Transcription
2018 NSLTCP: Adult Day Services Center Participant Public Use File (PUF) CodebookQUESTION NUMBERVARIABLE NAMEQUESTION TEXTCODE CATEGORIESFREQUENCY/RANGEWEIGHTED PERCENTAGESUs ASKEDADDITIONAL NOTESWhat is [SAMPLED PERSON'S INITIALS]'s gender?1 MALE52743.50AllIMPUTED2 FEMALE72856.50What is [SAMPLED PERSON'S INITIALS]'s age in years?RANGE49-91100.00AllIMPUTEDRACEETH2Is [SAMPLED PERSON'S INITIALS] of Hispanic, Latino, or Spanish origin or descent?1 HISPANIC20422.16All[DERIVED FROM HISPAN, BLACK, WHITE, AIAN, NHOPI, ASIAN ,AND MULTI ]1. YES2. NO3. DON’T KNOW2 BLACK22216.813 WHITE69344.774 OTHER13616.2731523.282 1 - 3 YEARS34927.743 MORE THAN 3 YEARS58148.35-9 MISSING100.6395377.58BACKGROUND INFORMATION12SEXAGE2[DERIVED FROM AGE]3&4Please look at the show card titled “Race” to answer this question. Which one or more of the following would you say is[SAMPLED PERSON'S INITIALS]'s race? Please tell me the numbers that apply from the show card. Any others?1. AMERICAN INDIAN OR ALASKA NATIVE2. ASIAN3. BLACK4. NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER5. WHITE6LOSRC2[RECODED]7LIVENOW2[DERIVED FROM LIVENOW ]8910111. 0 TO 3 MONTHS2. MORE THAN 3 MONTHS TO 6 MONTHS3. MORE THAN 6 MONTHS TO 1 YEAR4. MORE THAN 1 YEAR TO 3 YEARS5. MORE THAN 3 YEARS TO 5 YEARS6. MORE THAN 5 YEARSPlease look at the show card titled “Now Live” to answer this question. Where does [SAMPLED PERSON'S INITIALS] now live? 1 PRIVATE RESIDENCE, RETIREMENT COMMUNITYPlease tell me the number that applies from the show card.1. PRIVATE RESIDENCE (HOUSE, APARTMENT, ROOM)2. RETIREMENT OR INDEPENDENT LIVING COMMUNITY3. ASSISTED LIVING, RESIDENTIAL CARE COMMUNITY, OR GROUP HOME4. NURSING HOME OR OTHER INSTITUTIONAL SETTING ( 100 DAYS)5. INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH INTELLECTUAL OR DEVELOPMENTAL DISABILITIES6. OTHER2 ASSISTED LIVING, RESIDENTIAL CARE COMMUNITY, ORGROUP HOME20715.313 OTHER876.52-9 MISSING80.59LIVEWITHWho does [SAMPLED PERSON'S INITIALS] live with? Do they live SELECT ALL THAT APPLY1 ALONE16515.33[RECODED ]1. ALONE2. WITH A RELATIVE SUCH AS A SPOUSE, PARTNER, ADULT CHILD INCLUDING IN-LAW, PARENT, OR OTHER RELATIVE3. WITH A NON-RELATIVE2 WITH A RELATIVE/NON-RELATIVE78661.73-1 INAPPLICABLE30222.42-9 MISSING20.521 1-2 DAYS23116.422 3-4 DAYS30123.433 5-7 DAYS70859.02-9 MISSING151.13On the day(s) when [SAMPLED PERSON'S INITIALS] attends the adult day services center, does "he"/"she" typically attend 5hours or more, or less than 5 hours?1 5 HOURS OR MORE109884.701. 5 HOURS OR MORE2. LESS THAN 5 HOURS2 LESS THAN 5 HOURS14814.70-9 MISSING90.6024122.582 51 - 10038227.473 MORE THAN 10047236.44-9 MISSING16013.5073663.582 OTHER GOVERNMENT20615.733 OUT OF POCKET, PRIVATE INSURANCE AND OTHERSOURCES23415.10-9 MISSING795.5880670.9435722.48NUMDAYS2In a typical week, how many days does [SAMPLED PERSON'S INITIALS] attend the adult day services center?