Testing CMS107 QRDA 3 in the Cypress tool. Patient STROKE_B has only an entry for: Communication: From Provider to Patient: Written Information Given" OID = 2.16.840.1.113883.3.117.1.7.1.415 and this patient was in the numerator. However, based on the logic (shown below) the patient should not be included in the numerator unless ALL of the communication from provider to patient data elements have been met.

Please provide information regarding clarification of this logic.

Numerator =
AND:
OR: "Communication: From Provider to Patient not done: Patient Refusal" for "Written Information Given SNOMED-CT Value Set"
OR:
AND: "Communication: From Provider to Patient: Activation of Emergency Medical System Education"
AND: "Communication: From Provider to Patient: Instructions for Follow Up After Discharge"
AND: "Communication: From Provider to Patient: Prescribed Medications Education"
AND: "Communication: From Provider to Patient: Risk Factors Education"
AND: "Communication: From Provider to Patient: Warning Signs and Symptoms Education"
AND: "Communication: From Provider to Patient: Written Information Given"

during "Occurrence A of Encounter, Performed: Non-Elective Inpatient Encounter"