PACIO Functional Status Implementation Guide
1.0.0 - STU 1

This page is part of the PACIO Functional Status Implementation Guide (v1.0.0: STU 1) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: QResponse-SNF-Admission-Mobility-SelfCare-1 - JSON Representation

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{
  "resourceType" : "QuestionnaireResponse",
  "id" : "QResponse-SNF-Admission-Mobility-SelfCare-1",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<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 11, 2020 9:32:00 PM</p><p><b>author</b>: <a href=\"PractitionerRole-Role-OT-JenCadbury.html\">Generated Summary: active: true; <span title=\"Codes: {http://snomed.info/sct 80546007}\">Occupational therapist</span></a></p><blockquote><p><b>item</b></p><p><b>linkId</b>: Section-37</p><p><b>text</b>: Functional abilities and goals - admission [CMS Assessment]</p><blockquote><p><b>item</b></p><p><b>linkId</b>: Section-37/GG0130_1</p><p><b>text</b>: Self-care - admission performance [CMS Assessment]</p></blockquote></blockquote></div>"
  },
  "questionnaire" : "http://example.org/Questionnaire/MDS3.0-NC-1.17",
  "_questionnaire" : {
    "extension" : [
      {
        "url" : "http://hl7.org/fhir/StructureDefinition/display",
        "valueString" : "Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.17.1 [CMS Assessment]"
      }
    ]
  },
  "status" : "completed",
  "subject" : {
    "reference" : "Patient/patientBSJ1"
  },
  "authored" : "2020-07-11T16:32:00-05:00",
  "author" : {
    "reference" : "PractitionerRole/Role-OT-JenCadbury"
  },
  "item" : [
    {
      "linkId" : "Section-37",
      "text" : "Functional abilities and goals - admission [CMS Assessment]",
      "item" : [
        {
          "linkId" : "Section-37/GG0130_1",
          "text" : "Self-care - admission performance [CMS Assessment]",
          "item" : [
            {
              "linkId" : "Section-37/GG0130A1",
              "text" : "Eating",
              "answer" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA10055-4",
                    "display" : "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."
                  }
                }
              ]
            },
            {
              "linkId" : "Section-37/GG0130B1",
              "text" : "Oral hygiene",
              "answer" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA10055-4",
                    "display" : "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."
                  }
                }
              ]
            },
            {
              "linkId" : "Section-37/GG0130C1",
              "text" : "Toileting hygiene",
              "answer" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA10055-4",
                    "display" : "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."
                  }
                }
              ]
            },
            {
              "linkId" : "Section-37/GG0130E1",
              "text" : "Shower/bathe self",
              "answer" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "Section-37/GG0130F1",
              "text" : "Upper body dressing",
              "answer" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA10055-4",
                    "display" : "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."
                  }
                }
              ]
            },
            {
              "linkId" : "Section-37/GG0130G1",
              "text" : "Lower body dressing",
              "answer" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."
                  }
                }
              ]
            },
            {
              "linkId" : "Section-37/GG0130H1",
              "text" : "Putting on/taking off footwear",
              "answer" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."
                  }
                }
              ]
            }
          ]
        }
      ]
    }
  ]
}