[DERIVED FROM NUMDAYS ]1 . DAY2. DAYS3. DAYS4. DAYS5. DAYS6. DAYS7. DAYSNUMHOURSCHARGES2[DERIVED FROM CHARGES]12Please look at the show card titled “Enrolled at this Center” to answer this question. Approximately how long? Please tell me 1 LESS THAN 1 YEARthe number that applies from the show card.PAYSOURCE2[DERIVED USING PAYSOURCE]During the last complete month, what was the typical daily charge for [SAMPLED PERSON'S INITIALS] to attend this adult day 1 50 OR LESSservices center? Include the basic daily charge and charges for any additional services.Please look at the show card titled “Primary Payment Source” to answer this question. During the last complete month,what 1 MEDICAIDwas the one primary payment source for [SAMPLED PERSON'S INITIALS]'s adult day services charges? Please tell me thenumber that applies from the show card. SELECT ONLY ONE1. MEDICAID (INCLUDE MEDICAID STATE PLAN, MEDICAID WAIVER, MEDICAID MANAGED CARE, OR CALIFORNIA REGIONALCENTER)2. MEDICARE (INCLUDE MEDICARE ADVANTAGE MANAGED CARE PLAN)3. OLDER AMERICANS ACT/TITLE III4. VETERANS ADMINISTRATION5. PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)6. OTHER FEDERAL, STATE, OR LOCAL GOVERNMENT7. OUT-OF-POCKET PAYMENT BY THE PARTICIPANT OR FAMILY8. PRIVATE INSURANCE9. OTHER SOURCE13MEDPAID2[DERIVED USING MEDPAID]14ALZDuring the last complete month, did Medicaid pay for any of the services that [SAMPLED PERSON'S INITIALS] received at this 1 YEScenter? Please include any funding from a Medicaid state plan, Medicaid waiver, Medicaid managed care, or Californiaregional center.2 NO1. YES2. NO3. DON'T KNOW3 DON'T KNOW-9 MISSING926.58Please look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?1 SELECTED41227.602 NOT SELECTED83171.60-9 MISSING120.801 SELECTED826.202. Alzheimer's Disease or Other Dementia14ANEMIAPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card SELECT ALL THAT APPLY Any others?AllLength of stay (LOS) variable collapsedAllCategories 1 & 2 were collapsed to 1, and 4, 5, 6 were collapsedto 3 ( as 'OTHER') in PUF.If LIVENOW 1 or 2Asked if resident lived in a private residence or retirement orindependent community. Categories collapsed in PUF.(LIVENOW is original variable not provided in PUF; LIVENOW2provided in PUF)AllAllAllAllAllAllAllCategory "DON'T KNOW" was not selected
2018 NSLTCP: Adult Day Services Center Participant Public Use File (PUF) CodebookQUESTION NUMBERVARIABLE NAMEQUESTION TEXT3. Anemia14ANXIETYPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?4. Anxiety Disorder14ARTHPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?5. Arthritis or Rheumatoid Arthritis14ASTHMAPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?6. Asthma14CANCERPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?7. Cancer or Malignant Neoplasm of any kind14CPALSYPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?8. Cerebral palsy14CHFPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?9. Congestive heart failure14COPDPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?10. COPD (Chronic Bronchitis or Emphysema)14DEPRESSPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?11. Depression14DIABETESPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?12. Diabetes14EPILEPSYPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?13. Epilepsy14GLAUCOMAPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?14. Glaucoma14GOUTPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?15. Gout, Lupus, or