This page is part of the PACIO Personal Functioning and Engagement Implementation Guide (v1.0.0: STU 1) based on FHIR (HL7® FHIR® Standard) 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

• Narrative Content
• XML
• JSON
• TTL

Example QuestionnaireResponse: PFEIG-QResponse-Hospital-Discharge-Mobility-1

LinkId	Text	Definition	Answer
PFEIG-QResponse-Hospital-Discharge-Mobility-1			Questionnaire:http://example.org/Questionnaire/MDS3.0-NC-1.17
Section-37	Functional abilities and goals - discharge [CMS Assessment]
Section-37/GG0170_3	Mobility - discharge performance during 3 day assessment period [CMS Assessment]
Section-37/GG0170A3	Roll left and right - functional ability during 3 day assessment period [CMS Assessment]		Logical Observation Identifiers, Names and Codes (LOINC) LA10055-4: 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.
Section-37/GG0170B3	Sit to lying - functional ability during 3 day assessment period [CMS Assessment]		Logical Observation Identifiers, Names and Codes (LOINC) LA10055-4: 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.
Section-37/GG0170C3	Lying to sitting on side of bed - functional ability during 3 day assessment period [CMS Assessment]		Logical Observation Identifiers, Names and Codes (LOINC) LA10055-4: 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.
Section-37/GG0170D3	Sit to stand - functional ability during 3 day assessment period [CMS Assessment]		Logical Observation Identifiers, Names and Codes (LOINC) LA10055-4: 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.
Section-37/GG0170E3	Chair/bed-to-chair transfer - functional ability during 3 day assessment period [CMS Assessment]		Logical Observation Identifiers, Names and Codes (LOINC) 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.
Section-37/GG0170F3	Toilet transfer - functional ability during 3 day assessment period [CMS Assessment]		Logical Observation Identifiers, Names and Codes (LOINC) 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.
Section-37/GG0170G3	Car transfer - functional ability during 3 day assessment period [CMS Assessment]		Logical Observation Identifiers, Names and Codes (LOINC) LA26735-3: Not attempted due to medical condition or safety concerns
Section-37/GG0170I3	Walk 10 feet - functional ability during 3 day assessment period [CMS Assessment]		Logical Observation Identifiers, Names and Codes (LOINC) 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.
Section-37/GG0170J3	Walk 50 feet with two turns - functional ability during 3 day assessment period [CMS Assessment]		Logical Observation Identifiers, Names and Codes (LOINC) 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.
Section-37/GG0170K3	Walk 150 feet - functional ability during 3 day assessment period [CMS Assessment]		Logical Observation Identifiers, Names and Codes (LOINC) 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.
Section-37/GG0170L3	Walking 10 feet on uneven surfaces - functional ability during 3 day assessment period [CMS Assessment]		Logical Observation Identifiers, Names and Codes (LOINC) LA26735-3: Not attempted due to medical condition or safety concerns
Section-37/GG0170M3	1 step (curb) - functional ability during 3 day assessment period [CMS Assessment]		Logical Observation Identifiers, Names and Codes (LOINC) LA26735-3: Not attempted due to medical condition or safety concerns
Section-37/GG0170N3	4 steps - functional ability during 3 day assessment period [CMS Assessment]		Logical Observation Identifiers, Names and Codes (LOINC) LA26735-3: Not attempted due to medical condition or safety concerns
Section-37/GG0170O3	12 steps - functional ability during 3 day assessment period [CMS Assessment]		Logical Observation Identifiers, Names and Codes (LOINC) LA26735-3: Not attempted due to medical condition or safety concerns
Section-37/GG0170P3	Picking up object - functional ability during 3 day assessment period [CMS Assessment]		Logical Observation Identifiers, Names and Codes (LOINC) LA26735-3: Not attempted due to medical condition or safety concerns
Section-37/GG0170R3	Wheel 50 feet with two turns - functional ability during 3 day assessment period [CMS Assessment]		Logical Observation Identifiers, Names and Codes (LOINC) 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.
Section-37/GG0170S3	Wheel 150 feet - functional ability during 3 day assessment period [CMS Assessment]		Logical Observation Identifiers, Names and Codes (LOINC) 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.
Documentation for this format