diff --git a/refiner/app/services/ecr/README.md b/refiner/app/services/ecr/README.md
index 0abc41084..5aed85942 100644
--- a/refiner/app/services/ecr/README.md
+++ b/refiner/app/services/ecr/README.md
@@ -36,7 +36,7 @@ The pipeline creates an `AugmentationContext` for each document before any work
 All of this is per the eICR Data Augmentation Header template (`urn:hl7ii:2.16.840.1.113883.10.20.15.2.1.3:2025-11-01`):
 
 - **`templateId`** — signals the document conforms to the augmentation header template
-- **`id`** — new UUID with `assigningAuthorityName="ecr-refinement"`
+- **`id`** — new UUID with `assigningAuthorityName="ecr-refiner"`
 - **`effectiveTime`** — timestamp of the augmentation operation (with timezone)
 - **`setId`** — new UUID (replaces original, or inserted if absent)
 - **`versionNumber`** — reset to 1
@@ -57,9 +57,9 @@ Refinement attaches an unanchored `<footnote>` to every section in the refined e
 
 The "what was configured" and "what actually happened" columns usually agree, but they can diverge. The most common divergence is the no-match case: a jurisdiction configures a section for refinement, the matching step finds nothing in the section that matches the configured codes, and the refiner stubs the section rather than preserving an orphaned narrative. The footnote makes that decision visible — a reviewer sees "Action: refine, Outcome: Refined; no matches found" in the same row and doesn't have to wonder why a refine-configured section came out empty.
 
-The footnote ID is built from the section's LOINC code and the augmentation timestamp (`ecr-refinement-{loinc}-{timestamp}`), so every footnote in a refinement run is structurally tied to the augmentation author's `<time>` value. A consumer can verify document integrity by checking that all footnote IDs in a document carry the same timestamp the augmentation header advertises.
+The footnote ID is built from the section's LOINC code and the augmentation timestamp (`ecr-refiner-{loinc}-{timestamp}`), so every footnote in a refinement run is structurally tied to the augmentation author's `<time>` value. A consumer can verify document integrity by checking that all footnote IDs in a document carry the same timestamp the augmentation header advertises.
 
-The user-facing labels for the configuration source and the runtime outcome live in `section/constants.py` as small dicts keyed by enum values. Editing the copy is one file change with no code touches.
+The user-facing labels for the configuration source and the runtime outcome live in `narrative/constants.py` as small dicts keyed by enum values. Editing the copy is one file change with no code touches.
 
 ## Supporting modules
 
diff --git a/refiner/app/services/ecr/narrative/README.md b/refiner/app/services/ecr/narrative/README.md
new file mode 100644
index 000000000..0a815cfe6
--- /dev/null
+++ b/refiner/app/services/ecr/narrative/README.md
@@ -0,0 +1,61 @@
+# Section narrative writers
+
+This package owns every transformation the refiner makes to a CDA
+`<section>`'s human-readable narrative `<text>` element. A section's `<text>`
+is what a reviewer sees when they open a refined eICR in a CDA stylesheet; the
+machine-readable `<entry>` elements are handled elsewhere (the matching
+engines). These writers decide what story the `<text>` tells about what the
+refiner did.
+
+## Why this is its own module
+
+Everything that touches a section's `<text>` lives here so the narrative
+behavior — and the CDA R2 validity rules it has to respect — can be reasoned
+about in one place. The matching engines (`entry_matching`, `generic_matching`)
+and the orchestrator (`refine.py`) call into this package; they never build
+narrative elements directly.
+
+## Layout
+
+- **`elements.py`** — the shared low-level primitives. `_make_element` /
+  `_sub_element` emit namespace-qualified elements (every node written into
+  `<text>` must carry the `urn:hl7-org:v3` namespace or it fails
+  `NarrativeBlock.xsd`). `_ensure_text_element` places a `<text>` in the
+  correct CDA R2 `xs:sequence` slot. `remove_all_comments` scrubs stale source
+  comments. Every other module here builds on these.
+
+- **`footnote.py`** — the per-section provenance footnote. Refinement attaches
+  an unanchored `<footnote>` to every section (refined, retained, removed, or
+  narrative-stripped) carrying a one-row table: what the jurisdiction
+  configured vs. what the refiner actually did. The footnote's `xs:ID` encodes
+  the augmentation run's timestamp so a consumer can structurally tie every
+  footnote to the document's augmentation header.
+
+- **`writers.py`** — the narrative-body writers that replace or stub a
+  section's `<text>`:
+  - `replace_narrative_with_removal_notice` — strip the narrative to a notice
+    while keeping clinical entries for machine processing.
+  - `restore_narrative` — put back a saved `<text>` deep copy (the generic
+    matching path clears `<text>` during processing to avoid false matches,
+    then restores it).
+  - `create_minimal_section` — reduce a section to a `nullFlavor="NI"` stub
+    with a status message (no match found, or configured for removal).
+
+## Invariants
+
+- **Namespace everything.** All emitted elements go through
+  `_make_element` / `_sub_element`. A bare (unprefixed) element silently fails
+  `NarrativeBlock.xsd` validation.
+- **Respect the `xs:sequence`.** A `<text>` must sit after `<title>` (or
+  `<code>`) in `StrucDoc.Section`. Insertion always goes through the placement
+  helpers rather than a bare `append`.
+- **These functions mutate the section in place.** Consistent with the rest of
+  the `ecr` service; the pipeline owns parse/serialize.
+
+## Planned: narrative reconstruction
+
+A third narrative disposition — reconstruct the `<text>` from the entries that
+survived refinement — will land here as a `reconstruction.py` peer of
+`writers.py`, built on the same `elements.py` primitives. See
+`docs/decisions/0010_2026-06-05_narrative-reconstruction.md` for the design
+(typed-value renderer + per-`template_id` field maps + per-section joins).
diff --git a/refiner/app/services/ecr/narrative/__init__.py b/refiner/app/services/ecr/narrative/__init__.py
new file mode 100644
index 000000000..ab96a9151
--- /dev/null
+++ b/refiner/app/services/ecr/narrative/__init__.py
@@ -0,0 +1,19 @@
+from .elements import remove_all_comments
+from .footnote import append_section_provenance_footnote
+from .reconstruction import reconstruct_narrative
+from .writers import (
+    create_minimal_section,
+    replace_narrative_with_reconstruction,
+    replace_narrative_with_removal_notice,
+    restore_narrative,
+)
+
+__all__ = [
+    "append_section_provenance_footnote",
+    "create_minimal_section",
+    "reconstruct_narrative",
+    "remove_all_comments",
+    "replace_narrative_with_reconstruction",
+    "replace_narrative_with_removal_notice",
+    "restore_narrative",
+]
diff --git a/refiner/app/services/ecr/section/constants.py b/refiner/app/services/ecr/narrative/constants.py
similarity index 87%
rename from refiner/app/services/ecr/section/constants.py
rename to refiner/app/services/ecr/narrative/constants.py
index 6b79bfa39..c6ef0e84d 100644
--- a/refiner/app/services/ecr/section/constants.py
+++ b/refiner/app/services/ecr/narrative/constants.py
@@ -33,18 +33,8 @@
 # NOTE:
 # TABLE HEADERS
 # =============================================================================
-# column headers for the narrative tables the refiner writes. the clinical
-# data table headers describe the columns for the refined clinical content
-# table; the provenance table headers describe the columns for the
-# per-section provenance footnote table
-
-CLINICAL_DATA_TABLE_HEADERS: Final[list[str]] = [
-    "Display Text",
-    "Code",
-    "Code System",
-    "Is Trigger Code",
-    "Matching Condition Code",
-]
+# column headers for the per-section provenance footnote table the refiner
+# writes into every section's narrative
 
