RIC         1  2  $RIC                                  C Record Identification Code

                                   0                    A Administrative Data
                                   0                   DU Dental Events
                                   0                   FA Facility Events
                                   0                    H HMO Supplement
                                   0                   IA Income and Assets
                                   0                   IP Inpatient Hospital Events
                                   0                   IU Institutional Events
                                   0                    K Key Record
                                   0                   KN Knowledge and Information Needs
                                   0                   MD MDS
                                   0                   MP Medical Provider Events
                                   0                    N Non-Respondent
                                   0                   OA OASIS
                                   0                   OP Outpatient Events
                                   0                   PA Patient Activation
                                   0                   PM Prescribed Medicine Events
                                   0                   PS Person Summary
                                   0                   RX Drug Coverage
                                   0                   SS Service Summary
                                   0                    X Cross Sectional Weights
                                   0                   XE Ever Enrolled Weights
                                   0                   X2 2 year Weights
                                   0                   X3 3 year Weights
                                   0                   X4 4 year Weights
                                   0                    1 Survey Identification (Demographic)
                                   0                   10 MDS/OAS Timeline
                                   0                    2 Health Status/Functioning (Community)
                                   0                   2F Health Status/Functioning (Facility)
                                   0                   2H Health Status/Functioning (Helper)
                                   0                   2P Health Status/Functioning (Prevention)
                                   0                    3 Access to Care
                                   0                    4 Health Insurance
                              10,190                    5 Enumeration
                                   0                    6 Facility Residence History
                                   0                    7 Facility Characteristics
                                   0                   7S SNF Characteristics
                                   0                    8 Interview Description
                                   0                    9 Residence Timeline

VERSION     3  1  $VERSION                              C Version Number

                              10,190                    1 Version 1
                                   0                    2 Version 2
                                   0                    3 Version 3
                                   0                    4 Version 4

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                              10,190             LOW-HIGH BASEID Count

D_HHTOT    12  2  PEOPLE             EN1                N Total number of people in the household

                                   0                    0 No one
                               2,843                    1 One person
                               5,001                    2 Two people
                               1,284                    3 Three people
                                 534                    4 Four people
                                 271                    5 Five people
                                 138                    6 Six people
                                  63                    7 Seven people
                                  56                      Eight or more people

D_HHREL    14  2  PEOPLE             EN2                N No. in household (incl SP) related to SP

                                   0                    0 No one
                               3,268                    1 One person
                               4,793                    2 Two people
                               1,202                    3 Three people
                                 466                    4 Four people
                                 250                    5 Five people
                                 112                    6 Six people
                                  60                    7 Seven people
                                  39                      Eight or more people

D_HHUNRL   16  2  PEOPLE             EN2                N Total number of people not related to SP

                               9,470                    0 No one
                                 590                    1 One person
                                  79                    2 Two people
                                  30                    3 Three people
                                  12                    4 Four people
                                   5                    5 Five people
                                   3                    6 Six people
                                   0                    7 Seven people
                                   1                      Eight or more people

D_HHCOMP   18  2  HHCDFMT            EN1,2              N Household composition code

                               2,843                    1 Lives alone
                               3,708                    2 Spouse only
                               1,084                    3 Spouse & others
                                 747                    4 Children only
                                 545                    5 Children & others
                                 838                    6 Others only
                                 425                    7 Non relative

D_HHLT50   20  2  PEOPLE             EN1,7              N No. in household (incl SP) < 50 yrs old

                               7,299                    0 No one
                               1,490                    1 One person
                                 606                    2 Two people
                                 369                    3 Three people
                                 223                    4 Four people
                                 108                    5 Five people
                                  46                    6 Six people
                                  27                    7 Seven people
                                  22                      Eight or more people

D_HHGE50   22  2  PEOPLE             EN1,7              N No. in household (incl SP) > 49 yrs old

                                 619                    0 No one
                               3,713                    1 One person
                               5,302                    2 Two people
                                 489                    3 Three people
                                  59                    4 Four people
                                   7                    5 Five people
                                   1                    6 Six people
                                   0                    7 Seven people

D_HHRL18   24  2  PEOPLE                                N relatives in household under 18

                               9,174                    0 No one
                                 614                    1 One person
                                 255                    2 Two people
                                  85                    3 Three people
                                  35                    4 Four people
                                  19                    5 Five people
                                   5                    6 Six people
                                   3                    7 Seven people

