PACIO Personal Functioning and Engagement Implementation Guide
1.0.0-ballot - ballot1 US

This page is part of the PACIO Personal Functioning and Engagement Implementation Guide (v1.0.0-ballot: STU 1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

: PFEIG-QResponse-Hospital-Admission-Mobility-1 - TTL Representation

Raw ttl | Download


@prefix fhir: <http://hl7.org/fhir/> .
@prefix loinc: <http://loinc.org/rdf#> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:QuestionnaireResponse;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "PFEIG-QResponse-Hospital-Admission-Mobility-1"];
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/core/StructureDefinition/us-core-questionnaireresponse>     ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The linkId for the item\">LinkId</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the the itemcan appear in the instance\">Definition</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Answer</a><span style=\"float: right\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireResponseRoot\" class=\"hierarchy\"/> PFEIG-QResponse-Hospital-Admission-Mobility-1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">QuestionnaireResponse</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> Section-37</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Functional abilities and goals - admission [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck001.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> Section-37/GG0170_1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Mobility - admission performance during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> Section-37/GG0170A1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Roll left and right - functional ability during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"https://loinc.org/LA11759-0\">Logical Observation Identifiers, Names and Codes (LOINC)</a> LA11759-0: Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> Section-37/GG0170B1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Sit to lying - functional ability during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"https://loinc.org/LA11759-0\">Logical Observation Identifiers, Names and Codes (LOINC)</a> LA11759-0: Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> Section-37/GG0170C1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Lying to sitting on side of bed - functional ability during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"https://loinc.org/LA11759-0\">Logical Observation Identifiers, Names and Codes (LOINC)</a> LA11759-0: Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> Section-37/GG0170D1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Sit to stand - functional ability during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"https://loinc.org/LA11759-0\">Logical Observation Identifiers, Names and Codes (LOINC)</a> LA11759-0: Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> Section-37/GG0170E1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Chair/bed-to-chair transfer - functional ability during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"https://loinc.org/LA27665-1\">Logical Observation Identifiers, Names and Codes (LOINC)</a> LA27665-1: 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.</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> Section-37/GG0170F1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Toilet transfer - functional ability during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"https://loinc.org/LA26735-3\">Logical Observation Identifiers, Names and Codes (LOINC)</a> LA26735-3: Not attempted due to medical condition or safety concerns</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> Section-37/GG0170G1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Car transfer - functional ability during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"https://loinc.org/LA26735-3\">Logical Observation Identifiers, Names and Codes (LOINC)</a> LA26735-3: Not attempted due to medical condition or safety concerns</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> Section-37/GG0170I1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Walk 10 feet - functional ability during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"https://loinc.org/LA26735-3\">Logical Observation Identifiers, Names and Codes (LOINC)</a> LA26735-3: Not attempted due to medical condition or safety concerns</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> Section-37/GG0170J1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Walk 50 feet with two turns - functional ability during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"https://loinc.org/LA26735-3\">Logical Observation Identifiers, Names and Codes (LOINC)</a> LA26735-3: Not attempted due to medical condition or safety concerns</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> Section-37/GG0170K1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Walk 150 feet - functional ability during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"https://loinc.org/LA26735-3\">Logical Observation Identifiers, Names and Codes (LOINC)</a> LA26735-3: Not attempted due to medical condition or safety concerns</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> Section-37/GG0170L1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Walking 