PACIO Functional Status Implementation Guide
1.0.0 - STU 1

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

: QResponse-Hospital-Discharge-Mobility-1 - XML Representation

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<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>