRESS 1 AND ENTER TO SELECT THE DISCHARGE DATE. PRESS 95 TO INDICATE PERSON IS STILL IN THE HOSPITAL.

Responses: DISCHARGE DATE 1 EV260 (EV1222)

STILL IN THE HOSPITAL 95 BOX_150 (EV1225)

Display Instructions: Display EV240, EV250, and EV260 on the same form pane.

Display “also” if EV230 is coded ‘1’ (YES), otherwise use null display.

For {HS EVENT PROVIDER} display the provider name of the HS event selected at EV220.

For {IC EVENT PROVIDER} display the provider name of the IC event selected or added at EV210.

Display “What date were…” in brackets and lighter grayed out text.

EV260 (EV1222)

BLAISE NAME: HSEndDate2

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}

Question Text:

[What date {were/was} {you/{PERSON}} admitted to and discharged from {HS EVENT PROVIDER} that led to {your/his/her} stay on { ADMIT DATE} {also} to {IC EVENT PROVIDER}?]

ENTER DISCHARGE DATE:

Responses: 1 BOX_150 (EV1225)

Programmer Instructions: Hard check: Discharge date must be on or after Admit date. If the FI selects a date before the Admit date display: DISCHARGE DATE MUST BE ON OR AFTER ADMITTANCE DATE. CONFIRM DATES WITH RESPONDENT.

Hard check: If date entered is after the RU member's reference period, display the following message: 'YOU MUST SELECT A DISCHARGE DATE WITHIN THE REFERENCE PERIOD'.

Hard check: Beginning in Spring 2019, MEPS does not allow the entry of a zero night stay for any HS or IC event. Only stays of at least one night are allowed. If the discharge date entered is the same date as the admission date (EvntEndDate/HSEndDate2=EvntBegDate/HSBegDate2), display the following message: “You have entered a stay with the same admit and discharge date. MEPS defines hospital and institutional stays as requiring at least one night in the facility.”

Verify dates with respondent.

If the person stayed in the hospital/facility overnight:

Correct the admit/discharge dates.

If the person was seen on this day for outpatient treatment or did not stay at least one night:

Back-up to ED20.

Delete this event.

3. Re-add event as an OP event.

Display Instructions: Display EV240, EV250, and EV260 on the same form pane.

For {HS EVENT PROVIDER} display the provider name of the HS event selected at EV220.

For {IC EVENT PROVIDER} display the provider name of the IC event selected or added at EV220.

Display the date field for discharge date.

BOX_150 (EV1225)

END_LP30 (EV1230)

BOX_160 (EV1235)

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