10 feet on uneven surfaces - functional ability during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"https://loinc.org/LA26735-3\">Logical Observation Identifiers, Names and Codes (LOINC)</a> LA26735-3: Not attempted due to medical condition or safety concerns</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> Section-37/GG0170M1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1 step (curb) - functional ability during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"https://loinc.org/LA26735-3\">Logical Observation Identifiers, Names and Codes (LOINC)</a> LA26735-3: Not attempted due to medical condition or safety concerns</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> Section-37/GG0170N1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">4 steps - functional ability during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"https://loinc.org/LA26735-3\">Logical Observation Identifiers, Names and Codes (LOINC)</a> LA26735-3: Not attempted due to medical condition or safety concerns</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> Section-37/GG0170O1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">12 steps - functional ability during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"https://loinc.org/LA26735-3\">Logical Observation Identifiers, Names and Codes (LOINC)</a> LA26735-3: Not attempted due to medical condition or safety concerns</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> Section-37/GG0170P1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Picking up object - functional ability during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"https://loinc.org/LA26735-3\">Logical Observation Identifiers, Names and Codes (LOINC)</a> LA26735-3: Not attempted due to medical condition or safety concerns</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> Section-37/GG0170R1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Wheel 50 feet with two turns - functional ability during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"https://loinc.org/LA26735-3\">Logical Observation Identifiers, Names and Codes (LOINC)</a> LA26735-3: Not attempted due to medical condition or safety concerns</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> Section-37/GG0170S1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Wheel 150 feet - functional ability during 3 day assessment period [CMS Assessment]</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"https://loinc.org/LA26735-3\">Logical Observation Identifiers, Names and Codes (LOINC)</a> LA26735-3: Not attempted due to medical condition or safety concerns</span></span></td></tr>\r\n<tr><td colspan=\"4\" class=\"hierarchy\"><br/><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/R4/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"
  ];
  fhir:QuestionnaireResponse.questionnaire [
     fhir:value "http://example.org/Questionnaire/MDS3.0-NC-1.17";
     fhir:link <http://example.org/Questionnaire/MDS3.0-NC-1.17>;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/display" ];
       fhir:Extension.valueString [ fhir:value "Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.17.1 [CMS Assessment]" ]     ]
  ];
  fhir:QuestionnaireResponse.status [ fhir:value "completed"];
  fhir:QuestionnaireResponse.subject [
     fhir:Reference.reference [ fhir:value "Patient/PFEIG-patientBSJ1" ]
  ];
  fhir:QuestionnaireResponse.authored [ fhir:value "2020-07-08T16:00:00-05:00"^^xsd:dateTime];
  fhir:QuestionnaireResponse.author [
     fhir:Reference.reference [ fhir:value "PractitionerRole/PFEIG-Role-PT-SallySmith" ]
  ];
  fhir:QuestionnaireResponse.item [
     fhir:index 0;
     fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37" ];
     fhir:QuestionnaireResponse.item.text [ fhir:value "Functional abilities and goals - admission [CMS Assessment]" ];
     fhir:QuestionnaireResponse.item.item [
       fhir:index 0;
       fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170_1" ];
       fhir:QuestionnaireResponse.item.text [ fhir:value "Mobility - admission performance during 3 day assessment period [CMS Assessment]" ];
       fhir:QuestionnaireResponse.item.item [
         fhir:index 0;
         fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170A1" ];
         fhir:QuestionnaireResponse.item.text [ fhir:value "Roll left and right - functional ability during 3 day assessment period [CMS Assessment]" ];
         fhir:QuestionnaireResponse.item.answer [
           fhir:index 0;
           fhir:QuestionnaireResponse.item.answer.valueCoding [
             a loinc:LA11759-0;
             fhir:Coding.system [ fhir:value "http://loinc.org" ];
             fhir:Coding.code [ fhir:value "LA11759-0" ];
             fhir:Coding.display [ fhir: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." ]           ]         ]       ], [
         fhir:index 1;
         fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170B1" ];
         fhir:QuestionnaireResponse.item.text [ fhir:value "Sit to lying - functional ability during 3 day assessment period [CMS Assessment]" ];
         fhir:QuestionnaireResponse.item.answer [
           fhir:index 0;
           fhir:QuestionnaireResponse.item.answer.valueCoding [