Fibromyalgia14HEARTATKPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?16. Heart Attack (Myocardial Infarction)14HEARTDISEPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?17. Heart Disease (Coronary or Ischemic)14HBPPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?18. High Blood Pressure or Hypertension14MRDDPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?21. Intellectual or Developmental Disabilities14KIDNEYPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card SELECT ALL THAT APPLY Any others?CODE CATEGORIESFREQUENCY/RANGEWEIGHTED PERCENTAGE2 NOT SELECTED116193.00-9 MISSING120.801 SELECTED21417.002 NOT SELECTED102982.20-9 MISSING120.801 SELECTED21018.402 NOT SELECTED103380.80-9 MISSING120.801 SELECTED675.602 NOT SELECTED117693.60-9 MISSING120.801 SELECTED665.302 NOT SELECTED117793.90-9 MISSING120.801 SELECTED856.702 NOT SELECTED115892.50-9 MISSING120.801 SELECTED695.602 NOT SELECTED117493.60-9 MISSING120.801 SELECTED846.702 NOT SELECTED115992.50-9 MISSING120.801 SELECTED26421.702 NOT SELECTED97977.50-9 MISSING120.801 SELECTED31629.402 NOT SELECTED92769.80-9 MISSING120.801 SELECTED1007.402 NOT SELECTED114391.70-9 MISSING120.801 SELECTED394.002 NOT SELECTED120495.20-9 MISSING120.801 SELECTED232.202 NOT SELECTED122097.00-9 MISSING120.801 SELECTED302.302 NOT SELECTED121396.90-9 MISSING120.801 SELECTED15113.202 NOT SELECTED109286.00-9 MISSING120.801 SELECTED56650.702 NOT SELECTED67748.50-9 MISSING120.801 SELECTED37826.802 NOT SELECTED86572.40-9 MISSING120.801 SELECTED615.60SUs AllAllADDITIONAL NOTES
2018 NSLTCP: Adult Day Services Center Participant Public Use File (PUF) CodebookQUESTION NUMBERVARIABLE NAMEQUESTION TEXT22. Kidney Disease14MACULARPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?23. Macular Degeneration14OBESITYPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?26. Obesity14OSTEOPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?27. Osteoporosis14PARKINSONPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?28. Parkinson's Disease14PARALYPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?29. Partial or Total Paralysis14PRESWOUNDPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?30. Pressure wound/Injury14SMIPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?CODE CATEGORIESFREQUENCY/RANGEWEIGHTED PERCENTAGE2 NOT SELECTED118293.55-9 MISSING120.801 SELECTED262.402 NOT SELECTED121796.80-9 MISSING120.801 SELECTED1089.702 NOT SELECTED113589.50-9 MISSING120.801 SELECTED11512.602 NOT SELECTED112886.60-9 MISSING120.801 SELECTED291.902 NOT SELECTED121497.30-9 MISSING120.801 SELECTED472.902 NOT SELECTED119696.30-9 MISSING120.801 SELECTED232.102 NOT SELECTED122097.10-9 MISSING120.801 SELECTED16011.002 NOT SELECTED108388.10-9 MISSING120.801 SELECTED956.402 NOT SELECTED114892.70-9 MISSING120.801 SELECTED403.502 NOT SELECTED120395.70-9 8012010.907 More than 1028222.70-9 MISSING492.80774.910 NO28720.02-1 INAPPLICABLE89075.00-9 MISSING10.0717014.9665153.403 A LOT OF DIFFICULTY/CANNOT DO AT ALL42130.68-9 MISSING130.961 NO DIFFICULTY61844.192 SOME DIFFICULTY49144.243 A LOT OF DIFFICULTY/CANNOT DO AT ALL13310.55SUs ASKEDADDITIONAL NOTESAllAllAllAllAllAllAll31. Severe Mental Illness such as Schizophrenia