 PROVENANCE_TABLE_HEADERS: Final[list[str]] = [
     "Section (LOINC)",
diff --git a/refiner/app/services/ecr/narrative/elements.py b/refiner/app/services/ecr/narrative/elements.py
new file mode 100644
index 000000000..799d7ca3a
--- /dev/null
+++ b/refiner/app/services/ecr/narrative/elements.py
@@ -0,0 +1,105 @@
+from lxml import etree
+from lxml.etree import _Element
+
+from app.services.format import remove_element
+
+from ..model import (
+    HL7_NAMESPACE,
+    HL7_NS,
+)
+
+# NOTE:
+# ELEMENT FACTORY HELPERS
+# =============================================================================
+# every element emitted into <text> must be qualified with the HL7 v3
+# namespace for NarrativeBlock.xsd validation to pass
+
+
+def _make_element(local_name: str, **attribs: str) -> _Element:
+    """
+    Create a namespace-qualified narrative element.
+
+    Returns a detached element in the urn:hl7-org:v3 namespace. Use
+    `_sub_element` instead when the new element should be appended
+    to an existing parent.
+    """
+
+    element = etree.Element(f"{{{HL7_NAMESPACE}}}{local_name}")
+    for key, value in attribs.items():
+        element.set(key, value)
+    return element
+
+
+def _sub_element(parent: _Element, local_name: str, **attribs: str) -> _Element:
+    """
+    Create a namespace-qualified child element appended to `parent`.
+
+    Thin wrapper around etree.SubElement that applies Clark notation
+    for the HL7 v3 namespace, matching the pattern used in augment.py.
+    """
+
+    element = etree.SubElement(parent, f"{{{HL7_NAMESPACE}}}{local_name}")
+    for key, value in attribs.items():
+        element.set(key, value)
+    return element
+
+
+# NOTE:
+# TEXT PLACEMENT HELPERS
+# =============================================================================
+
+
+def _ensure_text_element(section: _Element) -> _Element:
+    """
+    Return the section's <text> element, creating one if absent.
+
+    If the section has no <text>, a new empty <text> is created and
+    inserted after <title> per the CDA R2 xs:sequence for
+    StrucDoc.Section: templateId -> id -> code -> title -> text ->
+    confidentialityCode -> languageCode -> subject -> author ->
+    informant -> entry -> component.
+
+    If there is no <title> either, the <text> is inserted after
+    <code>, which is the next-earliest required element in the
+    sequence. Last resort: append to the section.
+    """
+
+    text_element = section.find("hl7:text", namespaces=HL7_NS)
+    if text_element is not None:
+        return text_element
+
+    text_element = _make_element("text")
+
+    title_element = section.find("hl7:title", namespaces=HL7_NS)
+    if title_element is not None:
+        title_element.addnext(text_element)
+        return text_element
+
+    code_element = section.find("hl7:code", namespaces=HL7_NS)
+    if code_element is not None:
+        code_element.addnext(text_element)
+        return text_element
+
+    section.append(text_element)
+    return text_element
+
+
+# NOTE:
+# COMMENT CLEANUP
+# =============================================================================
+
+
+def remove_all_comments(section: _Element) -> None:
+    """
+    Remove all XML comments from a processed section.
+
+    After refining a section, inline comments left over from the source
+    document may no longer be accurate or relevant. This scrubs them
+    so the refined output doesn't carry misleading annotations forward.
+    """
+
+    xpath_result = section.xpath(".//comment()")
+    if isinstance(xpath_result, list):
+        for comment in xpath_result:
+            if isinstance(comment, etree._Element):
+                remove_element(comment)
diff --git a/refiner/app/services/ecr/narrative/footnote.py b/refiner/app/services/ecr/narrative/footnote.py
new file mode 100644
index 000000000..4a83955f9
--- /dev/null
+++ b/refiner/app/services/ecr/narrative/footnote.py
@@ -0,0 +1,169 @@
+import re
+
+from lxml.etree import _Element
+
+from ..model import SectionProvenanceRecord
+from .constants import (
+    PROVENANCE_LABEL,
+    PROVENANCE_OUTCOME_NOTES,
+    PROVENANCE_SOURCE_NOTES,
+    PROVENANCE_TABLE_HEADERS,
+)
+from .elements import _ensure_text_element, _sub_element
+
+# NOTE:
+# PROVENANCE FOOTNOTE
+# =============================================================================
+# every section in the refined document carries a trailing <footnote>
+# documenting how the refiner treated it. the footnote is unanchored:
+# no <footnoteRef> points to it. This represents "annotation attached
+# to the section as a whole" — valid per NarrativeBlock.xsd's
+# StrucDoc.Text and StrucDoc.Footnote content models (both allow
+# footnote as an optional child with no anchoring requirement) and
+# sidesteps the need to walk arbitrary source narrative looking for
+# anchor points, which would be fragile across eICR vendors
+#
+# the footnote's xs:ID ties it to the augmentation run's timestamp,
+# giving the two structural consistency that a consumer can verify
+# programmatically (e.g., "every refiner footnote ID should contain
+# the timestamp present in the augmentation author's <time> value")
+#
+# the footnote's data row carries both the configured action ("what
+# the jurisdiction asked for") and the runtime outcome ("what the
+# refiner actually did"). the two columns let a reader see at a glance
+# whether a refiner policy override fired — most rows show the outcome
+# confirming the configuration, but the no-match policy override
+# produces an outcome that diverges from the configured action
+
+
+def _build_footnote_id(
+    loinc_code: str,
+    augmentation_timestamp: str,
+    occurrence_index: int = 0,
+) -> str:
+    """
+    Build a document-unique xs:ID for a refiner provenance footnote.
+
+    The ID is of the form
+    `ecr-refiner-{loinc}-{timestamp-digits}`, optionally with a
+    `-{n}` suffix for the rare case where the same LOINC appears on
+    multiple top-level sections in a single document. The timestamp
+    digits are extracted from the augmentation author's <time> value
+    (HL7 V3 `YYYYMMDDHHMMSS±ZZZZ` format) by keeping the leading
+    run of digits — the timezone offset is stripped because `+` and
+    the offset digits are not wanted in the ID.
+
+    xs:ID cannot start with a digit or hyphen, so the `ecr-refiner-`
+    prefix is load-bearing: it ensures the resulting string always
+    satisfies the XML Name production.
+
+    Args:
+        loinc_code: The section's LOINC code (e.g., "46240-8").
+        augmentation_timestamp: The augmentation author's time value,
+            shared across all footnotes in this refinement run.
+        occurrence_index: Zero-based disambiguator for the rare case
+            where the same LOINC appears on multiple top-level
+            sections. Zero (the normal case) produces no suffix;
+            nonzero values append `-N`.
+
+    Returns:
+        A document-unique xs:ID-safe string.
+    """
+
+    match = re.match(r"^\d+", augmentation_timestamp)
+    timestamp_digits = match.group(0) if match else ""
+    base = f"ecr-refiner-{loinc_code}-{timestamp_digits}"
+    return base if occurrence_index == 0 else f"{base}-{occurrence_index}"
+
+
+def append_section_provenance_footnote(
+    section: _Element,
+    provenance: SectionProvenanceRecord,
+    augmentation_timestamp: str,
+    occurrence_index: int = 0,
+) -> None:
+    """
+    Append an unanchored <footnote> carrying refiner provenance.
+
+    Called by refine_eicr after processing every section (refine,
+    retain, remove, narrative-removed) so that every section in the
+    refined document carries a consistent provenance record.
+
+    The footnote contains a bolded label paragraph followed by a
+    single-row table summarizing the jurisdiction's configuration
+    and the runtime outcome for this section. The table follows
+    NarrativeBlock.xsd's StrucDoc.Table content model with proper
+    <thead>/<th> header semantics and <tbody>/<tr>/<td> body rows.
+
+    The provenance record passed in must have its `outcome` field
+    finalized — refine_eicr does this via dataclasses.replace before
+    calling this function. If the field still holds its default
+    value at render time, that's a bug in refine_eicr's
+    interpretation logic, not in this function.
+
+    If the section has no <text> element (e.g., a retained section
+    where the source document omitted it), one is created and inserted
+    per `_ensure_text_element`'s CDA R2 xs:sequence rules.
+
+    Args:
+        section: The section element to annotate.
+        provenance: The SectionProvenanceRecord built during plan
+            creation and finalized by refine_eicr.
+        augmentation_timestamp: The augmentation run's <time> value,
+            shared across all footnotes in this refinement run.
+        occurrence_index: Disambiguator for repeated-LOINC sections;
+            zero for the normal case.
+    """
+
+    text_element = _ensure_text_element(section)
+
+    footnote_id = _build_footnote_id(
+        loinc_code=provenance.loinc_code,
+        augmentation_timestamp=augmentation_timestamp,
+        occurrence_index=occurrence_index,
+    )
+    footnote = _sub_element(text_element, "footnote", ID=footnote_id)
+
+    # bolded label paragraph
+    label_paragraph = _sub_element(footnote, "paragraph")
+    label_content = _sub_element(label_paragraph, "content", styleCode="Bold")
+    label_content.text = PROVENANCE_LABEL
+
+    # provenance table
+    table = _sub_element(footnote, "table", border="1")
+    thead = _sub_element(table, "thead")
+    header_row = _sub_element(thead, "tr")
+    for header in PROVENANCE_TABLE_HEADERS:
+        th = _sub_element(header_row, "th")
+        th.text = header
+
+    tbody = _sub_element(table, "tbody")
+    row = _sub_element(tbody, "tr")
+    _add_provenance_cell(row, provenance.loinc_code)
+    _add_provenance_cell(row, provenance.display_name)
+    _add_provenance_cell(row, "Yes" if provenance.include else "No")
+    _add_provenance_cell(row, provenance.action)
+    _add_provenance_cell(row, "Yes" if provenance.narrative == "retain" else "No")
+    _add_provenance_cell(
+        row,
+        f"v{provenance.config_version}"
+        if provenance.config_version is not None
+        else "—",
+    )
+    _add_provenance_cell(
+        row,
+        PROVENANCE_SOURCE_NOTES.get(provenance.source, str(provenance.source)),
+    )
+    _add_provenance_cell(
+        row,
+        PROVENANCE_OUTCOME_NOTES.get(provenance.outcome, str(provenance.outcome)),
+    )
+
+
+def _add_provenance_cell(row: _Element, text: str) -> None:
+    """
+    Append a single <td> with text content to a provenance table row.
+    """
+
+    td = _sub_element(row, "td")
+    td.text = text
diff --git a/refiner/app/services/ecr/narrative/reconstruction.py b/refiner/app/services/ecr/narrative/reconstruction.py
new file mode 100644
index 000000000..f4b27e364
--- /dev/null
+++ b/refiner/app/services/ecr/narrative/reconstruction.py
@@ -0,0 +1,343 @@
+from collections.abc import Callable
+from typing import Literal, NamedTuple
+
+from lxml import etree
+from lxml.etree import _Element
+
+from ..model import HL7_NS, HL7_XSI_NS
+from .elements import _make_element, _sub_element
+
+# a section reconstructor takes a post-prune section and returns the
+# (columns, rows) for its narrative table
+type SectionReconstructor = Callable[[_Element], tuple[list[str], list[dict[str, str]]]]
+
+# NOTE:
+# RECONSTRUCTION OVERVIEW
+# =============================================================================
+# rebuild a section's human-readable <text> from the entries that SURVIVED
+# refinement, so the narrative reflects what the document still contains
+# rather than the stale story the source EHR authored against the full entry
+# set
+#
+# three layers, drawn at the honest DRY seam:
+#   1. shared primitives (typed-value renderer, field extractor, table
+#      builder)--closed-set mechanical work, written once, section-agnostic
+#   2. field maps (data)--per-statement (label, relative-xpath, kind) lists
+#   3. per-section joins (code)--the structural quirks: row anchor + the
+#      ancestor/sibling context a row reaches for
+#
+# sections relate by convention, not container: a flat LOINC -> function
+# dispatch dict. adding a section is "one field map + one function + one
+# dict entry"
+
+_XSI: str = HL7_XSI_NS["xsi"]
+
+
+# NOTE:
+# LAYER 1 — SHARED PRIMITIVE: typed-value renderer
+# =============================================================================
+# CDA data types are a CLOSED set, so every "render a value element to a
+# string" branch lives here, in one place. Field maps never mention xsi:type;
+# they hand the element to this function and let it decide
+#
+# it absorbs two flavours of polymorphism:
+#   - <value xsi:type="PQ"/> is polymorphic: the type rides on xsi:type
+#   - <doseQuantity value= unit=/> is monomorphic: PQ by the CDA model, with
+#     no xsi:type at all
+# this is also the logic the displayName enrichment performs by hand today;
+# it is the primitive most likely to be reused when the template-aware
+# matching engine lands
+
+
+def render_typed_value(el: _Element | None) -> str:
+    """
+    Render a CDA value-bearing element to a display string.
+
+    Branches over the closed CDA R2 abstract data-type set (CD, PQ, ST,
+    IVL_TS, PIVL_TS) plus a bare value/text fallback. Handles both
+    xsi:type-tagged polymorphic values and monomorphic elements that are a
+    given type by the CDA model (e.g. doseQuantity is PQ with no xsi:type).
+
+    Args:
+        el: The element to render, or None.
+
+    Returns:
+        A human-readable string, or "" when there is nothing to render.
+    """
+
+    if el is None:
+        return ""
+
+    xsi_type = el.get(f"{{{_XSI}}}type")
+
+    # coded value (CD)--declared via xsi:type, or monomorphic (a coded
+    # element such as interpretationCode that carries @code with no xsi:type)
+    if xsi_type == "CD" or (xsi_type is None and el.get("code")):
+        disp, code = el.get("displayName"), el.get("code")
+        if disp and code:
+            return f"{disp} ({code})"
+        return disp or code or ""
+
+    # physical quantity (PQ)--declared via xsi:type, or monomorphic
+    # (doseQuantity and friends are PQ by the model)
+    if xsi_type == "PQ" or (xsi_type is None and el.get("unit") is not None):
+        val, unit = el.get("value"), el.get("unit")
+        return f"{val} {unit}".strip() if val else ""
+
+    # simple text (ST)
+    if xsi_type == "ST":
+        return (el.text or "").strip()
+
+    # interval of time (IVL_TS)--low/high children
+    low, high = el.find("hl7:low", HL7_NS), el.find("hl7:high", HL7_NS)
+    if low is not None or high is not None:
+        lo = low.get("value") if low is not None else None
+        hi = high.get("value") if high is not None else None
+        if lo and hi:
+            return f"{lo} to {hi}"
+        return lo or hi or ""
+
+    # periodic interval (PIVL_TS)--frequency
+    period = el.find("hl7:period", HL7_NS)
+    if period is not None:
+        return f"every {period.get('value')} {period.get('unit')}".strip()
+
+    # bare timestamp / value, or text
+    return el.get("value") or (el.text or "").strip()
+
+
+# NOTE:
+# LAYER 1 — SHARED PRIMITIVE: field extractor + the field-spec record
+# =============================================================================
+# FieldSpec is a data record (NamedTuple), not a behaviour-bearing class:
+# "data record yes, extractor class hierarchy no." `kind` tells the extractor
+# how to stringify whatever the xpath lands on:
+#   "attr"  -> xpath ends at an attribute; lxml returns the string directly
+#   "typed" -> xpath ends at an element; hand it to render_typed_value
+#   "text"  -> xpath ends at an element; take its text content
+
+
+class FieldSpec(NamedTuple):
+    """
+    One field to read off an anchor element: header, relative xpath, kind.
+    """
+
+    label: str  # becomes the column header
+    xpath: str  # RELATIVE to the anchor element passed to extract_fields
+    kind: Literal["attr", "typed", "text"]
+
+
+def extract_fields(anchor: _Element, field_map: list[FieldSpec]) -> dict[str, str]:
+    """
+    Read a flat list of fields off ONE anchor element.
+
+    No joining happens here — every xpath is relative to ``anchor``. This is
+    reused at every structural level by the join functions (organizer,
+    procedure, observation all flow through this same call).
+
+    Args:
+        anchor: The element each field xpath is evaluated against.
+        field_map: The fields to read.
+
+    Returns:
+        A label -> value mapping; missing fields render as "".
+    """
+
+    row: dict[str, str] = {}
+    for spec in field_map:
+        results = anchor.xpath(spec.xpath, namespaces=HL7_NS)
+        if not isinstance(results, list) or not results:
+            row[spec.label] = ""
+            continue
+
+        first = results[0]
+        if spec.kind == "attr":
+            row[spec.label] = str(first)
+        elif spec.kind == "typed":
+            row[spec.label] = (
+                render_typed_value(first) if isinstance(first, _Element) else ""
+            )
+        elif spec.kind == "text":
+            row[spec.label] = (
+                (first.text or "").strip() if isinstance(first, _Element) else ""
+            )
+        else:
+            row[spec.label] = ""
+    return row
+
+
+# NOTE:
+# LAYER 1 — SHARED PRIMITIVE: CDA narrative table builder
+# =============================================================================
+# builds a <text><table>...</table> narrative block via the namespace-aware
+# element helpers (the same ones the footnote/stub writers use, so the output
+# is NarrativeBlock.xsd-valid rather than bare HTML — the failure mode that
+# disconnected the previous reconstruction attempt)
+# * the block-level "machine-derived" marker goes HERE, on the whole block;
+# not smeared across individual fields
+# * this is the seam that later grows into <author> participation provenance
+
+_RECONSTRUCTION_MARKER: str = (
+    " Narrative reconstructed by the eCR Refiner from surviving clinical "
+    "entries: machine-derived, not clinician-attested. "
+)
+
+
+def build_table(columns: list[str], rows: list[dict[str, str]]) -> _Element:
+    """
+    Build a detached narrative <text> containing a reconstruction table.
+
+    The <text> carries a block-level comment marking it as machine-derived,
+    then a <table> with one row per entry in ``rows``.
+
+    Args:
+        columns: Ordered column headers; also the keys read from each row.
+        rows: One mapping per table row (column -> value).
+
+    Returns:
+        A detached, namespace-qualified <text> element.
+    """
+
+    text = _make_element("text")
+    text.append(etree.Comment(_RECONSTRUCTION_MARKER))
+
+    table = _sub_element(text, "table", border="1")
+
+    thead = _sub_element(table, "thead")
+    header_row = _sub_element(thead, "tr")
+    for col in columns:
+        th = _sub_element(header_row, "th")
+        th.text = col
+
+    tbody = _sub_element(table, "tbody")
+    for row in rows:
+        tr = _sub_element(tbody, "tr")
+        for col in columns:
+            td = _sub_element(tr, "td")
+            td.text = row.get(col, "") or ""
+
+    return text
+
+
+# NOTE:
+# LAYER 2 — DATA: field maps (the part refiner_narrative.xlsx pins down)
+# =============================================================================
+# each map is "given THIS anchor element, here are its fields." None of them
+# mention joins or xsi:type. In the future template-aware engine these become
+# keyed by templateId and fold in unchanged
+
+# anchor: <organizer> (the panel context, reached UP to from each result row)
+PANEL_FIELDS: list[FieldSpec] = [
+    FieldSpec("Panel", "hl7:code/@displayName", "attr"),
+]
+
+# anchor: <procedure> (the specimen context, reached SIDEWAYS via a sibling)
+SPECIMEN_FIELDS: list[FieldSpec] = [
+    FieldSpec(
+        "Specimen",
+        "hl7:participant/hl7:participantRole/hl7:playingEntity/hl7:code/@displayName",
+        "attr",
+    ),
+]
+
+# anchor: <observation> (the result row's OWN fields)
+RESULT_FIELDS: list[FieldSpec] = [
+    FieldSpec("Test", "hl7:code/@displayName", "attr"),
+    FieldSpec("Result", "hl7:value", "typed"),  # PQ or CD — renderer decides
+    FieldSpec("Interpretation", "hl7:interpretationCode", "typed"),  # coded CE
+    FieldSpec("Date", "hl7:effectiveTime/@value", "attr"),
+]
+
+
+# NOTE:
+# LAYER 3 — PER-SECTION JOINS (the part kept as code)
+# =============================================================================
+
+
+def reconstruct_results(
+    section: _Element,
+) -> tuple[list[str], list[dict[str, str]]]:
+    """
+    Reconstruct the Results section rows.
+
+    JOIN section: the row is each result observation, but a complete row
+    needs context from two other structural levels — the PANEL, reached UP
+    to the enclosing organizer, and the SPECIMEN, reached SIDEWAYS to a
+    sibling procedure. Each level flows through the same extract_fields
+    primitive against its own field map; the per-organizer merge is the join.
+
+    Args:
+        section: The post-prune Results <section>.
+
+    Returns:
+        (columns, rows) for build_table.
+    """
+
+    columns = ["Panel", "Specimen"] + [f.label for f in RESULT_FIELDS]
+    rows: list[dict[str, str]] = []
+
+    for organizer in section.findall("hl7:entry/hl7:organizer", HL7_NS):
+        panel = extract_fields(organizer, PANEL_FIELDS)  # reach UP
+
+        procedure = organizer.find("hl7:component/hl7:procedure", HL7_NS)
+        specimen = (
+            extract_fields(procedure, SPECIMEN_FIELDS)  # reach SIDEWAYS
+            if procedure is not None
+            else {"Specimen": ""}
+        )
+
+        for obs in organizer.findall("hl7:component/hl7:observation", HL7_NS):
+            result = extract_fields(obs, RESULT_FIELDS)  # the row's own fields
+            rows.append({**panel, **specimen, **result})  # the join
+
+    return columns, rows
+
+
+# NOTE:
+# DISPATCH + PUBLIC ENTRY
+# =============================================================================
+# convention over container: a flat LOINC -> function dict relates the
+# per-section reconstructors. Adding a section is one field map + one
+# function + one entry here, touching no Layer 1 primitive
+
+# TODO:
+# next we will need to add problems, immunizations, and medications
+SECTION_RECONSTRUCTORS: dict[str, SectionReconstructor] = {
+    "30954-2": reconstruct_results,  # Results
+}
+
+
+def reconstruct_narrative(section: _Element) -> _Element | None:
+    """
+    Reconstruct a section's narrative <text> from its surviving entries.
+
+    Dispatches on the section's LOINC code. Returns a detached, namespace-
+    qualified <text> ready to replace the section's existing narrative, or
+    None when the section has no registered reconstructor or nothing
+    survived to reconstruct — in which case the caller should fall back to
+    retaining the original narrative.
+
+    This function is pure: it reads the section and returns a new element;
+    it does not mutate ``section``.
+
+    Args:
+        section: The post-prune, post-enrich <section>.
+
+    Returns:
+        A detached <text>, or None.
+    """
+
+    loinc_codes = section.xpath("hl7:code/@code", namespaces=HL7_NS)
+    loinc = (
+        str(loinc_codes[0]) if isinstance(loinc_codes, list) and loinc_codes else None
+    )
+
+    reconstruct = SECTION_RECONSTRUCTORS.get(loinc) if loinc else None
+    if reconstruct is None:
+        return None
+
+    columns, rows = reconstruct(section)
+    if not rows:
+        return None
+
+    return build_table(columns, rows)
diff --git a/refiner/app/services/ecr/narrative/writers.py b/refiner/app/services/ecr/narrative/writers.py
new file mode 100644
index 000000000..ca50a387a
--- /dev/null
+++ b/refiner/app/services/ecr/narrative/writers.py
@@ -0,0 +1,210 @@
+from typing import Final, Literal
+
+from lxml.etree import _Element
+
+from app.services.format import remove_element
+
+from ..model import HL7_NS, NamespaceMap
+from .constants import (
+    MINIMAL_SECTION_MESSAGE,
+    REFINER_OUTPUT_TITLE,
+    REMOVE_NARRATIVE_MESSAGE,
+    REMOVE_SECTION_MESSAGE,
+)
+from .elements import (
+    _ensure_text_element,
+    _make_element,
+    _sub_element,
+    remove_all_comments,
+)
+
+# NOTE:
+# INTERNAL CONSTANTS
+# =============================================================================
+
+_MESSAGE_MAP: Final[dict[str, str]] = {
+    "no_match": MINIMAL_SECTION_MESSAGE,
+    "configured": REMOVE_SECTION_MESSAGE,
+}
+
+
+# NOTE:
+# NARRATIVE PLACEMENT
+# =============================================================================
+# every "swap the section's <text>" operation--removal notice, generic-path
+# restoration, reconstruction--must land the new element in the same place:
+# replacing the existing <text>, or, when absent, inserted per the CDA R2
+# xs:sequence (after <title>, else after <code>, else appended). one helper
+# owns that placement so all three writers stay consistent
+
+
+def _place_section_text(
+    section: _Element,
+    new_text: _Element,
+    namespaces: NamespaceMap,
+) -> None:
+    current_text = section.find("hl7:text", namespaces=namespaces)
+    if current_text is not None:
+        section.replace(current_text, new_text)
+        return
+
+    title_element = section.find("hl7:title", namespaces=namespaces)
+    if title_element is not None:
+        title_element.addnext(new_text)
+        return
+
+    code_element = section.find("hl7:code", namespaces=namespaces)
+    if code_element is not None:
+        code_element.addnext(new_text)
+        return
+
+    section.append(new_text)
+
+
+# NOTE:
+# NARRATIVE REMOVAL NOTICE
+# =============================================================================
+
+
+def replace_narrative_with_removal_notice(
+    section: _Element,
+    namespaces: NamespaceMap = HL7_NS,
+) -> None:
+    """
+    Replace the section's <text> with a notice explaining the removal.
+
+    Produces a <text> containing a single <paragraph> carrying the
+    REMOVE_NARRATIVE_MESSAGE. This is used when a jurisdiction has
+    configured a section to have its narrative stripped while keeping
+    the clinical entries intact for machine processing.
+
+    The replacement is performed via `section.replace()` to preserve
+    the element's position in the CDA R2 xs:sequence. If no <text>
+    element exists, one is created via `_ensure_text_element`.
+
+    The provenance footnote that will be appended afterward by
+    refine_eicr is not this function's responsibility — this function
+    only writes the removal-notice paragraph.
+    """
+
+    new_text = _make_element("text")
+    paragraph = _sub_element(new_text, "paragraph")
+    paragraph.text = REMOVE_NARRATIVE_MESSAGE
+
+    _place_section_text(section, new_text, namespaces)
+
+
+# NOTE:
+# NARRATIVE RECONSTRUCTION SWAP
+# =============================================================================
+
+
+def replace_narrative_with_reconstruction(
+    section: _Element,
+    reconstructed_text: _Element,
+    namespaces: NamespaceMap = HL7_NS,
+) -> None:
+    """
+    Swap in a reconstructed <text> built from the section's surviving entries.
+
+    The reconstructed element is produced (pure, detached) by
+    `reconstruction.reconstruct_narrative`; this writer only places it
+    into the section per the CDA R2 xs:sequence, mirroring the removal
+    and restoration swaps.
+    """
+
+    _place_section_text(section, reconstructed_text, namespaces)
+
+
+# NOTE:
+# NARRATIVE RESTORATION (GENERIC PATH)
+# =============================================================================
+
+
+def restore_narrative(
+    section: _Element,
+    original_text: _Element,
+    namespaces: NamespaceMap = HL7_NS,
+) -> None:
+    """
+    Restore a previously-saved <text> element into a section.
+
+    Used by the generic matching path, which clears the section's
+    <text> during processing (to prevent inline narrative codes from
+    producing false matches) and then restores the original deep copy
+    afterward.
+
+    Replaces the current <text> element with the provided deep copy.
+    If no <text> element currently exists, the original is inserted
+    per the CDA R2 xs:sequence.
+    """
+
+    _place_section_text(section, original_text, namespaces)
+
+
+# NOTE:
+# MINIMAL SECTION STUB
+# =============================================================================
+
+
+def create_minimal_section(
+    section: _Element,
+    removal_reason: Literal["no_match", "configured"] = "no_match",
+) -> None:
+    """
+    Reduce a section to a minimal stub with an explanation message.
+
+    Updates the <text> element with a single-row status table, removes
+    all <entry> elements, and sets nullFlavor="NI" on the section. The
+    message displayed in the stub varies based on why the section was
+    reduced:
+
+      - "no_match":   No clinical information matched the configured
+                      code sets. Uses MINIMAL_SECTION_MESSAGE.
+      - "configured": Jurisdiction configured the section to be removed.
+                      Uses REMOVE_SECTION_MESSAGE.
+
+    The stub table uses proper <thead>/<th> header semantics and
+    <tbody>/<tr>/<td> body rows rather than the HTML-invalid
+    `<thead>/<tr>/<td>` structure the previous implementation used.
+
+    If the section has no <text> element at all, one is created via
+    `_ensure_text_element`, which inserts it in the correct xs:sequence
+    position.
+
+    Args:
+        section: The section element to reduce.
+        removal_reason: Which message to display in the stub.
+    """
+
+    section_message = _MESSAGE_MAP[removal_reason]
+
+    text_element = _ensure_text_element(section)
+
+    # clear whatever was in <text> and rebuild it as a stub table
+    text_element.clear()
+
+    table = _sub_element(text_element, "table", border="1")
+
+    caption = _sub_element(table, "caption")
+    caption.text = REFINER_OUTPUT_TITLE
+
+    thead = _sub_element(table, "thead")
+    header_row = _sub_element(thead, "tr")
+    th = _sub_element(header_row, "th")
+    th.text = "Status"
+
+    tbody = _sub_element(table, "tbody")
+    body_row = _sub_element(tbody, "tr")
+    td = _sub_element(body_row, "td")
+    td.text = section_message
+
+    # remove all <entry> elements from the section
+    for entry in section.findall("hl7:entry", namespaces=HL7_NS):
+        remove_element(entry)
+
+    # clean up any comments left inside the section
+    remove_all_comments(section)
+
+    # mark the section as nullFlavor="NI"
+    section.attrib["nullFlavor"] = "NI"
diff --git a/refiner/app/services/ecr/refine.py b/refiner/app/services/ecr/refine.py
index 1c1675475..837839412 100644
--- a/refiner/app/services/ecr/refine.py
+++ b/refiner/app/services/ecr/refine.py
@@ -17,6 +17,7 @@
     SectionRunResult,
     SectionSource,
 )
+from app.services.ecr.narrative import replace_narrative_with_removal_notice
 from app.services.ecr.policy import NARRATIVE_ONLY_SECTIONS, SECTION_PROCESSING_SKIP
 from app.services.ecr.section import (
     append_section_provenance_footnote,
@@ -25,7 +26,6 @@
     get_section_loinc_codes,
     process_section,
 )
-from app.services.ecr.section.narrative import replace_narrative_with_removal_notice
 from app.services.ecr.specification import detect_eicr_version, load_spec
 from app.services.format import remove_element
 from app.services.terminology import ProcessedConfiguration
@@ -511,21 +511,20 @@ def refine_eicr(
                 outcome = SectionOutcome.RETAINED
 
