Related prior issues:
CYPRESS-2773
CYPRESS-2194

Similar to prior issues with import/export where local offsets are applied by a vendor and then re-shifted to UTC by the Cypress calculation engine, we found a new case with CMS1017v2 where patient Z5 7 GP Geriatric has an encounter spanning Daylight Saving Time in the United States.

With the absence of offsets provided, the application at a localized site in the United States appends timezones on either side of DST.

<effectiveTime xsi:type="IVL_TS" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
   <low value="20240308080000-0600"/>
   <high value="20240314081500-0500"/>
</effectiveTime>

When retransformed back to UTC, this results in a Denominator Observation as duration in days of Global."HospitalizationWithObservation" of 5 instead of 6. I have not looked at the other patients, but I imagine there may be other patients that could be affected for CMS1017 if the random 1-10 day shift is applied. A potential solution could be to have the time of day of the "HospitalizationWithObservation" start/end dateTimes not be within the same hour for CMS1017 patients, unless this is a purposeful test case for day granularity testing.

The main purpose is to confirm previous guidance that calculation errors may occur due to time zone shifting during ONC-ATL validation of certified software.