Profile: EpisodeOfCare

• Service Enrollment Date and Service Initiation Date timestamp handling corrected - when EOC Status is Active and the Service Enrollment Date equals the Service Initiation Date, submitting either date with a full timestamp and timezone offset (e.g. 2026-09-30T00:00:00−04:00) caused the bundle to be rejected, even though the dates were logically equivalent. The constraint has been corrected to accept date-equivalent values regardless of whether a time component is included

Vendors may submit Service Enrollment Date and Service Initiation Date as either a plain date (YYYY-MM-DD) or a full dateTime with timezone offset. Bundles previously rejected solely on this basis should be resubmitted without any structural changes.

Profile: QuestionnaireResponse (Gambling Questionnaire)

• Problem Gambling Q4-b conditional rule enforced - when Q4-a is answered Yes, Q4-b is now required. Previously, omitting Q4-b when Q4-a = Yes was silently accepted; the bundle will now be rejected with a validation error if Q4-b is absent in this scenario

Vendors must ensure Q4-b is included in the QuestionnaireResponse whenever Q4-a is answered Yes. Payloads that omit Q4-b with Q4-a = Yes will be rejected from Snapshot 21 onwards.

• Questionnaire reference URL corrected - the questionnaire element in QuestionnaireResponse must now reference the canonical Questionnaire resource URL rather than the StructureDefinition URL. The corrected reference is required for the FHIR validator to resolve the questionnaire template from the IG package

Previous (incorrect e.g.):

"questionnaire": "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-mha-gambling-questionnaire-template"

Corrected (e.g.):

"questionnaire": "http://ontariohealth.ca/fhir/Questionnaire/ca-on-mha-gambling-questionnaire-template"

Vendors must update all QuestionnaireResponse bundles to reference the Questionnaire canonical URL (using /fhir/Questionnaire/) instead of /fhir/StructureDefinition/. Bundles using the StructureDefinition path will fail questionnaire resolution validation.