Assisted Living/Congregate Care

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX XXVI: Chain Approval Report

Preload 1 Number of facilities linked to chains a 1,455 2 Number of chains a 1,062 Chain Approval Needed/Requested 3 Number of chains where approval needed b 74 4

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX XXV: Verification Script

VERIFICATION SCRIPT November 5, 2009 INSTRUCTIONS: Refer to this hardcopy script to administer all verification cases. Type answers in Verif_WeekX_RegionX.xls. Refer to Project FAQs if necessary to answer questions from facility. READ IF NECESSARY

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX XXIV: Closure Letter

Department of Health & Human Services Public Health Service Centers for Disease Control and Prevention National Center for Health Statistics 3311 Toledo Road Hyattsville, Maryland 20782 [DATE] [DIRECTOR] [FACILITY NAME] [ADDRESS] [CITY/STATE/ZIP] Dear [FIRST NAME LAST NAME OR DIRECTOR] On behalf of the National Survey o

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX XXIII: Schedule Appointment Reminder Letter and Postcard

Exhibit A . Schedule Appointment Reminder Letter Exhibit B . Postcard Exhibit A. Schedule Appointment Reminder Letter Department of Health & Human Services Public Health Service Centers for Disease Control and Prevention National Center for Health Statistics 3311 Toledo Road Hyattsville, Maryland 20782 DATE: De

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX XXII: Refusal Conversion Letters

Exhibit A . Having trouble reaching you letter Exhibit B . No time letter Exhibit C . Not interested/not if voluntary letter Exhibit D . Cancelled appointment letter Exhibit A. Having Trouble Reaching You Letter

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX XXI: Interviewer Debriefing Questionnaire

DID THE ADMINISTRATOR HAVE THE PRE-INTERVIEW WORKSHEET FILLED OUT? YES NO (please explain) DID RESPONDENT(S) HAVE ANY SPECIFIC DIFFICULTIES ANSWERING ANY QUESTIONS? YES NO (please explain) DO YOU FEEL RESPONDENTS WERE ACCURATE IN THEIR ANSWERS? YES NO (please explain)

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX XX: NSRCF Resident Questionnaire

Question Number Question Item Code Categories Resident Asked Skip Pattern R_A_INTRO1

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX XIX: NSRCF Resident Selection Questionnaire

Question Number Resident Selection Question Item Code Categories Facility Asked Skip Pattern P_CHECK INTERVIEWER: ENTER WHAT STAGE YOU HAVE REACHED IN INTERVIEWING THIS FACILITY. 1 STARTED/ COMPLETED FACILITY QUESTIONNAIRE --WROTE DOWN # OF BEDS

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX XVIII: NSRCF Facility Questionnaire

Question Number Facility Question Item Code Categories Facility Asked Skip Pattern F_A1_Intro1 This survey is about the characteristics of residential care facilities and the individuals who live in them.

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX XVII: NCHS Thank You Letter

Department of Health & Human Services Public Health Service Centers for Disease Control and Prevention National Center for Health Statistics 3311 Toledo Road Hyattsville, Maryland 20782 Thank You

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX XVI: Appointment Reschedule Call Script

RESCHEDULE CALL OPEN FACESHEET . GO TO FACILITY & DIRECTOR TAB AND REVIEW DATA. GO TO APPOINTMENT TAB AND REVIEW DATA. PLACE CALL TO PRIMARY PERSON TO REMIND. SPEAKING TO RECEPTIONIST

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX XV: Interviewer Reminder Call Script

REMINDER CALL OPEN FACESHEET . GO TO FACILITY & DIRECTOR TAB AND REVIEW DATA. GO TO APPOINTMENT TAB AND REVIEW DATA. PLACE CALL TO PRIMARY PERSON TO REMIND. SPEAKING TO RECEPTIONIST Hello, this is FIRST AND LAST NAME OF INTERVIEWER. May I please speak with ____________________? Could you transfer me to his/her voicema

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX XIV: Pre-Interview Worksheet

OMB No. 0920-0780 Exp. Date 12/31/2012 2010 National Survey of Residential Care Facilities Pre-Interview Worksheet Dear {NAME OF DIRECTOR} at {NAME OF FACILITY} Thank you for agreeing to participate in the 2010 National Survey of Residential Care Facilities. The date and time of your interview and your interviewer's name are: {

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX XIII: NSRCF Screener Questionnaire

Question Number Screener Question Item Code Categories Facility Asked Skip Pattern S_I_STATEMENT_A I would like to verify some information we have about [ SAMPLED FACILITY ]. The questions I have right now should take just a few minutes.

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX XII: Frequently Asked Questions

WHO SPONSORS THIS STUDY? This is a federally-sponsored statistical survey. The government agency sponsors include the Centers for Disease Control and Prevention, the Assistant Secretary for Planning and Evaluation, and the Department of Veterans Affairs. I work for RTI International, a not-for-profit research institute located in Nort

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX XI: Set an Appointment Call Script

OPEN FACESHEET TO FACILITY & DIRECTOR AND REVIEW DATA. PLACE CALL. SPEAKING TO RECEPTIONIST:

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX X: Advance Package to Facilities

The advance package to facilities is the same as the NSRCF package to chains except that it included the NCHS letter to facilities with FAQs on the back, instead of the NCHS letter to chains.

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX IX: Advance Package Call Script

ADVANCE PACKAGE CALL: OPEN FACESHEET. GO TO ORIGINAL PRELOADS TAB AND REVIEW DATA. GO TO FACILITY & DIRECTOR. PLACE CALL. VERIFY INFORMATION:

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX VIII: NSRCF Chain Package

Exhibit A . NSRCF Pocket Folder Exhibit B . NCHS Letter to Chains Exhibit C . NCHS ERB Letter Exhibit D . NSRCF Brochure (available from: http://www.cdc.gov/nchs/data/nsrcf/nsrcf_brochure.pdf )

Design and Operation of the 2010 National Survey of Residential Care Facilities. APPENDIX VII: Provider Organization Newsletter Articles on NSRCF

Data Collection For Federal Health Center Assisted Living Study Begins In April The National Survey of Residential Care Facilities, a national study of assisted living and residential care communities, is scheduled to start the data collection phase in April 2010. The National Center for Health Statistics (NCHS), within the Centers for Disea

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