or Psychosis or Bipolar Disorder (Excludes Depression or Anxiety Disorder)14STROKEPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?33. Stroke14TBIPlease look at the show card titled "Conditions" to answer this question. As far as you know, has a doctor or other healthprofessional ever diagnosed [SAMPLED PERSON'S INITALS] with any of the following conditions? Please tell me the numbersthat apply from the show card. SELECT ALL THAT APPLY. Any others?34. Traumatic Brain Injury1516NUMMEDANTIPSY[DERIVED FROM ABILIFY, CLOZARIL, FANAPT, GEODON, HALDOL, INVEGA, LOXITANE, NAVANE,ORAP, RISPERDAL, SAPHRIS, SEROQUEL, ZYPREXA, & NOMED]The next question asks about prescription medications [SAMPLED PERSON'S INITIALS] may take. Include standing and PRN or 1 0as needed medications, but exclude over-the-counter medications or supplements, unless they have been prescribed by ahealth care provider. About how many prescription medications does [SAMPLED PERSON'S INITIALS] currently take on a2 1-2typical day? Would you say.3 3-41. 02. 1-24 5-63. 3-44. 5-65 7-85. 7-86. 9-10, or6 9-107. more than 10Please look at the show card titled "Antipsychotic Medications" to answer this question. The following is a list of the generic 1 YESand brand names of antipsychotic medications. In the past 7 days, which if any, of these medications did [SAMPLEDPERSON'S INITIALS] receive, either on an as needed basis or on a routine basis? Please tell me the number that apply fromthe show card. Any others?1. ABILIFY (ARIPIPRAZOLE)2. CLOZARIL OR FAZACLO (CLOZAPINE)3. FANAPT (ILOPERIDON)4. GEODON (ZIPRASIDONE)5. HALDOL (HALOPERIDOL)6. INVEGA (PALIPERIDONE)7. LOXITANE (LOXAPINE)8. NAVANE (THIOTHIXENE)9. ORAP (PIMOZIDE)10. RISPERDAL (RISPERIDONE)11. SAPHRIS (ASENAPINE)12. SEROQUEL (QUETIAPINE)13. ZYPREXA (OLANZAPINE)14. NONE OF THE ABOVE17MEMORY2[DERIVED FROM MEMORY ]The next questions ask about difficulties (SAMPLED PERSON'S INITIALS) may have doing certain activities because of a health 1 NO DIFFICULTYproblem. How much difficulty does (SAMPLED PERSON'S INITIALS) have remembering or concentrating? Would you say nodifficulty, some difficulty, a lot of difficulty, or cannot do at all?2 SOME DIFFICULTY1. NO DIFFICULTY2. SOME DIFFICULTY3. A LOT OF DIFFICULTY4. CANNOT DO AT ALL18SIGHT2[DERIVED FROM SIGHT ]How much difficulty does (SAMPLED PERSON'S INITIALS) have seeing, even if wearing glasses? Would you say no difficulty,some difficulty, a lot of difficulty, or cannot do at all?1. NO DIFFICULTY2. SOME DIFFICULTY3 A LOT OF DIFFICULTYAllAllAllIf ALZ 1 & NUMMED 1Asked if participant diagnosed with Alzheimer's Disease andtaking at least 1 prescription medication. Recoded to indicatetaking or not taking any of the medications listed ("YES" if takingat least one of the listed medications).AllCategories "A LOT OF DIFFICULTY" and "CANNOT DO AT ALL"collapsedAllCategories "A LOT OF DIFFICULTY" and "CANNOT DO AT ALL"collapsed