DWELLING   26  2  DWELFMT            HA1                N Description of SP's home

                                   2                    . Missing
                               7,131                    1 One-family detached
                                 396                    2 Two-family or duplex
                               1,571                    3 Apartment or condominium building
                                 782                    4 Mobile home or trailer
                                 191                    5 Row house or townhouse
                                  35                    6 Mother-in-law apartment
                                  68                   91 Other type of dwelling
                                  14                   96 Homeless/transient/jail/prison (eff. 04)

                  Note: First available in 2001

DWELLOS    28 30                     HA1                C Description of SP's home - other

                  Note: First available in 2001

HLEVELS    58  2  HLEVFMT            HA2                N How many levels in SP's home?

                                 798                    . Inapplicable
                                   3                   -8 Don't know
                                   1                   -7 Refused
                               4,620                    1 One level
                               3,090                    2 Two levels
                               1,678                    3 Three or more levels

                 Notes: Inapplicable if DWELLING = . or 4 or 96.
                        First available in 2001

HELEVTR    60  2  YES1FMT            HA3                N Does SP's residence have an elevator?

                               5,418                    . Inapplicable
                                 493                    1 Yes
                               4,279                    2 No

                 Notes: Inapplicable if HLEVELS = . or 1.
                        First available in 2001

HONELEVL   62  2  YES1FMT            HA4                N Is living space all on one level?

                               5,418                    . Inapplicable
                               2,159                    1 Yes
                               2,613                    2 No

                 Notes: Inapplicable if HLEVELS = . or 1.
                        First available in 2001

HBTHLEVL   64  2  YES1FMT            HA5                N Is a bathroom on all levels of residence

                               7,577                    . Inapplicable
                                   2                   -8 Don't know
                               1,771                    1 Yes
                                 840                    2 No

                 Notes: Applies only if HONELEVL does not equal . or 1.
                        First available in 2001

HRAMPS     66  2  YES1FMT            HA6                N Does SP's residence have ramps?

                                  16                    . Inapplicable
                                   9                   -8 Don't know
                                   1                   -7 Refused
                               1,215                    1 Yes
                               8,949                    2 No

                 Notes: Inapplicable if DWELLING = . or 96.
                        First available in 2001

HBATHRM    68  2  YES1FMT            HA7                N Does SP's bathroom have modifications?

                                  16                    . Inapplicable
                                   3                   -8 Don't know
                               3,882                    1 Yes
                               6,289                    2 No

                 Notes: Inapplicable if DWELLING = . or 96.
                        First available in 2001

HRAILING   70  2  YES1FMT            HA8                N Does SP's residence have special railing

                                  16                    . Inapplicable
                                 262                    1 Yes
                               9,912                    2 No

                 Notes: Inapplicable if DWELLING = . or 96.
                        First available in 2001

HOUSTYPE   72  2  YES1FMT            HA9                N Does SP live in type housing in HCOMUNTY

                                  16                    . Inapplicable
                                   5                   -8 Don't know
                                 712                    1 Yes
                               9,457                    2 No

                 Notes: Inapplicable if DWELLING = . or 96.
                        First available in 2001

HCOMUNTY   74  2  HCOMFMT            HA10               N Description of SP's housing site

                               9,473                    . Inapplicable
                                   2                   -8 Don't know
                                 292                    1 Retirement community
                                 258                    2 Senior citizens housing
                                  33                    3 Assisted living facility
                                  26                    4 Continuing care community
                                   3                    5 Stages living community
                                  67                    6 Retirement apartments
                                   8                    7 Church-provided housing
                                   8                    8 Personal or residential care home
                                  20                   91 Other

                 Notes: Inapplicable if HOUSTYPE = . or 2 or -9.
                        First available in 2001

HCOMUNOS   76 30                     HA10               C Description of SP's housing site-other

                 Notes: Inapplicable if HOUSTYPE = . or 2 or -9.
                        First available in 2001

HPERCARE  106  2  YES1FMT            HA11               N Does SP's residence offer personal care?

                               9,473                    . Inapplicable
                                   2                   -8 Don't know
                                 388                    1 Yes
                                 327                    2 No

                 Notes: Inapplicable if HOUSTYPE = . or 2.
                        First available in 2001

MEALPROB  108  2  YES1FMT            HA12a              N Do you have access to prepared meals?