         else:
-            # BRANCH 3: refine entries via the matching engines.
-            # process_section returns a SectionRunResult describing what
+            # BRANCH 3: refine entries via the matching engines:
+            # * process_section returns a SectionRunResult describing what
             # actually happened, which _interpret_run_result maps to a
             # user-facing outcome (including the no-match policy override)
-            # TODO: When narrative="refine" is implemented, this should trigger
-            # narrative reconstruction logic. For now, treat "refine" as "remove"
-            # to avoid keeping stale narrative when entries are being filtered.
-            include_narrative = section_rules.narrative == "retain"
+            # * the configured narrative action ("retain"/"remove"/
+            # "reconstruct") is threaded straight through to the engine,
+            # which owns the decision after pruning + enrichment
             run_result = process_section(
                 section=section,
                 codes_to_match=plan.codes_to_check,
                 namespaces=HL7_NS,
                 section_specification=section_specification,
                 code_system_sets=plan.code_system_sets,
-                include_narrative=include_narrative,
+                narrative=section_rules.narrative,
             )
             outcome = _interpret_run_result(run_result=run_result)
 
diff --git a/refiner/app/services/ecr/section/__init__.py b/refiner/app/services/ecr/section/__init__.py
index f1534241c..6900c2c33 100644
--- a/refiner/app/services/ecr/section/__init__.py
+++ b/refiner/app/services/ecr/section/__init__.py
@@ -1,15 +1,16 @@
-"""
-section module __init__ file
-"""
-
 from lxml.etree import _Element
 
 from app.services.terminology import CodeSystemSets
 
-from ..model import NamespaceMap, SectionRunResult, SectionSpecification
+from ..model import (
+    DbNarrativeAction,
+    NamespaceMap,
+    SectionRunResult,
+    SectionSpecification,
+)
+from ..narrative import append_section_provenance_footnote, create_minimal_section
 from . import entry_matching as _entry_matching
 from . import generic_matching as _generic_matching
-from .narrative import append_section_provenance_footnote, create_minimal_section
 from .traversal import get_section_by_code, get_section_loinc_codes
 
 # NOTE:
@@ -23,7 +24,7 @@ def process_section(
     namespaces: NamespaceMap,
     section_specification: SectionSpecification | None,
     code_system_sets: CodeSystemSets | None,
-    include_narrative: bool = True,
+    narrative: DbNarrativeAction = "retain",
 ) -> SectionRunResult:
     """
     Dispatch a section to the right matching engine.
@@ -62,11 +63,13 @@ def process_section(
         code_system_sets: Structured per-system code lookup used by
             the section-aware engine and for displayName enrichment
             in the generic engine.
-        include_narrative: Whether to keep the original section
-            narrative. When False, narrative is replaced with a
-            removal notice. Ignored when matches are zero; the
-            engine stubs the section regardless per the no-match
-            policy override.
+        narrative: What to do with the section's narrative <text>:
+            "retain" keeps the original, "remove" replaces it with a
+            removal notice, "reconstruct" rebuilds it from the
+            surviving entries (falling back to removal when the
+            section has no registered reconstructor or nothing
+            survived). Ignored when matches are zero; the engine stubs
+            the section regardless per the no-match policy override.
 
     Returns:
         SectionRunResult describing what the engine did. Consumed
@@ -83,7 +86,7 @@ def process_section(
             code_system_sets=code_system_sets,
             section_specification=section_specification,
             namespaces=namespaces,
-            include_narrative=include_narrative,
+            narrative=narrative,
         )
 
     return _generic_matching.process(
@@ -92,7 +95,7 @@ def process_section(
         namespaces=namespaces,
         section_specification=section_specification,
         code_system_sets=code_system_sets,
-        include_narrative=include_narrative,
+        narrative=narrative,
     )
 
 
diff --git a/refiner/app/services/ecr/section/entry_matching.py b/refiner/app/services/ecr/section/entry_matching.py
index 812aa4014..294a4f734 100644
--- a/refiner/app/services/ecr/section/entry_matching.py
+++ b/refiner/app/services/ecr/section/entry_matching.py
@@ -10,14 +10,17 @@
 
 from ..model import (
     HL7_XSI_NS,
+    DbNarrativeAction,
     EntryMatchRule,
     NamespaceMap,
     SectionRunResult,
     SectionSpecification,
 )
-from .narrative import (
+from ..narrative import (
     create_minimal_section,
+    reconstruct_narrative,
     remove_all_comments,
+    replace_narrative_with_reconstruction,
     replace_narrative_with_removal_notice,
 )
 from .utils import (
@@ -71,7 +74,7 @@ def process(
     code_system_sets: CodeSystemSets,
     section_specification: SectionSpecification,
     namespaces: NamespaceMap,
-    include_narrative: bool = True,
+    narrative: DbNarrativeAction = "retain",
 ) -> SectionRunResult:
     """
     Process a section using IG-driven entry match rules.
@@ -86,7 +89,7 @@ def process(
     4. Enriches displayName on all surviving code-bearing elements
     5. Injects per-entry match provenance comments above surviving
        entries — added after source comment cleanup so they survive
-    6. Handles narrative <text> based on `include_narrative`
+    6. Handles narrative <text> based on the `narrative` action
 
     No UUID swap needed — match rules only search within <entry>
     elements, so the section's own <code> is never at risk of matching.
@@ -142,18 +145,39 @@ def process(
             namespaces=namespaces,
         )
 
-        # STEP 6: handle narrative <text>
-        if not include_narrative:
-            replace_narrative_with_removal_notice(section, namespaces)
-            return SectionRunResult(
-                matches_found=True,
-                narrative_disposition="removed",
-            )
-
-        return SectionRunResult(
-            matches_found=True,
-            narrative_disposition="retained",
-        )
+        # STEP 6: handle narrative <text> reconstruction runs HERE,
+        # after STEP 4 enrichment, because it reads displayName off the
+        # surviving entries it rebuilds the table from
+        match narrative:
+            case "remove":
+                replace_narrative_with_removal_notice(section, namespaces)
+                return SectionRunResult(
+                    matches_found=True,
+                    narrative_disposition="removed",
+                )
+            case "reconstruct":
+                reconstructed = reconstruct_narrative(section)
+                if reconstructed is not None:
+                    replace_narrative_with_reconstruction(
+                        section, reconstructed, namespaces
+                    )
+                    return SectionRunResult(
+                        matches_found=True,
+                        narrative_disposition="reconstructed",
+                    )
+                # no registered reconstructor or nothing survived to
+                # rebuild--fall back to removal rather than leave the
+                # stale source narrative on a refined section
+                replace_narrative_with_removal_notice(section, namespaces)
+                return SectionRunResult(
+                    matches_found=True,
+                    narrative_disposition="removed",
+                )
+            case _:
+                return SectionRunResult(
+                    matches_found=True,
+                    narrative_disposition="retained",
+                )
 
     except etree.XPathEvalError as e:
         raise XMLParsingError(
diff --git a/refiner/app/services/ecr/section/generic_matching.py b/refiner/app/services/ecr/section/generic_matching.py
index 80774efc7..c1119bad0 100644
--- a/refiner/app/services/ecr/section/generic_matching.py
+++ b/refiner/app/services/ecr/section/generic_matching.py
@@ -10,13 +10,16 @@
 
 from ..model import (
     HL7_NS,
+    DbNarrativeAction,
     NamespaceMap,
     SectionRunResult,
     SectionSpecification,
 )
-from .narrative import (
+from ..narrative import (
     create_minimal_section,
+    reconstruct_narrative,
     remove_all_comments,
+    replace_narrative_with_reconstruction,
     replace_narrative_with_removal_notice,
     restore_narrative,
 )
@@ -37,7 +40,7 @@ def process(
     namespaces: NamespaceMap,
     section_specification: SectionSpecification | None,
     code_system_sets: CodeSystemSets | None = None,
-    include_narrative: bool = True,
+    narrative: DbNarrativeAction = "retain",
 ) -> SectionRunResult:
     """
     Process a section using the generic matching logic.
@@ -56,8 +59,8 @@ def process(
     `<text>` elements before searching to prevent false matches.
     Both are saved as deep copies and restored after processing —
     `<code>` unconditionally in the finally block (to avoid
-    corrupting the tree on error), and `<text>` conditionally based
-    on `include_narrative`.
+    corrupting the tree on error), and `<text>` only when the
+    `narrative` action is "retain".
 