2018 NSLTCP: Adult Day Services Center Participant Public Use File (PUF) CodebookQUESTION NUMBERVARIABLE NAMEQUESTION TEXTCODE CATEGORIESFREQUENCY/RANGEWEIGHTED PERCENTAGE-9 MISSING131.031 NO DIFFICULTY80661.822 SOME DIFFICULTY33528.653 A LOT OF DIFFICULTY/CANNOT DO AT ALL1008.54-9 MISSING140.991 NO DIFFICULTY33426.282 SOME DIFFICULTY51244.153 A LOT OF DIFFICULTY/CANNOT DO AT ALL39828.77-9 MISSING110.80How much difficulty does (SAMPLED PERSON'S INITIALS) have with self-care such as washing all over or dressing? Would you 1 NO DIFFICULTYsay no difficulty, some difficulty, a lot of difficulty, or cannot do at all?2 SOME DIFFICULTY1. NO DIFFICULTY2. SOME DIFFICULTY3 A LOT OF DIFFICULTY/CANNOT DO AT ALL3. A LOT OF DIFFICULTY4. CANNOT DO AT ALL-9 MISSING24419.9052644.6546633.94191.51Using “his”/“her” usual customary language, how much difficulty does (SAMPLED PERSON'S INITIALS) have communicating, 1 NO DIFFICULTYfor example understanding or being understood? Would you say no difficulty, some difficulty, a lot of difficulty, or cannot doat all?2 SOME DIFFICULTY53042.7743435.311. NO DIFFICULTY2. SOME DIFFICULTY3. A LOT OF DIFFICULTY4. CANNOT DO AT ALL3 A LOT OF DIFFICULTY/CANNOT DO AT ALL28021.18-9 MISSING110.74Which types of assistance, if any, does [SAMPLED PERSON'S INITIALS] currently need to transfer in and out of a chair at their 1 NEED HELP OR SUPERVISION FROM ANOTHER PERSONusual residence or this adult day services center? Does [SAMPLED PERSON'S INITIALS] need any help or supervision fromanother person, use an assistive device, both, or need no assistance?2 USE OF AN ASSISTIVE DEVICE30725.901168.501.2.3.4.3 BOTH25118.804 NEED NO ASSISTANCE57146.00-9 MISSING100.70Which types of assistance, if any, does [SAMPLED PERSON'S INITIALS] currently need to eat, like cutting food at their usualresidence or this adult day services center? Does [SAMPLED PERSON'S INITIALS] need any help or supervision from anotherperson, use an assistive device, both, or need no assistance?1 NEED HELP OR SUPERVISION FROM ANOTHER PERSON48834.702 USE OF AN ASSISTIVE DEVICE171.101.2.3.4.3 BOTH865.304 NEED NO ASSISTANCE65158.00-9 MISSING131.00Which types of assistance, if any, does [SAMPLED PERSON'S INITIALS] currently need to dress at their usual residence or thisadult day services center? Does [SAMPLED PERSON'S INITIALS] need any help or supervision from another person, use anassistive device, both, or need no assistance?1 NEED HELP OR SUPERVISION FROM ANOTHER PERSON74358.602 USE OF AN ASSISTIVE DEVICE50.301.2.3.4.3 BOTH704.204 NEED NO ASSISTANCE41735.20-9 MISSING201.70Which types of assistance, if any, does [SAMPLED PERSON'S INITIALS] currently need to bathe or shower at their usualresidence or this adult day services center? Does [SAMPLED PERSON'S INITIALS] need any help or supervision from anotherperson, use an assistive device, both, or need no assistance?1 NEED HELP OR SUPERVISION FROM ANOTHER PERSON74056.302 USE OF AN ASSISTIVE DEVICE181.501.2.3.4.3 BOTH17213.504 NEED NO ASSISTANCE26924.10-9 MISSING564.50Which types of assistance, if any, does [SAMPLED PERSON'S INITIALS] currently need to use the bathroom or toileting at their 1 NEED HELP OR SUPERVISION FROM ANOTHER PERSONusual residence or this adult day services center? Does [SAMPLED PERSON'S INITIALS] need any help or supervision fromanother person, use an assistive device, both, or need no assistance?2 USE OF AN ASSISTIVE DEVICE52340.00373.301.2.3.4.3 