             a loinc:LA11759-0;
             fhir:Coding.system [ fhir:value "http://loinc.org" ];
             fhir:Coding.code [ fhir:value "LA11759-0" ];
             fhir:Coding.display [ fhir: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." ]           ]         ]       ], [
         fhir:index 2;
         fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170C1" ];
         fhir:QuestionnaireResponse.item.text [ fhir:value "Lying to sitting on side of bed - functional ability during 3 day assessment period [CMS Assessment]" ];
         fhir:QuestionnaireResponse.item.answer [
           fhir:index 0;
           fhir:QuestionnaireResponse.item.answer.valueCoding [
             a loinc:LA11759-0;
             fhir:Coding.system [ fhir:value "http://loinc.org" ];
             fhir:Coding.code [ fhir:value "LA11759-0" ];
             fhir:Coding.display [ fhir: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." ]           ]         ]       ], [
         fhir:index 3;
         fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170D1" ];
         fhir:QuestionnaireResponse.item.text [ fhir:value "Sit to stand - functional ability during 3 day assessment period [CMS Assessment]" ];
         fhir:QuestionnaireResponse.item.answer [
           fhir:index 0;
           fhir:QuestionnaireResponse.item.answer.valueCoding [
             a loinc:LA11759-0;
             fhir:Coding.system [ fhir:value "http://loinc.org" ];
             fhir:Coding.code [ fhir:value "LA11759-0" ];
             fhir:Coding.display [ fhir: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." ]           ]         ]       ], [
         fhir:index 4;
         fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170E1" ];
         fhir:QuestionnaireResponse.item.text [ fhir:value "Chair/bed-to-chair transfer - functional ability during 3 day assessment period [CMS Assessment]" ];
         fhir:QuestionnaireResponse.item.answer [
           fhir:index 0;
           fhir:QuestionnaireResponse.item.answer.valueCoding [
             a loinc:LA27665-1;
             fhir:Coding.system [ fhir:value "http://loinc.org" ];
             fhir:Coding.code [ fhir:value "LA27665-1" ];
             fhir:Coding.display [ fhir: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." ]           ]         ]       ], [
         fhir:index 5;
         fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170F1" ];
         fhir:QuestionnaireResponse.item.text [ fhir:value "Toilet transfer - functional ability during 3 day assessment period [CMS Assessment]" ];
         fhir:QuestionnaireResponse.item.answer [
           fhir:index 0;
           fhir:QuestionnaireResponse.item.answer.valueCoding [
             a loinc:LA26735-3;
             fhir:Coding.system [ fhir:value "http://loinc.org" ];
             fhir:Coding.code [ fhir:value "LA26735-3" ];
             fhir:Coding.display [ fhir:value "Not attempted due to medical condition or safety concerns" ]           ]         ]       ], [
         fhir:index 6;
         fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170G1" ];
         fhir:QuestionnaireResponse.item.text [ fhir:value "Car transfer - functional ability during 3 day assessment period [CMS Assessment]" ];
         fhir:QuestionnaireResponse.item.answer [
           fhir:index 0;
           fhir:QuestionnaireResponse.item.answer.valueCoding [
             a loinc:LA26735-3;
             fhir:Coding.system [ fhir:value "http://loinc.org" ];
             fhir:Coding.code [ fhir:value "LA26735-3" ];
             fhir:Coding.display [ fhir:value "Not attempted due to medical condition or safety concerns" ]           ]         ]       ], [
         fhir:index 7;
         fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170I1" ];
         fhir:QuestionnaireResponse.item.text [ fhir:value "Walk 10 feet - functional ability during 3 day assessment period [CMS Assessment]" ];
         fhir:QuestionnaireResponse.item.answer [
           fhir:index 0;
           fhir:QuestionnaireResponse.item.answer.valueCoding [
             a loinc:LA26735-3;
             fhir:Coding.system [ fhir:value "http://loinc.org" ];
             fhir:Coding.code [ fhir:value "LA26735-3" ];
             fhir:Coding.display [ fhir:value "Not attempted due to medical condition or safety concerns" ]           ]         ]       ], [
         fhir:index 8;
         fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170J1" ];
         fhir:QuestionnaireResponse.item.text [ fhir:value "Walk 50 feet with two turns - functional ability during 3 day assessment period [CMS Assessment]" ];
         fhir:QuestionnaireResponse.item.answer [
           fhir:index 0;
           fhir:QuestionnaireResponse.item.answer.valueCoding [
             a loinc:LA26735-3;
             fhir:Coding.system [ fhir:value "http://loinc.org" ];
             fhir:Coding.code [ fhir:value "LA26735-3" ];
             fhir:Coding.display [ fhir:value "Not attempted due to medical condition or safety concerns" ]           ]         ]       ], [
         fhir:index 9;
         fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170K1" ];
         fhir:QuestionnaireResponse.item.text [ fhir:value "Walk 150 feet - functional ability during 3 day assessment period [CMS Assessment]" ];
