Related prior issues:
CYPRESS-2773
CYPRESS-2194
CYPRESS-2818

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 (rare) case with CMS832v3 where patient 3 AKI 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 for the encounter (Nov 1, 2026 in US).

<!-- Timing element for Encounter, Performed -->
<effectiveTime xsi:type="IVL_TS" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
   <low value="20261030080000-0500"/>
   <high value="20261103200000-0600"/>
</effectiveTime>

<!-- Timing element for Creatinine Lab -->
< effectiveTime value = "20261101073500-0600" />

This also means that the number of creatinine labs within the first 48 hours are variable due to DST. When timing is normalized to UTC by the calculating system, the time difference here is now 48 hours and 35 minutes from start of Encounter.

Now, this does seem somewhat rare. Day shifting of +1 day was done on this normalized patient. Additionally, the product under test selected "Shift Records" to move into 2026. 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.