     Source document XML comments are stripped before matching begins.
     Match provenance comments (`eCR Refiner: generic match — ...`)
@@ -93,12 +96,12 @@ def process(
 
     # neutralize <text>: clear it so inline codes in the narrative
     # don't produce false matches
-    # if include_narrative is True, a deep copy is saved so the original
+    # only when narrative="retain" is a deep copy saved so the original
     # can be restored after processing
     text_element = section.find("./hl7:text", namespaces=namespaces)
     original_text = (
         deepcopy(text_element)
-        if text_element is not None and include_narrative
+        if text_element is not None and narrative == "retain"
         else None
     )
     if text_element is not None:
@@ -155,27 +158,43 @@ def process(
             if code_system_sets is not None:
                 enrich_surviving_entries(section, code_system_sets, namespaces)
 
-            # STEP 5: handle narrative <text>
-            if include_narrative and original_text is not None:
-                restore_narrative(section, original_text, namespaces)
-                return SectionRunResult(
-                    matches_found=True,
-                    narrative_disposition="retained",
-                )
-            elif not include_narrative:
-                replace_narrative_with_removal_notice(section, namespaces)
-                return SectionRunResult(
-                    matches_found=True,
-                    narrative_disposition="removed",
-                )
-
-            # include_narrative=True but original_text was None —
-            # the section had no <text> in the source. nothing to
-            # restore, but matches were still found.
-            return SectionRunResult(
-                matches_found=True,
-                narrative_disposition="retained",
-            )
+            # STEP 5: handle narrative <text> reconstruction runs HERE,
+            # after STEP 4 enrichment, because it reads displayName off
+            # the surviving entries it rebuilds the table from
+            match narrative:
+                case "remove":
+                    replace_narrative_with_removal_notice(section, namespaces)
+                    return SectionRunResult(
+                        matches_found=True,
+                        narrative_disposition="removed",
+                    )
+                case "reconstruct":
+                    reconstructed = reconstruct_narrative(section)
+                    if reconstructed is not None:
+                        replace_narrative_with_reconstruction(
+                            section, reconstructed, namespaces
+                        )
+                        return SectionRunResult(
+                            matches_found=True,
+                            narrative_disposition="reconstructed",
+                        )
+                    # no registered reconstructor or nothing survived;
+                    # fall back to removal rather than leave a stale
+                    # narrative on a refined section
+                    replace_narrative_with_removal_notice(section, namespaces)
+                    return SectionRunResult(
+                        matches_found=True,
+                        narrative_disposition="removed",
+                    )
+                case _:
+                    # "retain": restore the saved original when present;
+                    # a None original means the source had no <text>
+                    if original_text is not None:
+                        restore_narrative(section, original_text, namespaces)
+                    return SectionRunResult(
+                        matches_found=True,
+                        narrative_disposition="retained",
+                    )
 
         except etree.XPathEvalError as e:
             raise XMLParsingError(
diff --git a/refiner/app/services/ecr/section/narrative.py b/refiner/app/services/ecr/section/narrative.py
deleted file mode 100644
index 567837079..000000000
--- a/refiner/app/services/ecr/section/narrative.py
+++ /dev/null
@@ -1,632 +0,0 @@
-import re
-from typing import Final, Literal
-
-from lxml import etree
-from lxml.etree import _Element
-
-from app.services.format import remove_element
-
-from ..model import (
-    HL7_NAMESPACE,
-    HL7_NS,
-    NamespaceMap,
-    SectionProvenanceRecord,
-)
-from .constants import (
-    CLINICAL_DATA_TABLE_HEADERS,
-    MINIMAL_SECTION_MESSAGE,
-    PROVENANCE_LABEL,
-    PROVENANCE_OUTCOME_NOTES,
-    PROVENANCE_SOURCE_NOTES,
-    PROVENANCE_TABLE_HEADERS,
-    REFINER_OUTPUT_TITLE,
-    REMOVE_NARRATIVE_MESSAGE,
-    REMOVE_SECTION_MESSAGE,
-)
-
-# NOTE:
-# INTERNAL CONSTANTS
-# =============================================================================
-
-_MESSAGE_MAP: Final[dict[str, str]] = {
-    "no_match": MINIMAL_SECTION_MESSAGE,
-    "configured": REMOVE_SECTION_MESSAGE,
-}
-
-
-# NOTE:
-# ELEMENT FACTORY HELPERS
-# =============================================================================
-# every element emitted into <text> must be qualified with the HL7 v3
-# namespace for NarrativeBlock.xsd validation to pass
-
-
-def _make_element(local_name: str, **attribs: str) -> _Element:
-    """
-    Create a namespace-qualified narrative element.
-
-    Returns a detached element in the urn:hl7-org:v3 namespace. Use
-    `_sub_element` instead when the new element should be appended
-    to an existing parent.
-    """
-
-    element = etree.Element(f"{{{HL7_NAMESPACE}}}{local_name}")
-    for key, value in attribs.items():
-        element.set(key, value)
-    return element
-
-
-def _sub_element(parent: _Element, local_name: str, **attribs: str) -> _Element:
-    """
-    Create a namespace-qualified child element appended to `parent`.
-
-    Thin wrapper around etree.SubElement that applies Clark notation
-    for the HL7 v3 namespace, matching the pattern used in augment.py.
-    """
-
-    element = etree.SubElement(parent, f"{{{HL7_NAMESPACE}}}{local_name}")
-    for key, value in attribs.items():
-        element.set(key, value)
-    return element
-
-
-# NOTE:
-# TEXT PLACEMENT HELPERS
-# =============================================================================
-
-
-def _ensure_text_element(section: _Element) -> _Element:
-    """
-    Return the section's <text> element, creating one if absent.
-
-    If the section has no <text>, a new empty <text> is created and
-    inserted after <title> per the CDA R2 xs:sequence for
-    StrucDoc.Section: templateId -> id -> code -> title -> text ->
-    confidentialityCode -> languageCode -> subject -> author ->
-    informant -> entry -> component.
-
-    If there is no <title> either, the <text> is inserted after
-    <code>, which is the next-earliest required element in the
-    sequence. Last resort: append to the section.
-    """
-
-    text_element = section.find("hl7:text", namespaces=HL7_NS)
-    if text_element is not None:
-        return text_element
-
-    text_element = _make_element("text")
-
-    title_element = section.find("hl7:title", namespaces=HL7_NS)
-    if title_element is not None:
-        title_element.addnext(text_element)
-        return text_element
-
-    code_element = section.find("hl7:code", namespaces=HL7_NS)
-    if code_element is not None:
-        code_element.addnext(text_element)
-        return text_element
-
-    section.append(text_element)
-    return text_element
-
-
-# NOTE:
-# PROVENANCE FOOTNOTE
-# =============================================================================
-# every section in the refined document carries a trailing <footnote>
-# documenting how the refiner treated it. the footnote is unanchored:
-# no <footnoteRef> points to it. This represents "annotation attached
-# to the section as a whole" — valid per NarrativeBlock.xsd's
-# StrucDoc.Text and StrucDoc.Footnote content models (both allow
-# footnote as an optional child with no anchoring requirement) and
-# sidesteps the need to walk arbitrary source narrative looking for
-# anchor points, which would be fragile across eICR vendors
-#
-# the footnote's xs:ID ties it to the augmentation run's timestamp,
-# giving the two structural consistency that a consumer can verify
-# programmatically (e.g., "every refiner footnote ID should contain
-# the timestamp present in the augmentation author's <time> value")
-#
-# the footnote's data row carries both the configured action ("what
-# the jurisdiction asked for") and the runtime outcome ("what the
-# refiner actually did"). the two columns let a reader see at a glance
-# whether a refiner policy override fired — most rows show the outcome
-# confirming the configuration, but the no-match policy override
-# produces an outcome that diverges from the configured action
-
-
-def _build_footnote_id(
-    loinc_code: str,
-    augmentation_timestamp: str,
-    occurrence_index: int = 0,
-) -> str:
-    """
-    Build a document-unique xs:ID for a refiner provenance footnote.
-
-    The ID is of the form
-    `ecr-refinement-{loinc}-{timestamp-digits}`, optionally with a
-    `-{n}` suffix for the rare case where the same LOINC appears on
-    multiple top-level sections in a single document. The timestamp
-    digits are extracted from the augmentation author's <time> value
-    (HL7 V3 ``YYYYMMDDHHMMSS±ZZZZ`` format) by keeping the leading
-    run of digits — the timezone offset is stripped because ``+`` and
-    the offset digits are not wanted in the ID.
-
-    xs:ID cannot start with a digit or hyphen, so the ``ecr-refinement-``
-    prefix is load-bearing: it ensures the resulting string always
-    satisfies the XML Name production.
-
-    Args:
-        loinc_code: The section's LOINC code (e.g., "46240-8").
-        augmentation_timestamp: The augmentation author's time value,
-            shared across all footnotes in this refinement run.
-        occurrence_index: Zero-based disambiguator for the rare case
-            where the same LOINC appears on multiple top-level
-            sections. Zero (the normal case) produces no suffix;
-            nonzero values append ``-N``.
-
-    Returns:
-        A document-unique xs:ID-safe string.
-    """
-
-    match = re.match(r"^\d+", augmentation_timestamp)
-    timestamp_digits = match.group(0) if match else ""
-    base = f"ecr-refinement-{loinc_code}-{timestamp_digits}"
-    return base if occurrence_index == 0 else f"{base}-{occurrence_index}"
-
-
-def append_section_provenance_footnote(
-    section: _Element,
-    provenance: SectionProvenanceRecord,
-    augmentation_timestamp: str,
-    occurrence_index: int = 0,
-) -> None:
-    """
-    Append an unanchored <footnote> carrying refiner provenance.
-
-    Called by refine_eicr after processing every section (refine,
-    retain, remove, narrative-removed) so that every section in the
-    refined document carries a consistent provenance record.
-
-    The footnote contains a bolded label paragraph followed by a
-    single-row table summarizing the jurisdiction's configuration
-    and the runtime outcome for this section. The table follows
-    NarrativeBlock.xsd's StrucDoc.Table content model with proper
-    <thead>/<th> header semantics and <tbody>/<tr>/<td> body rows.
-
-    The provenance record passed in must have its `outcome` field
-    finalized — refine_eicr does this via dataclasses.replace before
-    calling this function. If the field still holds its default
-    value at render time, that's a bug in refine_eicr's
-    interpretation logic, not in this function.
-
-    If the section has no <text> element (e.g., a retained section
-    where the source document omitted it), one is created and inserted
-    per `_ensure_text_element`'s CDA R2 xs:sequence rules.
-
-    Args:
-        section: The section element to annotate.
-        provenance: The SectionProvenanceRecord built during plan
-            creation and finalized by refine_eicr.
-        augmentation_timestamp: The augmentation run's <time> value,
-            shared across all footnotes in this refinement run.
-        occurrence_index: Disambiguator for repeated-LOINC sections;
-            zero for the normal case.
-    """
-
-    text_element = _ensure_text_element(section)
-
-    footnote_id = _build_footnote_id(
-        loinc_code=provenance.loinc_code,
-        augmentation_timestamp=augmentation_timestamp,
-        occurrence_index=occurrence_index,
-    )
-    footnote = _sub_element(text_element, "footnote", ID=footnote_id)
-
-    # bolded label paragraph
-    label_paragraph = _sub_element(footnote, "paragraph")
-    label_content = _sub_element(label_paragraph, "content", styleCode="Bold")
-    label_content.text = PROVENANCE_LABEL
-
-    # provenance table
-    table = _sub_element(footnote, "table", border="1")
-    thead = _sub_element(table, "thead")
-    header_row = _sub_element(thead, "tr")
-    for header in PROVENANCE_TABLE_HEADERS:
-        th = _sub_element(header_row, "th")
-        th.text = header
-
-    tbody = _sub_element(table, "tbody")
-    row = _sub_element(tbody, "tr")
-    _add_provenance_cell(row, provenance.loinc_code)
-    _add_provenance_cell(row, provenance.display_name)
-    _add_provenance_cell(row, "Yes" if provenance.include else "No")
-    _add_provenance_cell(row, provenance.action)
-    _add_provenance_cell(row, "Yes" if provenance.narrative == "retain" else "No")
-    _add_provenance_cell(
-        row,
-        f"v{provenance.config_version}"
-        if provenance.config_version is not None
-        else "—",
-    )
-    _add_provenance_cell(
-        row,
-        PROVENANCE_SOURCE_NOTES.get(provenance.source, str(provenance.source)),
-    )
-    _add_provenance_cell(
-        row,
-        PROVENANCE_OUTCOME_NOTES.get(provenance.outcome, str(provenance.outcome)),
-    )
-
-
-def _add_provenance_cell(row: _Element, text: str) -> None:
-    """
-    Append a single <td> with text content to a provenance table row.
-    """
-
-    td = _sub_element(row, "td")
-    td.text = text
-
-
-# NOTE:
-# NARRATIVE REMOVAL NOTICE
-# =============================================================================
-
-
-def replace_narrative_with_removal_notice(
-    section: _Element,
-    namespaces: NamespaceMap = HL7_NS,
-) -> None:
-    """
-    Replace the section's <text> with a notice explaining the removal.
-
-    Produces a <text> containing a single <paragraph> carrying the
-    REMOVE_NARRATIVE_MESSAGE. This is used when a jurisdiction has
-    configured a section to have its narrative stripped while keeping
-    the clinical entries intact for machine processing.
-
-    The replacement is performed via `section.replace()` to preserve
-    the element's position in the CDA R2 xs:sequence. If no <text>
-    element exists, one is created via `_ensure_text_element`.
-
-    The provenance footnote that will be appended afterward by
-    refine_eicr is not this function's responsibility — this function
-    only writes the removal-notice paragraph.
-    """
-
-    new_text = _make_element("text")
-    paragraph = _sub_element(new_text, "paragraph")
-    paragraph.text = REMOVE_NARRATIVE_MESSAGE
-
-    existing_text = section.find("hl7:text", namespaces=namespaces)
-    if existing_text is not None:
-        section.replace(existing_text, new_text)
-        return
-
-    # no existing <text>; insert after <title> (or <code>) per xs:sequence
-    title_element = section.find("hl7:title", namespaces=namespaces)
-    if title_element is not None:
-        title_element.addnext(new_text)
-        return
-
-    code_element = section.find("hl7:code", namespaces=namespaces)
-    if code_element is not None:
-        code_element.addnext(new_text)
-        return
-
-    section.append(new_text)
-
-
-# NOTE:
-# NARRATIVE RESTORATION (GENERIC PATH)
-# =============================================================================
-
-
-def restore_narrative(
-    section: _Element,
-    original_text: _Element,
-    namespaces: NamespaceMap = HL7_NS,
-) -> None:
-    """
-    Restore a previously-saved <text> element into a section.
-
-    Used by the generic matching path, which clears the section's
-    <text> during processing (to prevent inline narrative codes from
-    producing false matches) and then restores the original deep copy
-    afterward.
-
-    Replaces the current <text> element with the provided deep copy.
-    If no <text> element currently exists, the original is inserted
-    per the CDA R2 xs:sequence.
-    """
-
-    current_text = section.find("hl7:text", namespaces=namespaces)
-    if current_text is not None:
-        section.replace(current_text, original_text)
-        return
-
-    title_element = section.find("hl7:title", namespaces=namespaces)
-    if title_element is not None:
-        title_element.addnext(original_text)
-        return
-
-    code_element = section.find("hl7:code", namespaces=namespaces)
-    if code_element is not None:
-        code_element.addnext(original_text)
-        return
-
-    section.append(original_text)
-
-
-# NOTE:
-# MINIMAL SECTION STUB
-# =============================================================================
-
-
-def create_minimal_section(
-    section: _Element,
-    removal_reason: Literal["no_match", "configured"] = "no_match",
-) -> None:
-    """
-    Reduce a section to a minimal stub with an explanation message.
-
-    Updates the <text> element with a single-row status table, removes
-    all <entry> elements, and sets nullFlavor="NI" on the section. The
-    message displayed in the stub varies based on why the section was
-    reduced:
-
-      - "no_match":   No clinical information matched the configured
-                      code sets. Uses MINIMAL_SECTION_MESSAGE.
-      - "configured": Jurisdiction configured the section to be removed.
-                      Uses REMOVE_SECTION_MESSAGE.
-
-    The stub table uses proper <thead>/<th> header semantics and
-    <tbody>/<tr>/<td> body rows rather than the HTML-invalid
-    `<thead>/<tr>/<td>` structure the previous implementation used.
-
-    If the section has no <text> element at all, one is created via
-    `_ensure_text_element`, which inserts it in the correct xs:sequence
-    position.
-
-    Args:
-        section: The section element to reduce.
-        removal_reason: Which message to display in the stub.
-    """
-
-    section_message = _MESSAGE_MAP[removal_reason]
-
-    text_element = _ensure_text_element(section)
-
-    # clear whatever was in <text> and rebuild it as a stub table
-    text_element.clear()
-
-    table = _sub_element(text_element, "table", border="1")
-
-    caption = _sub_element(table, "caption")
-    caption.text = REFINER_OUTPUT_TITLE
-
-    thead = _sub_element(table, "thead")
-    header_row = _sub_element(thead, "tr")
-    th = _sub_element(header_row, "th")
-    th.text = "Status"
-
-    tbody = _sub_element(table, "tbody")
-    body_row = _sub_element(tbody, "tr")
-    td = _sub_element(body_row, "td")
-    td.text = section_message
-
-    # remove all <entry> elements from the section
-    for entry in section.findall("hl7:entry", namespaces=HL7_NS):
-        remove_element(entry)
-
-    # clean up any comments left inside the section
-    remove_all_comments(section)
-
-    # mark the section as nullFlavor="NI"
-    section.attrib["nullFlavor"] = "NI"
-
-
-# NOTE:
-# CLINICAL DATA TABLE (REFINED PATH)
-# =============================================================================
-# used by the generic and section-aware matching paths to replace a
-# section's <text> with a table summarizing the refined clinical
-# content. each row describes one matched clinical element with
-# trigger-code elements rendered in bold
-
-
-def update_text_element(
-    section: _Element,
-    clinical_elements: list[_Element],
-    trigger_code_elements: set[int],
-) -> None:
-    """
-    Replace the section's <text> with a refined clinical data table.
-
-    The new <text> contains a single <table> with one row per element
-    in `clinical_elements`. Elements whose `id()` appears in
-    `trigger_code_elements` are rendered in bold and placed at the
-    top of the table so trigger codes are visually prominent.
-
-    If no <text> exists, one is created in the correct xs:sequence
-    position.
-
-    Args:
-        section: The section whose <text> is being replaced.
-        clinical_elements: The clinical elements to render as rows.
-        trigger_code_elements: Set of Python ``id()`` values identifying
-            which elements are trigger codes. Using id() rather than
-            element equality because lxml elements don't hash stably
-            across tree mutations.
-    """
-
-    new_text = _build_clinical_data_text(clinical_elements, trigger_code_elements)
-
-    existing_text = section.find("hl7:text", namespaces=HL7_NS)
-    if existing_text is not None:
-        section.replace(existing_text, new_text)
-        return
-
-    title_element = section.find("hl7:title", namespaces=HL7_NS)
-    if title_element is not None:
-        title_element.addnext(new_text)
-        return
-
-    code_element = section.find("hl7:code", namespaces=HL7_NS)
-    if code_element is not None:
-        code_element.addnext(new_text)
-        return
-
-    section.append(new_text)
-
-
-def _build_clinical_data_text(
-    clinical_elements: list[_Element],
-    trigger_code_elements: set[int],
-) -> _Element:
-    """
-    Build a <text> element containing a refined clinical data table.
-
-    Returns a detached <text> ready to be inserted into a section.
-    """
-
-    text_element = _make_element("text")
-
-    table = _sub_element(text_element, "table", border="1")
-
-    caption = _sub_element(table, "caption")
-    caption.text = REFINER_OUTPUT_TITLE
-
-    thead = _sub_element(table, "thead")
-    header_row = _sub_element(thead, "tr")
-    for header in CLINICAL_DATA_TABLE_HEADERS:
-        th = _sub_element(header_row, "th")
-        th.text = header
-
-    tbody = _sub_element(table, "tbody")
-
-    # put trigger code rows first so reviewers see them without scanning
-    trigger_rows = [el for el in clinical_elements if id(el) in trigger_code_elements]
-    other_rows = [el for el in clinical_elements if id(el) not in trigger_code_elements]
-
-    for clinical_element in trigger_rows:
-        _add_clinical_data_row(tbody, clinical_element, is_trigger=True)
-    for clinical_element in other_rows:
-        _add_clinical_data_row(tbody, clinical_element, is_trigger=False)
-
-    return text_element
-
-
-def _add_clinical_data_row(
-    tbody: _Element,
-    clinical_element: _Element,
-    is_trigger: bool,
-) -> None:
-    """
-    Append one <tr> to ``tbody`` describing a single clinical element.
-    """
-
-    data = _extract_clinical_data(clinical_element)
-    row = _sub_element(tbody, "tr")
-
-    # display text cell
-    display_td = _sub_element(row, "td")
-    display_text = data.get("display_text") or "Not specified"
-    if is_trigger:
-        bold = _sub_element(display_td, "content", styleCode="Bold")
-        bold.text = display_text
-    else:
-        display_td.text = display_text
-
-    # code cell
-    code_td = _sub_element(row, "td")
-    code_value = data.get("code") or "Not specified"
-    if is_trigger:
-        bold = _sub_element(code_td, "content", styleCode="Bold")
-        bold.text = code_value
-    else:
-        code_td.text = code_value
-
-    # code system cell
-    code_system_td = _sub_element(row, "td")
-    code_system_td.text = data.get("code_system") or "Not specified"
-
-    # is trigger code cell
-    trigger_td = _sub_element(row, "td")
-    trigger_td.text = "YES" if is_trigger else "NO"
-
-    # matching condition code cell
-    matching_td = _sub_element(row, "td")
-    matching_td.text = "YES"
-
-
-def _extract_clinical_data(
-    clinical_element: _Element,
-) -> dict[str, str | None]:
-    """
-    Extract display text, code, and code system from a clinical element.
-
-    Inspects the element itself if it is a ``code``/``value``/``translation``
-    element with a ``@code`` attribute; otherwise searches for a
-    descendant ``<code>`` element. Trigger-code status is handled
-    separately by the caller.
-
-    Returns:
-        Dictionary with ``display_text``, ``code``, and ``code_system``
-        keys, each either a string or None.
-    """
-
-    tag_local = (
-        clinical_element.tag.split("}")[-1]
-        if "}" in clinical_element.tag
-        else clinical_element.tag
-    )
-
-    if tag_local in ("code", "value", "translation") and clinical_element.get("code"):
-        code_element: _Element | None = clinical_element
-    else:
-        code_element = clinical_element.find(".//hl7:code", namespaces=HL7_NS)
-
-    display_text: str | None = None
-    code: str | None = None
-    code_system: str | None = None
-
-    if code_element is not None:
-        display_text_raw = code_element.get("displayName")
-        if isinstance(display_text_raw, str):
-            display_text = display_text_raw
-
-        code_raw = code_element.get("code")
-        if isinstance(code_raw, str):
-            code = code_raw
-
-        code_system_raw = code_element.get("codeSystemName")
-        if isinstance(code_system_raw, str):
-            code_system = code_system_raw
-
-    return {
-        "display_text": display_text,
-        "code": code,
-        "code_system": code_system,
-    }
-
-
-# NOTE:
-# COMMENT CLEANUP
-# =============================================================================
-
-
-def remove_all_comments(section: _Element) -> None:
-    """
-    Remove all XML comments from a processed section.
-
-    After refining a section, inline comments left over from the source
-    document may no longer be accurate or relevant. This scrubs them
-    so the refined output doesn't carry misleading annotations forward.
-    """
-
-    xpath_result = section.xpath(".//comment()")
-    if isinstance(xpath_result, list):
-        for comment in xpath_result:
-            if isinstance(comment, etree._Element):
-                remove_element(comment)
diff --git a/refiner/tests/integration/scenarios/README.md b/refiner/tests/integration/scenarios/README.md
index 73d229bc6..65a41ed47 100644
--- a/refiner/tests/integration/scenarios/README.md
+++ b/refiner/tests/integration/scenarios/README.md
@@ -32,16 +32,16 @@ A snapshot change should ride with the change that caused it. If you alter a sce
 