         fhir:QuestionnaireResponse.item.answer [
           fhir:index 0;
           fhir:QuestionnaireResponse.item.answer.valueCoding [
             a loinc:LA26735-3;
             fhir:Coding.system [ fhir:value "http://loinc.org" ];
             fhir:Coding.code [ fhir:value "LA26735-3" ];
             fhir:Coding.display [ fhir:value "Not attempted due to medical condition or safety concerns" ]           ]         ]       ], [
         fhir:index 10;
         fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170L1" ];
         fhir:QuestionnaireResponse.item.text [ fhir:value "Walking 10 feet on uneven surfaces - functional ability during 3 day assessment period [CMS Assessment]" ];
         fhir:QuestionnaireResponse.item.answer [
           fhir:index 0;
           fhir:QuestionnaireResponse.item.answer.valueCoding [
             a loinc:LA26735-3;
             fhir:Coding.system [ fhir:value "http://loinc.org" ];
             fhir:Coding.code [ fhir:value "LA26735-3" ];
             fhir:Coding.display [ fhir:value "Not attempted due to medical condition or safety concerns" ]           ]         ]       ], [
         fhir:index 11;
         fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170M1" ];
         fhir:QuestionnaireResponse.item.text [ fhir:value "1 step (curb) - functional ability during 3 day assessment period [CMS Assessment]" ];
         fhir:QuestionnaireResponse.item.answer [
           fhir:index 0;
           fhir:QuestionnaireResponse.item.answer.valueCoding [
             a loinc:LA26735-3;
             fhir:Coding.system [ fhir:value "http://loinc.org" ];
             fhir:Coding.code [ fhir:value "LA26735-3" ];
             fhir:Coding.display [ fhir:value "Not attempted due to medical condition or safety concerns" ]           ]         ]       ], [
         fhir:index 12;
         fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170N1" ];
         fhir:QuestionnaireResponse.item.text [ fhir:value "4 steps - functional ability during 3 day assessment period [CMS Assessment]" ];
         fhir:QuestionnaireResponse.item.answer [
           fhir:index 0;
           fhir:QuestionnaireResponse.item.answer.valueCoding [
             a loinc:LA26735-3;
             fhir:Coding.system [ fhir:value "http://loinc.org" ];
             fhir:Coding.code [ fhir:value "LA26735-3" ];
             fhir:Coding.display [ fhir:value "Not attempted due to medical condition or safety concerns" ]           ]         ]       ], [
         fhir:index 13;
         fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170O1" ];
         fhir:QuestionnaireResponse.item.text [ fhir:value "12 steps - functional ability during 3 day assessment period [CMS Assessment]" ];
         fhir:QuestionnaireResponse.item.answer [
           fhir:index 0;
           fhir:QuestionnaireResponse.item.answer.valueCoding [
             a loinc:LA26735-3;
             fhir:Coding.system [ fhir:value "http://loinc.org" ];
             fhir:Coding.code [ fhir:value "LA26735-3" ];
             fhir:Coding.display [ fhir:value "Not attempted due to medical condition or safety concerns" ]           ]         ]       ], [
         fhir:index 14;
         fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170P1" ];
         fhir:QuestionnaireResponse.item.text [ fhir:value "Picking up object - functional ability during 3 day assessment period [CMS Assessment]" ];
         fhir:QuestionnaireResponse.item.answer [
           fhir:index 0;
           fhir:QuestionnaireResponse.item.answer.valueCoding [
             a loinc:LA26735-3;
             fhir:Coding.system [ fhir:value "http://loinc.org" ];
             fhir:Coding.code [ fhir:value "LA26735-3" ];
             fhir:Coding.display [ fhir:value "Not attempted due to medical condition or safety concerns" ]           ]         ]       ], [
         fhir:index 15;
         fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170R1" ];
         fhir:QuestionnaireResponse.item.text [ fhir:value "Wheel 50 feet with two turns - functional ability during 3 day assessment period [CMS Assessment]" ];
         fhir:QuestionnaireResponse.item.answer [
           fhir:index 0;
           fhir:QuestionnaireResponse.item.answer.valueCoding [
             a loinc:LA26735-3;
             fhir:Coding.system [ fhir:value "http://loinc.org" ];
             fhir:Coding.code [ fhir:value "LA26735-3" ];
             fhir:Coding.display [ fhir:value "Not attempted due to medical condition or safety concerns" ]           ]         ]       ], [
         fhir:index 16;
         fhir:QuestionnaireResponse.item.linkId [ fhir:value "Section-37/GG0170S1" ];
         fhir:QuestionnaireResponse.item.text [ fhir:value "Wheel 150 feet - functional ability during 3 day assessment period [CMS Assessment]" ];
         fhir:QuestionnaireResponse.item.answer [
           fhir:index 0;
           fhir:QuestionnaireResponse.item.answer.valueCoding [
             a loinc:LA26735-3;
             fhir:Coding.system [ fhir:value "http://loinc.org" ];
             fhir:Coding.code [ fhir:value "LA26735-3" ];
             fhir:Coding.display [ fhir:value "Not attempted due to medical condition or safety concerns" ]           ]         ]       ]     ]
  ].

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.