PACIO Functional Status Implementation Guide, published by HL7 Patient Care Work Group. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/fhir-pacio-functional-status/ and changes regularly. See the Directory of published versions
<QuestionnaireResponse xmlns="http://hl7.org/fhir">
<id value="QResponse-Hospital-Discharge-Mobility-1"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>questionnaire</b>: <a href="http://example.org/Questionnaire/MDS3.0-NC-1.17">http://example.org/Questionnaire/MDS3.0-NC-1.17</a></p><p><b>status</b>: completed</p><p><b>subject</b>: <a href="Patient-patientBSJ1.html">Generated Summary: Betsy Smith-Johnson </a></p><p><b>authored</b>: Jul 10, 2020, 7:34:00 PM</p><p><b>author</b>: <a href="PractitionerRole-Role-PT-RonMarble.html">Generated Summary: active: true; <span title="Codes: {http://snomed.info/sct 36682004}">Physiotherapist</span></a></p><blockquote><p><b>item</b></p><p><b>linkId</b>: Section-37</p><p><b>text</b>: Functional abilities and goals - discharge [CMS Assessment]</p><blockquote><p><b>item</b></p><p><b>linkId</b>: Section-37/GG0170_3</p><p><b>text</b>: Mobility - discharge performance during 3 day assessment period [CMS Assessment]</p></blockquote></blockquote></div>
</text>
<questionnaire value="http://example.org/Questionnaire/MDS3.0-NC-1.17">
<extension url="http://hl7.org/fhir/StructureDefinition/display">
<valueString
value="Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.17.1 [CMS Assessment]"/>
</extension>
</questionnaire>
<status value="completed"/>
<subject>
<reference value="Patient/patientBSJ1"/>
</subject>
<authored value="2020-07-10T14:34:00-05:00"/>
<author>
<reference value="PractitionerRole/Role-PT-RonMarble"/>
</author>
<item>
<linkId value="Section-37"/>
<text value="Functional abilities and goals - discharge [CMS Assessment]"/>
<item>
<linkId value="Section-37/GG0170_3"/>
<text
value="Mobility - discharge performance during 3 day assessment period [CMS Assessment]"/>
<item>
<linkId value="Section-37/GG0170A3"/>
<text
value="Roll left and right - functional ability during 3 day assessment period [CMS Assessment]"/>
<answer>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA10055-4"/>
<display
value="Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds or supports trunk or limbs, but provides less than half the effort."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170B3"/>
<text
value="Sit to lying - functional ability during 3 day assessment period [CMS Assessment]"/>
<answer>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA10055-4"/>
<display
value="Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds or supports trunk or limbs, but provides less than half the effort."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170C3"/>
<text
value="Lying to sitting on side of bed - functional ability during 3 day assessment period [CMS Assessment]"/>
<answer>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA10055-4"/>
<display
value="Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds or supports trunk or limbs, but provides less than half the effort."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170D3"/>
<text
value="Sit to stand - functional ability during 3 day assessment period [CMS Assessment]"/>
<answer>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA10055-4"/>
<display
value="Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds or supports trunk or limbs, but provides less than half the effort."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170E3"/>
<text
value="Chair/bed-to-chair transfer - functional ability during 3 day assessment period [CMS Assessment]"/>
<answer>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA11759-0"/>
<display
value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170F3"/>
<text
value="Toilet transfer - functional ability during 3 day assessment period [CMS Assessment]"/>
<answer>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA11759-0"/>
<display
value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170G3"/>
<text
value="Car transfer - functional ability during 3 day assessment period [CMS Assessment]"/>
<answer>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA26735-3"/>
<display
value="Not attempted due to medical condition or safety concerns"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170I3"/>
<text
value="Walk 10 feet - functional ability during 3 day assessment period [CMS Assessment]"/>
<answer>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA11759-0"/>
<display
value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170J3"/>
<text
value="Walk 50 feet with two turns - functional ability during 3 day assessment period [CMS Assessment]"/>
<answer>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA11759-0"/>
<display
value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170K3"/>
<text
value="Walk 150 feet - functional ability during 3 day assessment period [CMS Assessment]"/>
<answer>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA11759-0"/>
<display
value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170L3"/>
<text
value="Walking 10 feet on uneven surfaces - functional ability during 3 day assessment period [CMS Assessment]"/>
<answer>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA26735-3"/>
<display
value="Not attempted due to medical condition or safety concerns"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170M3"/>
<text
value="1 step (curb) - functional ability during 3 day assessment period [CMS Assessment]"/>
<answer>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA26735-3"/>
<display
value="Not attempted due to medical condition or safety concerns"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170N3"/>
<text
value="4 steps - functional ability during 3 day assessment period [CMS Assessment]"/>
<answer>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA26735-3"/>
<display
value="Not attempted due to medical condition or safety concerns"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170O3"/>
<text
value="12 steps - functional ability during 3 day assessment period [CMS Assessment]"/>
<answer>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA26735-3"/>
<display
value="Not attempted due to medical condition or safety concerns"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170P3"/>
<text
value="Picking up object - functional ability during 3 day assessment period [CMS Assessment]"/>
<answer>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA26735-3"/>
<display
value="Not attempted due to medical condition or safety concerns"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170R3"/>
<text
value="Wheel 50 feet with two turns - functional ability during 3 day assessment period [CMS Assessment]"/>
<answer>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA11759-0"/>
<display
value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170S3"/>
<text
value="Wheel 150 feet - functional ability during 3 day assessment period [CMS Assessment]"/>
<answer>
<valueCoding>
<system value="http://loinc.org"/>
<code value="LA11759-0"/>
<display
value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/>
</valueCoding>
</answer>
</item>
</item>
</item>
</QuestionnaireResponse>