 ## Regenerating the stakeholder report
 
-`REPORT.md` is an auto-generated summary of the suite intended for stakeholder review. It pulls from the committed snapshots and the roll-up coverage table inside `authoring/build_report.py`. Regenerate it whenever you update snapshots or change scenario coverage:
+`REPORT.md` is an auto-generated summary of the suite intended for stakeholder review. It pulls from the committed snapshots and the roll-up coverage table inside `build_report.py`. Regenerate it whenever you update snapshots or change scenario coverage:
 
 ```bash
 pytest tests/integration/scenarios/ --update-snapshots
-python tests/integration/scenarios/authoring/build_report.py
+python tests/integration/scenarios/build_report.py
 ```
 
 Commit both the regenerated snapshots and the regenerated `REPORT.md` together. A follow-up PR will add a CI step that runs `build_report.py` and fails with `git diff --exit-code` if the committed `REPORT.md` is out of date; until that lands, the discipline is on the developer.
 
-To update the roll-up coverage matrix shown in the report (e.g. after adding a scenario that closes a gap, or after Tim or another stakeholder shares additional concerns), edit the `ROLLUP_COVERAGE` list at the top of `authoring/build_report.py` and re-run the script.
+To update the coverage tables shown in the report, edit the data lists at the top of `build_report.py` and re-run the script: `ROLLUP_COVERAGE` for Tim's numbered Roll-up issues (e.g. after adding a scenario that closes a gap, or after a stakeholder shares additional concerns), and `CAPABILITY_COVERAGE` for product capabilities the suite pins that aren't Roll-up issues (e.g. narrative reconstruction). A scenario listed in either gets a back-reference in its detail section.
 
 ## How configurations are built
 
@@ -65,7 +65,7 @@ pytest tests/integration/scenarios/test_all_sections_covid_influenza.py \
 ```
 
 1. Inspect the snapshots; commit them.
-2. Run `python tests/integration/scenarios/authoring/build_report.py` to regenerate `REPORT.md`.
+2. Run `python tests/integration/scenarios/build_report.py` to regenerate `REPORT.md`.
 3. Commit `REPORT.md` alongside the new snapshots and the `conftest.py` change.
 
 There is no `awslocal s3 cp` step and no committed `active.json` — authoring is entirely in code via the recipe. If the condition's `display_name` doesn't resolve against the seeded TES data, `get_condition_id` fails diagnostically; query the `conditions` table to find the exact name.
diff --git a/refiner/tests/integration/scenarios/REPORT.md b/refiner/tests/integration/scenarios/REPORT.md
index 33193794a..b804852a2 100644
--- a/refiner/tests/integration/scenarios/REPORT.md
+++ b/refiner/tests/integration/scenarios/REPORT.md
@@ -4,7 +4,7 @@
 
