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 
{
"resourceType" : "QuestionnaireResponse",
"id" : "QResponse-Hospital-Discharge-Mobility-1",
"meta" : {
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"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 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>"
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"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" : "2020-07-10T14:34:00-05:00",
"author" : {
"reference" : "PractitionerRole/Role-PT-RonMarble"
},
"item" : [
{
"linkId" : "Section-37",
"text" : "Functional abilities and goals - discharge [CMS Assessment]",
"item" : [
{
"linkId" : "Section-37/GG0170_3",
"text" : "Mobility - discharge performance during 3 day assessment period [CMS Assessment]",
"item" : [
{
"linkId" : "Section-37/GG0170A3",
"text" : "Roll left and right - functional ability during 3 day assessment period [CMS Assessment]",
"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/GG0170B3",
"text" : "Sit to lying - functional ability during 3 day assessment period [CMS Assessment]",
"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/GG0170C3",
"text" : "Lying to sitting on side of bed - functional ability during 3 day assessment period [CMS Assessment]",
"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/GG0170D3",
"text" : "Sit to stand - functional ability during 3 day assessment period [CMS Assessment]",
"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/GG0170E3",
"text" : "Chair/bed-to-chair transfer - functional ability during 3 day assessment period [CMS Assessment]",
"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/GG0170F3",
"text" : "Toilet transfer - functional ability during 3 day assessment period [CMS Assessment]",
"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/GG0170G3",
"text" : "Car transfer - functional ability during 3 day assessment period [CMS Assessment]",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA26735-3",
"display" : "Not attempted due to medical condition or safety concerns"
}
}
]
},
{
"linkId" : "Section-37/GG0170I3",
"text" : "Walk 10 feet - functional ability during 3 day assessment period [CMS Assessment]",
"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/GG0170J3",
"text" : "Walk 50 feet with two turns - functional ability during 3 day assessment period [CMS Assessment]",
"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/GG0170K3",
"text" : "Walk 150 feet - functional ability during 3 day assessment period [CMS Assessment]",
"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/GG0170L3",
"text" : "Walking 10 feet on uneven surfaces - functional ability during 3 day assessment period [CMS Assessment]",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA26735-3",
"display" : "Not attempted due to medical condition or safety concerns"
}
}
]
},
{
"linkId" : "Section-37/GG0170M3",
"text" : "1 step (curb) - functional ability during 3 day assessment period [CMS Assessment]",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA26735-3",
"display" : "Not attempted due to medical condition or safety concerns"
}
}
]
},
{
"linkId" : "Section-37/GG0170N3",
"text" : "4 steps - functional ability during 3 day assessment period [CMS Assessment]",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA26735-3",
"display" : "Not attempted due to medical condition or safety concerns"
}
}
]
},
{
"linkId" : "Section-37/GG0170O3",
"text" : "12 steps - functional ability during 3 day assessment period [CMS Assessment]",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA26735-3",
"display" : "Not attempted due to medical condition or safety concerns"
}
}
]
},
{
"linkId" : "Section-37/GG0170P3",
"text" : "Picking up object - functional ability during 3 day assessment period [CMS Assessment]",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "LA26735-3",
"display" : "Not attempted due to medical condition or safety concerns"
}
}
]
},
{
"linkId" : "Section-37/GG0170R3",
"text" : "Wheel 50 feet with two turns - functional ability during 3 day assessment period [CMS Assessment]",
"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/GG0170S3",
"text" : "Wheel 150 feet - functional ability during 3 day assessment period [CMS Assessment]",
"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."
}
}
]
}
]
}
]
}
]
}
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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