BOTH1419.004 NEED NO ASSISTANCE54146.90-9 MISSING130.80Which types of assistance, if any, does [SAMPLED PERSON'S INITIALS] currently need for locomotion or to walk at their usual 1 NEED HELP OR SUPERVISION FROM ANOTHER PERSONresidence or this adult day services center? Does [SAMPLED PERSON'S INITIALS] need any help or supervision from anotherperson, use an assistive device, both, or need no assistance?2 USE OF AN ASSISTIVE DEVICE23720.7023515.901.2.3.4.3 BOTH26520.504 NEED NO ASSISTANCE50341.90-9 MISSING151.001 YES, BOWEL ONLY151.192 YES, URINARY ONLY27223.763 YES, BOTH BOWEL AND URINARY22015.454 NO, NEITHER71357.32-9 MISSING352.28During the past 12 months, was [SAMPLED PERSON'S INITIALS] treated in a hospital emergency department?1 Yes28019.111. YES2. NO3. DON'T KNOW2 No79367.043 DON'T KNOW554.90-1 INAPPLICABLE704.60-9 MISSING574.301 Yes1419.704. CANNOT DO AT ALL19HEARING2[DERIVED FROM HEARING ]20STAIRS2[DERIVED FROM STAIRS ]21SELFCARE2[DERIVED FROM SELFCARE ]22COMUNICAT2[DERIVED FROM COMUNICAT WALKHLPINCONT2[DERIVED FROM INCONT]How much difficulty does (SAMPLED PERSON'S INITIALS) have hearing, even if using a hearing aid? Would you say nodifficulty, some difficulty, a lot of difficulty, or cannot do at all?1. NO DIFFICULTY2. SOME DIFFICULTY3. A LOT OF DIFFICULTY4. CANNOT DO AT ALLHow much difficulty does (SAMPLED PERSON'S INITIALS) have walking or climbing steps? Would you say no difficulty, somedifficulty, a lot of difficulty, or cannot do at all?1. NO DIFFICULTY2. SOME DIFFICULTY3. A LOT OF DIFFICULTY4. CANNOT DO AT ALLNEED HELP OR SUPERVISION FROM ANOTHER PERSONUSE OF AN ASSISTIVE DEVICEBOTHNEED NO ASSISTANCENEED HELP OR SUPERVISION FROM ANOTHER PERSONUSE OF AN ASSISTIVE DEVICEBOTHNEED NO ASSISTANCENEED HELP OR SUPERVISION FROM ANOTHER PERSONUSE OF AN ASSISTIVE DEVICEBOTHNEED NO ASSISTANCENEED HELP OR SUPERVISION FROM ANOTHER PERSONUSE OF AN ASSISTIVE DEVICEBOTHNEED NO ASSISTANCENEED HELP OR SUPERVISION FROM ANOTHER PERSONUSE OF AN ASSISTIVE DEVICEBOTHNEED NO ASSISTANCENEED HELP OR SUPERVISION FROM ANOTHER PERSONUSE OF AN ASSISTIVE DEVICEBOTHNEED NO ASSISTANCEPlease look at the show card titled “Incontinence” to answer this question. As far as you know, has [SAMPLED PERSON'SINITIALS] had any episodes of incontinence during the past seven days either at their usual residence or this adult dayservices center? Please tell me the number that applies from the show card.1. YES, BOWEL ONLY2. YES, URINARY ONLY3. YES, BOTH BOWEL AND URINARY4. NO, NEITHER5. NOT APPLICABLE (COLOSTOMY, ILEOSTOMY)6. NOT APPLICABLE (INDWELLING CATHETER, UROSTOMY)3031HOSPEMER12HOSPEMER3During the past 90 days, was [SAMPLED PERSON'S INITIALS] treated in a hospital emergency department?SUs ASKEDADDITIONAL NOTESAllCategories "A LOT OF DIFFICULTY" and "CANNOT DO AT ALL"collapsedAllCategories "A LOT OF DIFFICULTY" and "CANNOT DO AT ALL"collapsedAllCategories "A LOT OF DIFFICULTY" and "CANNOT DO AT ALL"collapsedAllCategories "A LOT OF DIFFICULTY" and "CANNOT DO AT ALL"collapsedAllAllAllAllAllAllAllIf LOS 1Asked if participant has attended ADSC for over 3 months.If HOSPEMER12 1Asked if participant had emergency department visit in the past12 months or since enrolled.