 ```
 pytest tests/integration/scenarios/ --update-snapshots
-python tests/integration/scenarios/authoring/build_report.py
+python tests/integration/scenarios/build_report.py
 ```
 
 This report summarizes the behaviors pinned by the scenarios test suite at `tests/integration/scenarios/`. Each scenario refines a committed eICR/RR pair against a committed configuration JSON and asserts in two layers: validation (well-formedness, CDA R2 XSD, schematron) and snapshot comparison against committed expected files.
@@ -56,9 +56,24 @@ The concern has two halves.
 `covid_with_custom_codes` adds Heart Rate (LOINC 8867-4) as a single custom code. Combined with body temperature (LOINC 8310-5) -- a member of the COVID condition grouper, matched from the baseline configuration -- the snapshot pins panel pruning at a two-of-nine cardinality. `covid_with_multi_vital_sign_codes` adds three more vital sign codes (8867-4, 8480-6, 9279-1) and pins the four-of-nine case (those three plus body temperature). The surviving sub-components are the configured-and-present codes, not only the custom additions. If the bug returned, both snapshots would shift to retaining all nine sub-components.
 
 
+## Capability coverage
+
+Behaviors the suite pins that are product capabilities rather than entries on the Roll-up sheet. Each scenario reference links to its detail section below.
+
+| Capability | Status | Scenario(s) |
+|------------|--------|-------------|
+| Narrative reconstruction from surviving entries | **Direct** | [`covid_results_reconstruction`](#covid-results-reconstruction) |
+
+### Evidence per capability
+
+**Narrative reconstruction from surviving entries** (Direct)
+
+`covid_results_reconstruction` configures the Results section (LOINC 30954-2) with `narrative="reconstruct"`. After entry refinement prunes the section to the surviving SARS-CoV-2 result, the engine rebuilds the section `<text>` from those entries rather than retaining the stale source narrative. The snapshot pins the reconstructed table: a machine-derived `<text>` carrying the result row (panel, test, result, interpretation, date) plus the "machine-derived, not clinician-attested" provenance marker, and the validation layer confirms it stays CDA R2 XSD- and schematron-valid. Reconstruction is only reachable on the refine path — a retained section never reconstructs — so a regression that stopped rebuilding the narrative would surface here as the Results `<text>` reverting to the source narrative or a removal notice.
+
+
 ## Scenarios
 
-Total: 8 scenarios across 1 fixture.
+Total: 9 scenarios across 1 fixture.
 
 ### covid_baseline
 
@@ -154,6 +169,53 @@ Total: 8 scenarios across 1 fixture.
 
 **Pins Roll-up issues:** #1 (direct)
 
+### covid_results_reconstruction
+
+**Fixture:** `all_sections_covid_influenza`
+
+**Snapshot files:** [trace JSON](snapshots/all_sections_covid_influenza/covid_results_reconstruction/expected_trace.json) · [refined eICR](snapshots/all_sections_covid_influenza/covid_results_reconstruction/expected_eICR.xml) · [refined RR](snapshots/all_sections_covid_influenza/covid_results_reconstruction/expected_RR.xml)
+
+**Refinement summary**
+
+| Field | Value |
+|-------|-------|
+| Outcome | `refined` |
+| Configuration version | `9` |
+| Configuration resolved | `True` |
+| eICR size reduction | `55%` |
+| Canonical URL | `https://tes.tools.aimsplatform.org/api/fhir/ValueSet/07221093-b8a1-4b1d-8678-259277bfba64` |
+| Augmented eICR id | `dca02d8c-8b32-507c-91da-0ce03d64700b` |
+| Augmented RR id | `65fbb67d-d377-5c19-838f-7856dcb7f16a` |
+| Original eICR id | `2.16.840.1.113883.9.9.9.9.9` |
+| Original RR id | `329b9b59-c1be-4036-8984-42266155b321` |
+
+**Refined eICR — sections retained**
+
+| LOINC | Section | Entries | Disposition |
+|-------|---------|---------|-------------|
+| `18776-5` | Plan of Treatment | 1 | refined or retained |
+| `46240-8` | History of encounters | 1 | refined or retained |
+| `10164-2` | HISTORY OF PRESENT ILLNESS | 0 | narrative-only |
+| `11348-0` | HISTORY OF PAST ILLNESS | 0 | stubbed (no matches) |
+| `29549-3` | Medications Administered | 1 | refined or retained |
+| `10160-0` | HISTORY OF MEDICATION USE | 1 | refined or retained |
+| `42346-7` | ? | 1 | refined or retained |
+| `46241-6` | Hospital Admission             Diagnosis | 1 | refined or retained |
+| `11535-2` | Hospital Discharge Diagnosis | 1 | refined or retained |
+| `10187-3` | REVIEW OF SYSTEMS | 0 | narrative-only |
+| `11450-4` | Problem List | 1 | refined or retained |
+| `10154-3` | Chief complaint Narrative - Reported | 0 | narrative-only |
+| `29299-5` | Reason for visit Narrative | 0 | narrative-only |
+| `30954-2` | Relevant diagnostic tests and/or laboratory data | 1 | refined or retained |
+| `47519-4` | History of Procedures | 0 | stubbed (no matches) |
+| `11369-6` | Hx of Immunization | 1 | refined or retained |
+| `29762-2` | Social History | 1 | refined or retained |
+| `90767-5` | Pregnancy summary Document | 1 | refined or retained |
+| `8716-3` | Vital Signs | 1 | refined or retained |
+| `83910-0` | Public health Note | 2 | refined or retained |
+
+**Pins capabilities:** Narrative reconstruction from surviving entries (direct)
+
 ### covid_with_custom_codes
 
 **Fixture:** `all_sections_covid_influenza`
@@ -439,7 +501,7 @@ Total: 8 scenarios across 1 fixture.
 pytest tests/integration/scenarios/                                  # run all scenarios + smoke tests
 pytest tests/integration/scenarios/test_<fixture>.py -k <scenario>   # one scenario
 pytest tests/integration/scenarios/ --update-snapshots               # regenerate after intentional changes
-python tests/integration/scenarios/authoring/build_report.py        # regenerate this report
+python tests/integration/scenarios/build_report.py        # regenerate this report
 ```
 
 See [`tests/integration/scenarios/README.md`](./README.md) for adding fixtures, configurations, and scenarios.
diff --git a/refiner/tests/integration/scenarios/build_report.py b/refiner/tests/integration/scenarios/build_report.py
index 3562f0a53..209786619 100644
--- a/refiner/tests/integration/scenarios/build_report.py
+++ b/refiner/tests/integration/scenarios/build_report.py
@@ -20,7 +20,7 @@
 # NOTE:
 # REFINER OUTPUT MARKER STRINGS
 # =============================================================================
-# duplicated from app/services/ecr/section/constants.py rather than imported
+# duplicated from app/services/ecr/narrative/constants.py rather than imported
 # * if the production strings change without a corresponding update
 # here, the report's "Disposition" column will show outdated labels (e.g.
 # "refined or retained" where the section is actually stubbed). that's a
@@ -164,6 +164,48 @@ class RollupRow:
 ]
 
 
+# NOTE:
+# CAPABILITY COVERAGE DATA
+# =============================================================================
+# behaviors the suite pins that are NOT entries on Tim's roll-up sheet —
+# product capabilities the scenarios exercise. kept separate from
+# ROLLUP_COVERAGE so the roll-up section stays a faithful mapping of Tim's
+# numbered concerns; capabilities have no issue number. same `scenarios`
+# convention: list the scenario names that exercise the capability.
+
+
+@dataclass(frozen=True)
+class CapabilityRow:
+    title: str
+    status: str
+    scenarios: list[str] = field(default_factory=list)
+    evidence: str = ""
+
+
+CAPABILITY_COVERAGE: list[CapabilityRow] = [
+    CapabilityRow(
+        title="Narrative reconstruction from surviving entries",
+        status="Direct",
+        scenarios=["covid_results_reconstruction"],
+        evidence=(
+            "`covid_results_reconstruction` configures the Results section "
+            '(LOINC 30954-2) with `narrative="reconstruct"`. After entry '
+            "refinement prunes the section to the surviving SARS-CoV-2 result, "
+            "the engine rebuilds the section `<text>` from those entries rather "
+            "than retaining the stale source narrative. The snapshot pins the "
+            "reconstructed table: a machine-derived `<text>` carrying the result "
+            "row (panel, test, result, interpretation, date) plus the "
+            '"machine-derived, not clinician-attested" provenance marker, and '
+            "the validation layer confirms it stays CDA R2 XSD- and "
+            "schematron-valid. Reconstruction is only reachable on the refine "
+            "path — a retained section never reconstructs — so a regression that "
+            "stopped rebuilding the narrative would surface here as the Results "
+            "`<text>` reverting to the source narrative or a removal notice."
+        ),
+    ),
+]
+
+
 # NOTE:
 # SCENARIO DISCOVERY FROM SNAPSHOTS
 # =============================================================================
@@ -394,6 +436,38 @@ def _render_coverage_matrix() -> str:
     return "\n".join(lines)
 
 
+def _render_capability_coverage() -> str:
+    lines = [
+        "## Capability coverage",
+        "",
+        "Behaviors the suite pins that are product capabilities rather than entries on the Roll-up sheet. Each scenario reference links to its detail section below.",
+        "",
+        "| Capability | Status | Scenario(s) |",
+        "|------------|--------|-------------|",
+    ]
+
+    for row in CAPABILITY_COVERAGE:
+        if not row.scenarios:
+            scenarios_cell = "—"
+        else:
+            scenarios_cell = ", ".join(
+                f"[`{s}`](#{_scenario_anchor(s)})"
+                if s != "all scenarios"
+                else "all scenarios"
+                for s in row.scenarios
+            )
+        lines.append(f"| {row.title} | **{row.status}** | {scenarios_cell} |")
+
+    lines.extend(["", "### Evidence per capability", ""])
+    for row in CAPABILITY_COVERAGE:
+        lines.append(f"**{row.title}** ({row.status})")
+        lines.append("")
+        lines.append(row.evidence)
+        lines.append("")
+
+    return "\n".join(lines)
+
+
 def _render_scenario(scenario: ScenarioSnapshot) -> str:
     summary = scenario.summary
     lines = [
@@ -443,6 +517,16 @@ def _render_scenario(scenario: ScenarioSnapshot) -> str:
             ]
         )
 
+    related_caps = [c for c in CAPABILITY_COVERAGE if scenario.name in c.scenarios]
+    if related_caps:
+        lines.extend(
+            [
+                "",
+                "**Pins capabilities:** "
+                + ", ".join(f"{c.title} ({c.status.lower()})" for c in related_caps),
+            ]
+        )
+
     lines.append("")
     return "\n".join(lines)
 
@@ -490,6 +574,8 @@ def _compose_report(scenarios: list[ScenarioSnapshot]) -> str:
         "",
         _render_coverage_matrix(),
         "",
+        _render_capability_coverage(),
+        "",
         _render_scenarios_section(scenarios),
         "",
         _render_appendix(),
@@ -519,11 +605,15 @@ def _check_coverage_references_known_scenarios(
         for name in row.scenarios:
             if name != "all scenarios":
                 referenced.add(name)
+    for cap in CAPABILITY_COVERAGE:
+        for name in cap.scenarios:
+            if name != "all scenarios":
+                referenced.add(name)
 
     missing = referenced - snapshot_names
     if missing:
         raise SystemExit(
-            "ROLLUP_COVERAGE references scenarios that don't exist as "
+            "Coverage data references scenarios that don't exist as "
             f"snapshots: {sorted(missing)}\n"
             "Either remove the references or generate the missing snapshots "
             "with `pytest tests/integration/scenarios/ --update-snapshots`."
diff --git a/refiner/tests/integration/scenarios/conftest.py b/refiner/tests/integration/scenarios/conftest.py
index 690cfb986..9e20be637 100644
--- a/refiner/tests/integration/scenarios/conftest.py
+++ b/refiner/tests/integration/scenarios/conftest.py
@@ -248,6 +248,20 @@ class Scenario:
         configuration_version=8,
         custom_codes=(CustomCode("385857005", "snomed", "Artificial respiration"),),
     ),
+    Scenario(
+        name="covid_results_reconstruction",
+        fixture_dir="ecr_pairs/all_sections_covid_influenza",
+        condition_name="COVID-19",
+        rsg_code="840539006",
+        canonical_url=(
+            "https://tes.tools.aimsplatform.org/api/fhir/ValueSet/"
+            "07221093-b8a1-4b1d-8678-259277bfba64"
+        ),
+        configuration_version=9,
+        section_overrides=(
+            SectionOverride(current_code="30954-2", narrative="reconstruct"),
+        ),
+    ),
 ]
 
