Attachment 39 Attachment 39 – HC Institutional Care Section

SpecWriter Data

Form Version:

10/17/2017 4:08:32 PM

Report Type:

Full Detail

Project Database:
Language:

English

WESSQL6.MEPS_V2

Spec Label:

This is the cover page. Additional contents currently project specific.

IC - Page 1 of 6

MEPS_V2

Institutional Care Stay (IC) Section
(Rout

Full Detail Spec

BOX_00

Route Details:

(IC1000)

Item Type: Route

Type Class: If Then

01 Box = BOX_00, BOX_10
04 S ingle S e le ct = IC10, IC20
11 Multiple S e le ct with Add/Edit/De le te = IC30
Ros te r 3 = IC30

BOX_05

Programmer
Instructions:

(IC1005)

Item Type: Route

Type Class: If Then

If provider already has IC10 (provider type) recorded for this round (for any RU member) or
in a previous round (for any RU member) (preload.ICPlaceTp=1) go to IC20, otherwise,
continue with IC10.

IC - Page 2 of 6

MEPS_V2

Institutional Care Stay (IC) Section
(Que

Full Detail Spec

IC10
Item Type:

(IC1010)
Question

Type Class:

Enumerated

Answer Type:

TIC10_PLACE

BLAISE NAME: ICPlaceTP
Field kind: Datafield
ArrayMin:
Field Size:
Answers allowed: 1

Help Available (ICPlaceHelp)
Context Header:

Min value:

ArrayMax:

Show Card (IC-1)

Max value:

Look Up File (

)

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER......} {ADM-DT}
{DIS-DT}

Question Text:
IC-1.
Looking at card IC-1, what kind of place is {PROVIDER}?
HELP: F1

Responses:

INPATIENT REHABILITATION FACILITY
OR CONVALESCENT HOME
NURSING HOME
RESIDENTIAL MENTAL HEALTH
TREATMENT CENTER
RESIDENTIAL EATING DISORDER
TREATMENT CENTER
RESIDENTIAL DRUG AND ALCOHOL OR
ADDICTION TREATMENT CENTER
RESIDENTIAL HOSPICE CARE
RESIDENTIAL RESPITE CARE
OTHER
REFUSED
DON'T KNOW

1

IC20

(IC1015)

2
3

IC20
IC20

(IC1015)
(IC1015)

4

IC20

(IC1015)

5

IC20

(IC1015)

6
7
91
RF
DK

IC20
IC20
IC20
IC20
IC20

(IC1015)
(IC1015)
(IC1015)
(IC1015)
(IC1015)

Display
Instructions:

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.IC_Main
Variable stored at MEPSSpring2018_Event.IC_Main

IC - Page 3 of 6

MEPS_V2

Institutional Care Stay (IC) Section
(Que

Full Detail Spec

IC20
Item Type:

(IC1015)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (
Context Header:

)

BLAISE NAME: ICRelCond
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

Show Card (

ArrayMax:

Max value:

)

Look Up File (

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER......} {ADM-DT}
{DIS-DT}

Question Text:
Was {your/{PERSON}’s} stay at {PROVIDER} related to any specific health condition or were any conditions discovered
during this stay?

Responses:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

Display
Instructions:

Testing/Editing
Notes:

Variable collected at MEPSSpring2018.IC_Main
Variable stored at MEPSSpring2018_Event.IC_Main

IC - Page 4 of 6

IC30
BOX_10
BOX_10
BOX_10

(IC1020)
(IC1025)
(IC1025)
(IC1025)

)

MEPS_V2

Institutional Care Stay (IC) Section
(Que

Full Detail Spec

IC30
Item Type:

(IC1020)
Question

Type Class:

Enumerated

Answer Type:

TCONDITION

BLAISE NAME: ICCondRoster
Field kind: Datafield
ArrayMin:
Field Size:
Answers allowed: 1

Help Available (CondHelp)
Context Header:

Min value:

ArrayMax:

Show Card (

Max value:

)

Look Up File (

)

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER......} {ADM-DT}
{DIS-DT}

Question Text:
What conditions were discovered or led {you/{PERSON}} to enter {PROVIDER}?
PROBE: Any other condition?
ENTER ALL THAT APPLY
CTRL-A: ADD
CTRL-E: EDIT
CTRL-D: DELETE
HELP: F1

Responses:

{MEDICAL CONDITION} 1
{MEDICAL CONDITION} 2
{MEDICAL CONDITION} 3
{MEDICAL CONDITION} 4
{MEDICAL CONDITION}N

1
2
3
4
5

IC - Page 5 of 6

BOX_10
BOX_10
BOX_10
BOX_10
BOX_10

(IC1025)
(IC1025)
(IC1025)
(IC1025)
(IC1025)

MEPS_V2

Institutional Care Stay (IC) Section
(Que

Full Detail Spec

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:
This item displays Person-Medical-Conditions-Roster for selection and addition of one or many
medical conditions associated with this event. Display name of medical condition
(COND.CONDNAM)
Roster filter:
Display all conditions on person's roster; display all.

Testing/Editing
Notes:

BOX_10

Route Details:

Variable collected at MEPSSpring2018.IC_Main
Variable stored at MEPSSpring2018_Event.IC_Main

(IC1025)

Item Type: Route

Type Class: If Then

The Cha rge /Pa yme nt (CP) s e ction is not re quire d for this Ins titutiona l Ca re S ta y (IC)
e ve nt.
Go to the Eve nt Drive r (ED) s e ction.

[End of IC]

IC - Page 6 of 6