PACIO Functional Status Implementation Guide
1.0.0 - STU 1
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 in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions 
<QuestionnaireResponse xmlns="http://hl7.org/fhir">
<id value="QResponse-Hospital-Admission-Mobility-1"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse"/>
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<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 8, 2020 9:00:00 PM</p><p><b>author</b>: <a href="PractitionerRole-Role-PT-SallySmith.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 - admission [CMS Assessment]</p><blockquote><p><b>item</b></p><p><b>linkId</b>: Section-37/GG0170_1</p><p><b>text</b>: Mobility - admission 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="2020-07-08T16:00:00-05:00"/>
<author>
<reference value="PractitionerRole/Role-PT-SallySmith"/>
</author>
<item>
<linkId value="Section-37"/>
<text value="Functional abilities and goals - admission [CMS Assessment]"/>
<item>
<linkId value="Section-37/GG0170_1"/>
<text
value="Mobility - admission performance during 3 day assessment period [CMS Assessment]"/>
<item>
<linkId value="Section-37/GG0170A1"/>
<text
value="Roll left and right - 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/GG0170B1"/>
<text
value="Sit to lying - 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/GG0170C1"/>
<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="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/GG0170D1"/>
<text
value="Sit to stand - 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/GG0170E1"/>
<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="LA27665-1"/>
<display
value="Dependent - Helper does all of the effort. Patient does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the patient to complete the activity."/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170F1"/>
<text
value="Toilet 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/GG0170G1"/>
<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/GG0170I1"/>
<text
value="Walk 10 feet - 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/GG0170J1"/>
<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="LA26735-3"/>
<display
value="Not attempted due to medical condition or safety concerns"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170K1"/>
<text
value="Walk 150 feet - 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/GG0170L1"/>
<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/GG0170M1"/>
<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/GG0170N1"/>
<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/GG0170O1"/>
<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/GG0170P1"/>
<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/GG0170R1"/>
<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="LA26735-3"/>
<display
value="Not attempted due to medical condition or safety concerns"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="Section-37/GG0170S1"/>
<text
value="Wheel 150 feet - 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>
</item>
</QuestionnaireResponse>
IG © 2020+ HL7 Patient Care Work Group. Package hl7.fhir.us.pacio-fs#1.0.0 based on FHIR 4.0.1. Generated 2021-11-03
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