 # name -> Scenario lookup for the explicit-assertion suite, which references
diff --git a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_baseline/expected_eICR.xml b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_baseline/expected_eICR.xml
index e198a8150..eada5c250 100644
--- a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_baseline/expected_eICR.xml
+++ b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_baseline/expected_eICR.xml
@@ -407,7 +407,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-18776-5-20260101000000">
+            <footnote ID="ecr-refiner-18776-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -617,7 +617,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-46240-8-20260101000000">
+            <footnote ID="ecr-refiner-46240-8-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -755,7 +755,7 @@
               not reported<br/> Paroxysms Of Coughing REPORTED starting on 2020/11/04<br/>
               Post-tussive vomiting not reported<br/>
             </paragraph>
-            <footnote ID="ecr-refinement-10164-2-20260101000000">
+            <footnote ID="ecr-refiner-10164-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -809,7 +809,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11348-0-20260101000000">
+            <footnote ID="ecr-refiner-11348-0-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -869,7 +869,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-29549-3-20260101000000">
+            <footnote ID="ecr-refiner-29549-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1164,7 +1164,7 @@
           <title>MEDICATIONS</title>
           <text>
             Narrative Text
-          <footnote ID="ecr-refinement-10160-0-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>10160-0</td><td>Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v1</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <footnote ID="ecr-refiner-10160-0-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>10160-0</td><td>Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v1</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: code[1165486] 'ritonavir Oral Product' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
           <entry>
             <substanceAdministration classCode="SBADM" moodCode="EVN">
@@ -1218,7 +1218,7 @@
           <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.2.44"/>
           <code code="42346-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
           <title>Admission Medications</title>
-          <text>Some text here<footnote ID="ecr-refinement-42346-7-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>42346-7</td><td>Admission Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v1</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Some text here<footnote ID="ecr-refiner-42346-7-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>42346-7</td><td>Admission Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v1</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: code[1165486] 'ritonavir Oral Product' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1304,7 +1304,7 @@
             <translation code="42347-5" codeSystem="2.16.840.1.113883.6.1" displayName="Admission Diagnosis"/>
           </code>
           <title>HOSPITAL ADMISSION DIAGNOSIS</title>
-          <text>Appendicitis<footnote ID="ecr-refinement-46241-6-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>46241-6</td><td>Admission Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v1</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Appendicitis<footnote ID="ecr-refiner-46241-6-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>46241-6</td><td>Admission Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v1</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: value[1017214008] 'Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1377,7 +1377,7 @@
             <translation code="78375-3" displayName="Discharge Diagnosis" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
           </code>
           <title>Discharge Diagnosis</title>
-          <text>Some text here<footnote ID="ecr-refinement-11535-2-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>11535-2</td><td>Discharge Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v1</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Some text here<footnote ID="ecr-refiner-11535-2-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>11535-2</td><td>Discharge Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v1</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: value[1017214008] 'Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1454,7 +1454,7 @@
               For weakness and shortness of breath. One episode of melena. No recent
               headaches. Positive for osteoarthritis in hips, knees and hands.
             </paragraph>
-            <footnote ID="ecr-refinement-10187-3-20260101000000">
+            <footnote ID="ecr-refiner-10187-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1559,7 +1559,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11450-4-20260101000000">
+            <footnote ID="ecr-refiner-11450-4-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1629,7 +1629,7 @@
           <title>Chief Complaint</title>
           <text>
             <paragraph>Chief Complaint (the patient's own description): Headache and rash</paragraph>
-            <footnote ID="ecr-refinement-10154-3-20260101000000">
+            <footnote ID="ecr-refiner-10154-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1671,7 +1671,7 @@
           <title>Reason for Visit</title>
           <text>
             <paragraph>Reason for Visit (as documented by provider): Headache, rash, and fever</paragraph>
-            <footnote ID="ecr-refinement-29299-5-20260101000000">
+            <footnote ID="ecr-refiner-29299-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1879,7 +1879,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-30954-2-20260101000000">
+            <footnote ID="ecr-refiner-30954-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1961,7 +1961,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-47519-4-20260101000000">
+            <footnote ID="ecr-refiner-47519-4-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2053,7 +2053,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11369-6-20260101000000">
+            <footnote ID="ecr-refiner-11369-6-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2303,7 +2303,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-29762-2-20260101000000">
+            <footnote ID="ecr-refiner-29762-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2502,7 +2502,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-90767-5-20260101000000">
+            <footnote ID="ecr-refiner-90767-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2638,7 +2638,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-8716-3-20260101000000">
+            <footnote ID="ecr-refiner-8716-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2763,7 +2763,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-83910-0-20260101000000">
+            <footnote ID="ecr-refiner-83910-0-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
diff --git a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_plus_unrelated_condition/expected_eICR.xml b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_plus_unrelated_condition/expected_eICR.xml
index 0b98cc2d0..9a6c520ac 100644
--- a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_plus_unrelated_condition/expected_eICR.xml
+++ b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_plus_unrelated_condition/expected_eICR.xml
@@ -407,7 +407,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-18776-5-20260101000000">
+            <footnote ID="ecr-refiner-18776-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -617,7 +617,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-46240-8-20260101000000">
+            <footnote ID="ecr-refiner-46240-8-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -755,7 +755,7 @@
               not reported<br/> Paroxysms Of Coughing REPORTED starting on 2020/11/04<br/>
               Post-tussive vomiting not reported<br/>
             </paragraph>
-            <footnote ID="ecr-refinement-10164-2-20260101000000">
+            <footnote ID="ecr-refiner-10164-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -809,7 +809,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11348-0-20260101000000">
+            <footnote ID="ecr-refiner-11348-0-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -869,7 +869,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-29549-3-20260101000000">
+            <footnote ID="ecr-refiner-29549-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1164,7 +1164,7 @@
           <title>MEDICATIONS</title>
           <text>
             Narrative Text
-          <footnote ID="ecr-refinement-10160-0-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>10160-0</td><td>Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v5</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <footnote ID="ecr-refiner-10160-0-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>10160-0</td><td>Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v5</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: code[1165486] 'ritonavir Oral Product' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
           <entry>
             <substanceAdministration classCode="SBADM" moodCode="EVN">
@@ -1218,7 +1218,7 @@
           <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.2.44"/>
           <code code="42346-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
           <title>Admission Medications</title>
-          <text>Some text here<footnote ID="ecr-refinement-42346-7-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>42346-7</td><td>Admission Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v5</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Some text here<footnote ID="ecr-refiner-42346-7-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>42346-7</td><td>Admission Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v5</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: code[1165486] 'ritonavir Oral Product' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1304,7 +1304,7 @@
             <translation code="42347-5" codeSystem="2.16.840.1.113883.6.1" displayName="Admission Diagnosis"/>
           </code>
           <title>HOSPITAL ADMISSION DIAGNOSIS</title>
-          <text>Appendicitis<footnote ID="ecr-refinement-46241-6-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>46241-6</td><td>Admission Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v5</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Appendicitis<footnote ID="ecr-refiner-46241-6-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>46241-6</td><td>Admission Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v5</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: value[1017214008] 'Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1377,7 +1377,7 @@
             <translation code="78375-3" displayName="Discharge Diagnosis" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
           </code>
           <title>Discharge Diagnosis</title>
-          <text>Some text here<footnote ID="ecr-refinement-11535-2-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>11535-2</td><td>Discharge Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v5</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Some text here<footnote ID="ecr-refiner-11535-2-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>11535-2</td><td>Discharge Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v5</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: value[1017214008] 'Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1454,7 +1454,7 @@
               For weakness and shortness of breath. One episode of melena. No recent
               headaches. Positive for osteoarthritis in hips, knees and hands.
             </paragraph>
-            <footnote ID="ecr-refinement-10187-3-20260101000000">
+            <footnote ID="ecr-refiner-10187-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1559,7 +1559,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11450-4-20260101000000">
+            <footnote ID="ecr-refiner-11450-4-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1629,7 +1629,7 @@
           <title>Chief Complaint</title>
           <text>
             <paragraph>Chief Complaint (the patient's own description): Headache and rash</paragraph>
-            <footnote ID="ecr-refinement-10154-3-20260101000000">
+            <footnote ID="ecr-refiner-10154-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1671,7 +1671,7 @@
           <title>Reason for Visit</title>
           <text>
             <paragraph>Reason for Visit (as documented by provider): Headache, rash, and fever</paragraph>
-            <footnote ID="ecr-refinement-29299-5-20260101000000">
+            <footnote ID="ecr-refiner-29299-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1879,7 +1879,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-30954-2-20260101000000">
+            <footnote ID="ecr-refiner-30954-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1961,7 +1961,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-47519-4-20260101000000">
+            <footnote ID="ecr-refiner-47519-4-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2053,7 +2053,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11369-6-20260101000000">
+            <footnote ID="ecr-refiner-11369-6-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2303,7 +2303,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-29762-2-20260101000000">
+            <footnote ID="ecr-refiner-29762-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2502,7 +2502,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-90767-5-20260101000000">
+            <footnote ID="ecr-refiner-90767-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2638,7 +2638,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-8716-3-20260101000000">
+            <footnote ID="ecr-refiner-8716-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2763,7 +2763,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-83910-0-20260101000000">
+            <footnote ID="ecr-refiner-83910-0-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
diff --git a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_results_reconstruction/expected_RR.xml b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_results_reconstruction/expected_RR.xml
new file mode 100644
index 000000000..6ee7dfd04
--- /dev/null
+++ b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_results_reconstruction/expected_RR.xml
@@ -0,0 +1,505 @@
+<ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:cda="urn:hl7-org:v3" xmlns:sdtc="urn:hl7-org:sdtc" xmlns:voc="http://www.lantanagroup.com/voc" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="urn:hl7-org:v3 ../../schema/infrastructure/cda/CDA_SDTC.xsd">
+  <realmCode code="US"/>
+  <typeId extension="POCD_HD000040" root="2.16.840.1.113883.1.3"/>
+  <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.1.2"/>
+  <templateId root="2.16.840.1.113883.10.20.15.2.1.4" extension="2026-04-01"/>
+  <id root="65fbb67d-d377-5c19-838f-7856dcb7f16a" assigningAuthorityName="ecr-refiner"/>
+  <code code="88085-6" codeSystem="2.16.840.1.113883.6.1" displayName="Reportability response report Document Public health"/>
+  <title>Reportability Response</title>
+  <effectiveTime value="20260101000000+0000"/>
+  <confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25" displayName="Normal"/>
+  <languageCode code="en-US"/>
+  <setId root="ca55d79a-3987-5d5f-8adf-002132ebc0bb" assigningAuthorityName="ecr-refiner"/>
+  <versionNumber value="2"/>
+  <recordTarget>
+    <patientRole>
+      <id extension="123453" root="2.16.840.1.113883.19.5"/>
+      <id extension="444-22-2222" root="2.16.840.1.113883.4.1"/>
+      <addr use="H">
+        <streetAddressLine>2222 Home Street</streetAddressLine>
+        <city>Provo</city>
+        <state>UT</state>
+        <postalCode>84097</postalCode>
+        <country>US</country>
+        <useablePeriod xsi:type="IVL_TS">
+          <low value="200007200845"/>
+        </useablePeriod>
+      </addr>
+      <telecom use="HP" value="tel:+1-555-555-2003"/>
+      <telecom use="WP" value="tel:+1-555-555-2004"/>
+      <patient>
+        <name use="L">
+          <given>Eve</given>
+          <given qualifier="IN">H</given>
+          <family>Everywoman</family>
+        </name>
+        <name use="A">
+          <given>Ruth</given>
+          <given qualifier="IN">L</given>
+          <family>Everywoman</family>
+        </name>
+        <administrativeGenderCode code="F" codeSystem="2.16.840.1.113883.5.1"/>
+        <birthTime value="19741124"/>
+        <sdtc:deceasedInd value="false"/>
+        <raceCode code="2106-3" codeSystem="2.16.840.1.113883.6.238" codeSystemName="Race &amp; Ethnicity - CDC" displayName="White"/>
+        <ethnicGroupCode code="2186-5" codeSystem="2.16.840.1.113883.6.238" codeSystemName="Race &amp; Ethnicity - CDC" displayName="Not Hispanic or Latino"/>
+        <guardian>
+          <addr use="H">
+            <streetAddressLine>4444 Home Street</streetAddressLine>
+            <city>Provo</city>
+            <state>UT</state>
+            <postalCode>84097</postalCode>
+            <country>US</country>
+          </addr>
+          <telecom use="HP" value="tel:+1-555-555-2006"/>
+          <telecom value="mailto:mail@guardian.com"/>
+          <guardianPerson>
+            <name use="L">
+              <given>Martha</given>
+              <given qualifier="IN">L</given>
+              <family>Mum</family>
+            </name>
+          </guardianPerson>
+        </guardian>
+        <languageCommunication>
+          <languageCode code="en"/>
+          <modeCode code="ESP" codeSystem="2.16.840.1.113883.5.60" codeSystemName="LanguageAbilityMode" displayName="Expressed spoken"/>
+          <proficiencyLevelCode code="G" codeSystem="2.16.840.1.113883.5.61" codeSystemName="LanguageAbilityProficiency" displayName="Good"/>
+          <preferenceInd value="true"/>
+        </languageCommunication>
+      </patient>
+    </patientRole>
+  </recordTarget>
+  <author>
+    <time value="20260324164911+0000"/>
+    <assignedAuthor>
+      <id root="2.16.840.1.114222.4.1.217446"/>
+      <addr>
+        <streetAddressLine>7700 Wisconsin Avenue, Suite 1000</streetAddressLine>
+        <city>Bethesda</city>
+        <state>MD</state>
+        <postalCode>20814</postalCode>
+        <country>US</country>
+      </addr>
+      <telecom use="WP" value="mailto:support@aimsplatform.com"/>
+      <assignedAuthoringDevice>
+        <manufacturerModelName displayName="APHL"/>
+        <softwareName displayName="AIMS"/>
+      </assignedAuthoringDevice>
+    </assignedAuthor>
+  </author>
+  <author>
+    <time value="20260101000000+0000"/>
+    <assignedAuthor>
+      <id nullFlavor="NA"/>
+      <addr nullFlavor="NA"/>
+      <telecom nullFlavor="NA"/>
+      <assignedAuthoringDevice>
+        <softwareName code="ecr-refiner" codeSystem="2.16.840.1.113883.10.20.15.2.7.1" codeSystemName="eCRDataAugmentation" displayName="eCR Refiner"/>
+      </assignedAuthoringDevice>
+    </assignedAuthor>
+  </author>
+  <custodian>
+    <assignedCustodian>
+      <representedCustodianOrganization>
+        <id root="2.16.840.1.114222.4.1.217446"/>
+        <name>APHL | Association of Public Health Laboratories.</name>
+        <telecom use="WP" value="mailto:support@aimsplatform.com"/>
+        <addr>
+          <streetAddressLine>7700 Wisconsin Avenue, Suite 1000</streetAddressLine>
+          <city>Bethesda</city>
+          <state>MD</state>
+          <postalCode>20814</postalCode>
+          <country>US</country>
+        </addr>
+      </representedCustodianOrganization>
+    </assignedCustodian>
+  </custodian>
+  <informationRecipient typeCode="PRCP">
+    <intendedRecipient>
+      <id extension="6666666666666" root="2.16.840.1.113883.4.6"/>
+      <addr>
+        <streetAddressLine>1002 Healthcare Drive</streetAddressLine>
+        <city>Provo</city>
+        <state>UT</state>
+        <postalCode>84097</postalCode>
+        <country>US</country>
+      </addr>
+      <telecom use="WP" value="tel:+1(555)555-1003"/>
+      <telecom use="WP" value="fax:+1(555)555-1234"/>
+      <telecom use="WP" value="mailto:mail@provider_domain.com"/>
+      <informationRecipient>
+        <name>
+          <given>Henry</given>
+          <family>Seven</family>
+          <suffix qualifier="AC">M.D.</suffix>
+        </name>
+      </informationRecipient>
+      <receivedOrganization>
+        <name>Community Health and Hospitals</name>
+        <addr>
+          <streetAddressLine>1002 Healthcare Drive</streetAddressLine>
+          <city>Provo</city>
+          <state>UT</state>
+          <postalCode>84097</postalCode>
+          <country>US</country>
+        </addr>
+      </receivedOrganization>
+    </intendedRecipient>
+  </informationRecipient>
+  <relatedDocument typeCode="XFRM">
+    <parentDocument>
+      <id root="329b9b59-c1be-4036-8984-42266155b321" assigningAuthorityName="original-document"/>
+    </parentDocument>
+  </relatedDocument>
+  <componentOf>
+    <encompassingEncounter>
+      <id extension="9937012" root="2.16.840.1.113883.19"/>
+      <code code="AMB" codeSystem="2.16.840.1.113883.5.4" codeSystemName="HL7 ActEncounterCode" displayName="Ambulatory"/>
+      <effectiveTime>
+        <low value="20201107084421-0500"/>
+        <high value="20201108112103-0500"/>
+      </effectiveTime>
+      <responsibleParty>
+        <assignedEntity>
+          <id extension="6666666666666" root="2.16.840.1.113883.4.6"/>
+          <addr>
+            <streetAddressLine>1002 Healthcare Drive</streetAddressLine>
+            <city>Provo</city>
+            <state>UT</state>