2018 NSLTCP: Adult Day Services Center Participant Public Use File (PUF) CodebookQUESTION NUMBER32VARIABLE NAMEHOSPNITE12QUESTION TEXTCODE CATEGORIESFREQUENCY/RANGEWEIGHTED PERCENTAGE1. YES2. NO3. DON'T KNOW2 No1329.203 DON'T KNOW70.30-1 INAPPLICABLE97580.901 YES1762 NODuring the past 12 months, was [SAMPLED PERSON'S INITIALS] discharged from an overnight hospital stay? Exclude trips tothe hospital emergency department that did not result in an overnight hospital stay.1. YES2. NO3. DON'T KNOW33HOSPNITE3Was [SAMPLED PERSON'S INITALS] discharged from an overnight hospital stay during the past 90 days? Exclude trips to thehospital emergency department that did not result in an overnight hospital stay.1. YES2. NO3. DON'T KNOW36FALL2[DERIVED FROM FALLNUM ]FALLINJ[DERIVED FROM MINORINJ, MAJORINJ, & NOINJ ]ADDITIONAL NOTES12.90If LOS 1Asked if participant has attended ADSC for over 3 months.89072.803 DON'T KNOW615.30(original length of stayvariable not provided inPUF)-1 INAPPLICABLE704.60-9 MISSING584.401 Yes675.402 No1067.303 DON'T KNOW30.20-1 8The next section asks whether [SAMPLED PERSON'S INITIALS] has had any falls. By falls we mean any fall, slip, or trip in which 1 YES[SAMPLED PERSON'S INITIALS] lost “his”/“her” balance and landed on the floor or ground or at a lower level. Please includefalls that occurred at your adult day services center or off-site, whether or not [SAMPLED PERSON'S INITIALS] was injured,0 NOand whether or not anyone saw [SAMPLED PERSON'S INITIALS] fall or caught them. As best you know, in the past 90 days,how many falls has [SAMPLED PERSON'S INITIALS] had?Number of falls38SUs ASKED-9 MISSINGPlease look at the show card titled “Fall Injury” to answer this question. Did [SAMPLED PERSON'S INITIALS]'s fall/any of these 1 MAJOR OR MINOR INJURYfalls [SAMPLED PERSON'S INITIALS] had result in a minor injury, a major injury, or no injury? Please tell me the numbers thatapply from the show card. SELECT ALL THAT APPLY1. MINOR INJURY - ABRASION, CUT, HEMATOMA, LACERATION, SCRATCH, SKIN TEAR, SPRAIN, SUPERFICIAL BRUISE0 NO INJURY715.622. MAJOR INJURY - BONE FRACTURE, BROKEN BONE, CLOSED HEAD INJURY WITH ALTERED CONSCIOUSNESS, JOINTDISLOCATION, SUBDURAL HEMATOMA-1 INAPPLICABLE106885.991 YES85565.802 NO38733.20-9 MISSING131.001 YES34828.502 NO89470.50-9 MISSING131.001 YES50836.902 NO73462.10-9 MISSING131.001 YES1069.402 NO113689.60-9 MISSING131.001 YES65753.602 NO58545.40-9 MISSING131.001 YES48940.702 NO75358.40-9 MISSING131.001 YES13718.302 NO110580.80-9 MISSING131.001 YES17018.602 NO107280.40-9 MISSING131.001 YES24726.802 NO99572.30-9 MISSING131.001 YES22024.402 NO102274.60-9 MISSING131.001 YES14812.002 NO109487.00-9 MISSING131.00If HOSPNITE12 1AllIf FALL 0(original variable notprovided in PUF)3. NO INJURY39ADLSERVPlease look at the show card titled "Services" to answer this question. The following services may be offered adult dayservices center staff or provided at the center by non-center staff. Which of these services does [SAMPLED PERSON'SINITIALS] currently use? Please tell me the numbers that apply from the show card. SELECT ALL THAT APPLY. Any others?1. ASSISTANCE FROM A PERSON WITH AT LEAST ONE ACTIVITY OF DAILY LIVING (BATHING, DRESSING, EATING, TOLIETING,TRASFERRING)39MHSERVPlease look at the show card titled "Services" to answer this question. The following services may be offered adult dayservices center staff or provided at the center by non-center staff. Which of these services does [SAMPLED PERSON'SINITIALS
1. medicaid (include medicaid state plan, medicaid waiver, medicaid managed care, or california regional center) 2. medicare (include medicare advantage managed care plan) 3. older americans act/title iii 4. veterans administration 5. program of all-inclusive care for the elderly (pace) 6. other federal, state, or local government 7.
![Welcome [dashdiet.me]](/img/17/30-day-weight-loss-journal.jpg)