                               9,800                    . Inapplicable
                                   4                   -8 Don't know
                                 231                    1 Yes
                                 155                    2 No

                 Notes: Applies only if HPERCARE = 1 or -8.
                        First available in 2001

MAIDPROB  110  2  YES1FMT            HA12b              N Do you have access to cleaning services?

                               9,800                    . Inapplicable
                                   4                   -8 Don't know
                                 214                    1 Yes
                                 172                    2 No

                 Notes: Applies only if HPERCARE = 1 or -8.
                        First available in 2001

WASHPROB  112  2  YES1FMT            HA12c              N Do you have access to laundry services?

                               9,800                    . Inapplicable
                                   4                   -8 Don't know
                                 173                    1 Yes
                                 213                    2 No

                 Notes: Applies only if HPERCARE = 1 or -8.
                        First available in 2001

HELPPROB  114  2  YES1FMT            HA12d              N Do you have access to help w/ medication

                               9,800                    . Inapplicable
                                   7                   -8 Don't know
                                 130                    1 Yes
                                 253                    2 No

                 Notes: Applies only if HPERCARE = 1 or -8.
                        First available in 2001

TRANPROB  116  2  YES1FMT            HA12e              N Do you have access to transportation?

                               9,800                    . Inapplicable
                                   4                   -8 Don't know
                                 248                    1 Yes
                                 138                    2 No

                 Notes: Applies only if HPERCARE = 1 or -8.
                        First available in 2001

RECPROB   118  2  YES1FMT            HA12f              N Do you have access to recreational servi

                               9,800                    . Inapplicable
                                   3                   -8 Don't know
                                 361                    1 Yes
                                  26                    2 No

                 Notes: Applies only if HPERCARE = 1 or -8.
                        First available in 2001

SERVINCL  120  2  SERVFMT            HA13               N Are services included in housing cost?

                               9,806                    . Inapplicable
                                   2                   -8 Don't know
                                 200                    1 All included
                                 134                    2 Some included/some separate
                                  48                    3 All separate

                 Notes: Applies only if any personal services are available at residence (HA12).
                        First available in 2001

STAYPUT   122  2  YES1FMT            HA14               N If seriously ill, could SP remain there?

                               9,800                    . Inapplicable
                                  31                   -8 Don't know
                                 224                    1 Yes
                                 135                    2 No

                 Notes: Applies only if HPERCARE = 1 or -8.
                        First available in 2001

CAREPART  124  2  YES1FMT            HA15               N Is care provided in another part of HA10

                              10,055                    . Inapplicable
                                   2                   -8 Don't know
                                  41                    1 Yes
                                  92                    2 No

                 Notes: Applies only if STAYPUT = 2.
                        First available in 2001

REQAGE    126  2  YES1FMT            HA16               N Is there a required age to live there?

                               9,800                    . Inapplicable
                                  25                   -8 Don't know
                                 313                    1 Yes
                                  52                    2 No

                 Notes: Applies only if HPERCARE = 1 or -8.
                        First available in 2001

PERSBATH  128  2  YES1FMT            HA17               N Do you have your own bath facility?

                               5,081                    . Inapplicable
                               4,923                    1 Yes
                                 186                    2 No

                 Notes: Inapplicable if HBTHLEVL =1 or HBATHRM =1.
                        First available in 2001

NBRROOMS  130  2  NBRMFMT            HA18               N How many rooms in your residence?

                                  16                    . Inapplicable
                                  13                   -8 Don't know
                                  18                   -7 Refused
                                  87                    1 One room
                                 253                    2 Two rooms
                                 844                    3 Three rooms
                               1,296                    4 Four rooms
                               2,117                    5 Five rooms
                               2,272                    6 Six rooms
                               1,615                    7 Seven rooms
                                 898                    8 Eight rooms
                                 398                    9 Nine rooms
                                 363                      Ten or more rooms

                 Notes: Inapplicable if DWELLING = . or 96.
                        First available in 2001

PERKITCH  132  2  YES1FMT            HA19               N Do you have your own kitchen?

                                  16                    . Inapplicable
                                   1                   -7 Refused
                               9,958                    1 Yes
                                 215                    2 No

                 Notes: Inapplicable if DWELLING = . or 96.
                        First available in 2001

OUTSTATE  134  2  YES2FMT            IR7a               N Does SP have home in another state?

                                 101                    . Missing
                                   1                   -8 Don't know
                                 400                    1 Yes
                               9,688                    2 No

                  Note: First available in 2001