+            <postalCode>84097</postalCode>
+            <country>US</country>
+          </addr>
+          <telecom use="WP" value="tel:+1(555)555-1003"/>
+          <telecom use="WP" value="fax:+1(555)555-1234"/>
+          <telecom use="WP" value="mailto:mail@provider_domain.com"/>
+          <assignedPerson>
+            <name>
+              <given>Henry</given>
+              <family>Seven</family>
+              <suffix qualifier="AC">M.D.</suffix>
+            </name>
+          </assignedPerson>
+          <representedOrganization>
+            <name>Community Health and Hospitals</name>
+            <addr>
+              <streetAddressLine>1002 Healthcare Drive</streetAddressLine>
+              <city>Provo</city>
+              <state>UT</state>
+              <postalCode>84097</postalCode>
+              <country>US</country>
+            </addr>
+          </representedOrganization>
+        </assignedEntity>
+      </responsibleParty>
+      <location>
+        <healthCareFacility>
+          <id extension="77777777777" root="2.16.840.1.113883.4.6"/>
+          <code code="OF" codeSystem="2.16.840.1.113883.5.111" displayName="Outpatient facility"/>
+          <location>
+            <addr>
+              <streetAddressLine>1000 Hospital Lane</streetAddressLine>
+              <city>Provo</city>
+              <state>UT</state>
+              <postalCode>84097</postalCode>
+              <country>US</country>
+            </addr>
+          </location>
+          <serviceProviderOrganization>
+            <name>Good Health Hospital</name>
+            <telecom use="WP" value="tel: 1+(555)-555-1212"/>
+            <telecom use="WP" value="fax: 1+(555)-555-3333"/>
+            <addr>
+              <streetAddressLine>1000 Hospital Lane</streetAddressLine>
+              <city>Provo</city>
+              <state>UT</state>
+              <postalCode>84097</postalCode>
+              <country>US</country>
+            </addr>
+          </serviceProviderOrganization>
+        </healthCareFacility>
+      </location>
+    </encompassingEncounter>
+  </componentOf>
+  <component>
+    <structuredBody>
+      <component>
+        <section>
+          <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.2.1"/>
+          <code code="88084-9" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
+          <title>.</title>
+          <text>
+            <br/>
+            <content styleCode="Bold">Subject:</content>
+            <paragraph>Public Health Reporting Communication: one or more conditions are reportable,
+              or may be reportable, to public health. </paragraph>
+          </text>
+          <entry typeCode="DRIV">
+            <act classCode="ACT" moodCode="INT">
+              <templateId extension="2014-06-09" root="2.16.840.1.113883.10.20.22.4.20"/>
+              <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.7"/>
+              <id root="f43773a1-c556-4347-9e2e-c5adc5fac794"/>
+              <code code="131195008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Subject of information"/>
+              <text>Public Health Reporting Communication: one or more conditions are reportable, or
+                may be reportable, to public health.</text>
+              <statusCode code="completed"/>
+            </act>
+          </entry>
+        </section>
+      </component>
+      <component>
+        <section>
+          <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.2.3"/>
+          <code code="88082-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Initial case report processing information Document"/>
+          <text>
+            <content styleCode="Bold">eICR Information:</content>
+            <paragraph>An initial report for a possible reportable condition was received on
+              20260324164911 with the file name
+              2.16.840.1.113883.9.9.9.9.9&amp;db734647-fc99-424c-a864-7e3cda82e704. The eICR was
+              processed with the warning of: outdated eRSD (RCTC) version.</paragraph>
+          </text>
+          <entry>
+            <act classCode="ACT" moodCode="EVN">
+              <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.9"/>
+              <id root="6bff7990-f218-4f9d-a5aa-eb7afa6e9a3c"/>
+              <code code="RR5" codeSystem="2.16.840.1.114222.4.5.232" codeSystemName="PHIN VS (CDC Local Coding System)" displayName="Received eICR Information"/>
+              <statusCode code="completed"/>
+              <effectiveTime value="20260324164911+0000"/>
+              <reference typeCode="REFR">
+                <externalDocument classCode="DOCCLIN" moodCode="EVN">
+                  <templateId extension="2014-06-09" root="2.16.840.1.113883.10.20.22.4.115"/>
+                  <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.10"/>
+                  <id extension="db734647-fc99-424c-a864-7e3cda82e704" root="2.16.840.1.113883.9.9.9.9.9"/>
+                  <code code="55751-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Public Health Case Report (eICR)"/>
+                  <setId extension="31" root="2.16.840.1.113883.3.117.1.1.5.2.1.1.1"/>
+                  <versionNumber value="2"/>
+                </externalDocument>
+              </reference>
+            </act>
+          </entry>
+          <entry>
+            <act classCode="ACT" moodCode="EVN">
+              <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.29"/>
+              <id root="39d966b9-8a3a-4024-93d8-138e97d5898a"/>
+              <code code="RRVS20" codeSystem="2.16.840.1.114222.4.5.274" codeSystemName="PHIN VS (CDC Local Coding System)" displayName="eICR was processed - with a warning"/>
+              <entryRelationship typeCode="RSON">
+                <observation classCode="OBS" moodCode="EVN">
+                  <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.21"/>
+                  <id root="e39d6ae2-8c6e-4638-9b33-412996586f42"/>
+                  <code code="RR6" codeSystem="2.16.840.1.114222.4.5.232" codeSystemName="PHIN Questions" displayName="eICR processing status reason"/>
+                  <value code="RRVS29" codeSystem="2.16.840.1.114222.4.5.274" codeSystemName="PHIN VS (CDC Local Coding System)" displayName="The eICR was processed with the warning of: outdated eRSD (RCTC) version." xsi:type="CD"/>
+                  <entryRelationship typeCode="RSON">
+                    <observation classCode="OBS" moodCode="EVN">
+                      <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.32"/>
+                      <id root="80f7b4ff-4d96-46ef-ae8f-af1f9c1f206c"/>
+                      <code code="RRVS31" codeSystem="2.16.840.1.114222.4.5.274" codeSystemName="PHIN VS (CDC Local Coding System)" displayName="Outdated eRSD (RCTC) Version Detail"/>
+                      <value xsi:type="ST">2020-11-13</value>
+                    </observation>
+                  </entryRelationship>
+                  <entryRelationship typeCode="RSON">
+                    <observation classCode="OBS" moodCode="EVN">
+                      <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.32"/>
+                      <id root="80f7b4ff-4d96-46ef-ae8f-af1f9c1f206c"/>
+                      <code code="RRVS33" codeSystem="2.16.840.1.114222.4.5.274" codeSystemName="PHIN VS (CDC Local Coding System)" displayName="Expected eRSD (RCTC) Version Detail"/>
+                      <value xsi:type="ST">The expected eRSD (RCTC) version should be one of the
+                        following: ["2025-03-18","2025-07-03","2.0.1","2.0.2","3.0.2","3.0.3"] </value>
+                    </observation>
+                  </entryRelationship>
+                </observation>
+              </entryRelationship>
+            </act>
+          </entry>
+        </section>
+      </component>
+      <component>
+        <section>
+          <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.2.2"/>
+          <code code="55112-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
+          <title>.</title>
+          <text>
+            <content styleCode="Bold">Summary:</content>
+            <paragraph>Your organization electronically submitted an initial case report to
+              determine if reporting to public health is needed for a patient.</paragraph>
+            <paragraph>"Influenzal acute upper respiratory infection (disorder)" is reportable to
+              "Utah Department of Health". The initial case report was sent to "Utah Department of
+              Health". Additional information may be required for this report."Infection caused by
+              novel Influenza A virus variant (disorder)" is reportable to "Utah Department of
+              Health". The initial case report was sent to "Utah Department of Health". Additional
+              information may be required for this report."Disease caused by severe acute
+              respiratory syndrome coronavirus 2 (disorder)" is reportable to "Utah Department of
+              Health". The initial case report was sent to "Utah Department of Health". Additional
+              information may be required for this report.<br/></paragraph>
+            <paragraph>The trigger code version your organization is using is out-of-date. Please
+              have your EHR administrators install the current version for complete eCR functioning.<br/></paragraph>
+            <paragraph>
+              <content styleCode="Bold">"Influenzal acute upper respiratory infection (disorder)"
+                for "Utah Department of Health" </content>
+            </paragraph>
+            <paragraph>Reporting to this Public Health Agency is based on "Both patient home address
+              and provider facility address"<br/></paragraph>
+            <paragraph>
+              <content styleCode="Bold">"Infection caused by novel Influenza A virus variant
+                (disorder)" for "Utah Department of Health" </content>
+            </paragraph>
+            <paragraph>Reporting to this Public Health Agency is based on "Both patient home address
+              and provider facility address"<br/></paragraph>
+            <paragraph>
+              <content styleCode="Bold">"Disease caused by severe acute respiratory syndrome
+                coronavirus 2 (disorder)" for "Utah Department of Health" </content>
+            </paragraph>
+            <paragraph>Reporting is required immediately. Reporting to this Public Health Agency is
+              based on "Both patient home address and provider facility address"<br/></paragraph>
+            <paragraph>
+              <content>&gt; Public Health Agency Contact Information<br/><br/></content>
+              <content>&gt; CDC COVID-19 webpage (<linkHtml href="https://www.cdc.gov/coronavirus/2019-ncov/index.html">Information only</linkHtml>
+                )<br/><br/></content>
+            </paragraph>
+          </text>
+          <entry typeCode="DRIV">
+            <act classCode="ACT" moodCode="INT">
+              <templateId extension="2014-06-09" root="2.16.840.1.113883.10.20.22.4.20"/>
+              <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.8"/>
+              <id root="a9899836-4e77-4c0f-8388-8b04b732e850"/>
+              <code code="304561000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Informing health care professional (procedure)"/>
+              <text>Your organization electronically submitted an initial case report to determine
+                if reporting to public health is needed for a patient. The eICR was processed with
+                the warning of: outdated eRSD (RCTC) version.</text>
+              <statusCode code="completed"/>
+            </act>
+          </entry>
+          <entry typeCode="DRIV">
+            <observation classCode="OBS" moodCode="EVN">
+              <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.30"/>
+              <code code="RR9" codeSystem="2.16.840.1.114222.4.5.232" codeSystemName="PHIN Questions" displayName="Reportability response priority"/>
+              <value code="RRVS15" codeSystem="2.16.840.1.114222.4.5.274" codeSystemName="PHIN VS (CDC Local Coding System)" displayName="Information Only" xsi:type="CD"/>
+            </observation>
+          </entry>
+          <entry typeCode="DRIV">
+            <organizer classCode="CLUSTER" moodCode="EVN">
+              <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.34"/>
+              <code code="RR11" codeSystem="2.16.840.1.114222.4.5.232" codeSystemName="PHIN Questions" displayName="Reportability Response Coded Information"/>
+              <statusCode code="completed"/>
+              <component>
+                <observation classCode="OBS" moodCode="EVN">
+                  <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.12"/>
+                  <id root="c3d7f04b-f238-492b-87bf-e1b8b02a0de7"/>
+                  <code code="64572001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED" displayName="Condition">
+                    <translation code="75323-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Condition"/>
+                  </code>
+                  <value code="840539006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Disease caused by severe acute respiratory syndrome coronavirus 2 (disorder)" xsi:type="CD"/>
+                  <entryRelationship typeCode="COMP">
+                    <organizer classCode="CLUSTER" moodCode="EVN">
+                      <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.13"/>
+                      <id root="be4129c0-7036-43a7-b949-e4930227af0a"/>
+                      <code code="RRVS7" codeSystem="2.16.840.1.114222.4.5.274" codeSystemName="Location Relevance" displayName="Both patient home address and provider facility address"/>
+                      <statusCode code="completed"/>
+                      <participant typeCode="LOC">
+                        <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.4.3"/>
+                        <participantRole>
+                          <id extension="ut" root="2.16.840.1.113883.4.6"/>
+                          <code code="RR12" codeSystem="2.16.840.1.114222.4.5.232" codeSystemName="PHIN Questions" displayName="Rules Authoring Agency"/>
+                          <addr use="WP">
+                            <streetAddressLine>288 N. 1460 W.</streetAddressLine>
+                            <city>Salt Lake City</city>
+                            <state>UT</state>
+                            <postalCode>84116</postalCode>
+                          </addr>
+                          <telecom use="WP" value="edx@utah.gov"/>
+                          <telecom use="WP" value="888-888-8888"/>
+                          <telecom use="WP" value="000-000-0000"/>
+                          <playingEntity>
+                            <name>Utah Department of Health</name>
+                          </playingEntity>
+                        </participantRole>
+                      </participant>
+                      <participant typeCode="LOC">
+                        <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.4.1"/>
+                        <participantRole>
+                          <id extension="ut" root="2.16.840.1.113883.4.6"/>
+                          <code code="RR7" codeSystem="2.16.840.1.114222.4.5.232" codeSystemName="PHIN Questions" displayName="Routing Entity"/>
+                          <addr use="WP">
+                            <streetAddressLine>288 N. 1460 W.</streetAddressLine>
+                            <city>Salt Lake City</city>
+                            <state>UT</state>
+                            <postalCode>84116</postalCode>
+                          </addr>
+                          <telecom use="WP" value="edx@utah.gov"/>
+                          <telecom use="WP" value="888-888-8888"/>
+                          <telecom use="WP" value="000-000-0000"/>
+                          <playingEntity>
+                            <name>Utah Department of Health</name>
+                          </playingEntity>
+                        </participantRole>
+                      </participant>
+                      <component typeCode="COMP">
+                        <observation classCode="OBS" moodCode="EVN">
+                          <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.19"/>
+                          <id root="3bcf4705-4421-4daf-bebb-c49884f6cad2"/>
+                          <code code="RR1" codeSystem="2.16.840.1.114222.4.5.232" codeSystemName="PHIN Questions" displayName="Determination of reportability"/>
+                          <value code="RRVS1" codeSystem="2.16.840.1.114222.4.5.274" codeSystemName="PHIN VS (CDC Local Coding System)" displayName="Reportable" xsi:type="CD"/>
+                          <entryRelationship typeCode="RSON">
+                            <observation classCode="OBS" moodCode="EVN">
+                              <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.27"/>
+                              <id root="ceecbcdb-bf14-461f-b7d3-bef5d90beab7"/>
+                              <code code="RR3" codeSystem="2.16.840.1.114222.4.5.232" codeSystemName="PHIN Questions" displayName="Determination of reportability rule"/>
+                              <value xsi:type="ST">COVID-19 (as a diagnosis or active problem)</value>
+                            </observation>
+                          </entryRelationship>
+                        </observation>
+                      </component>
+                      <component typeCode="COMP">
+                        <act classCode="ACT" moodCode="EVN">
+                          <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.20"/>
+                          <id root="ae19913f-f989-4ae2-8630-582733828d6a"/>
+                          <code code="RRVS12" codeSystem="2.16.840.1.114222.4.5.274" codeSystemName="PHIN VS (CDC Local Coding System)" displayName="PHA Contact Information"/>
+                          <priorityCode code="RRVS15" codeSystem="2.16.840.1.114222.4.5.274" codeSystemName="PHIN VS (CDC Local Coding System)" displayName="Information only"/>
+                          <reference typeCode="REFR">
+                            <externalDocument classCode="DOC" moodCode="EVN">
+                              <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.17"/>
+                              <code nullFlavor="OTH">
+                                <originalText>Public Health Agency Contact Information</originalText>
+                              </code>
+                            </externalDocument>
+                          </reference>
+                        </act>
+                      </component>
+                      <component typeCode="COMP">
+                        <act classCode="ACT" moodCode="EVN">
+                          <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.20"/>
+                          <id root="60c971db-a1f3-46b1-94e1-045e273f9255"/>
+                          <code code="RRVS13" codeSystem="2.16.840.1.114222.4.5.274" codeSystemName="PHIN VS (CDC Local Coding System)" displayName="Outbreak- or Cluster related"/>
+                          <priorityCode code="RRVS15" codeSystem="2.16.840.1.114222.4.5.274" codeSystemName="PHIN VS (CDC Local Coding System)" displayName="Information only"/>
+                          <reference typeCode="REFR">
+                            <externalDocument classCode="DOC" moodCode="EVN">
+                              <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.17"/>
+                              <code nullFlavor="OTH">
+                                <originalText>CDC COVID-19 webpage</originalText>
+                              </code>
+                              <text mediaType="text/html">
+                                <reference value="https://www.cdc.gov/coronavirus/2019-ncov/index.html"/>
+                              </text>
+                            </externalDocument>
+                          </reference>
+                        </act>
+                      </component>
+                      <component typeCode="COMP">
+                        <observation classCode="OBS" moodCode="EVN">
+                          <templateId extension="2017-04-01" root="2.16.840.1.113883.10.20.15.2.3.14"/>
+                          <id root="a4090692-87a2-4b18-bcbf-acaf79240121"/>
+                          <code code="RR4" codeSystem="2.16.840.1.114222.4.5.232" codeSystemName="PHIN Questions" displayName="Timeframe to report (urgency)"/>
+                          <value unit="min" value="0" xsi:type="PQ">
+                            <translation code="88694003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Immediate (qualifier value)"/>
+                          </value>
+                        </observation>
+                      </component>
+                    </organizer>
+                  </entryRelationship>
+                </observation>
+              </component>
+            </organizer>
+          </entry>
+        </section>
+      </component>
+    </structuredBody>
+  </component>
+</ClinicalDocument>
diff --git a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_results_reconstruction/expected_eICR.xml b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_results_reconstruction/expected_eICR.xml
new file mode 100644
index 000000000..8e8f6fd2b
--- /dev/null
+++ b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_results_reconstruction/expected_eICR.xml
@@ -0,0 +1,2718 @@
+<ClinicalDocument xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="urn:hl7-org:v3" xmlns:cda="urn:hl7-org:v3" xmlns:sdtc="urn:hl7-org:sdtc" xmlns:voc="http://www.lantanagroup.com/voc" xsi:schemaLocation="urn:hl7-org:v3 ../../../cda-core-2.0/schema/extensions/SDTC/infrastructure/cda/CDA_SDTC.xsd">
+  <!-- **** CDA Header
+        ********************************************************
+    -->
+  <!-- US Realm Header template -->
+  <realmCode code="US"/>
+  <typeId extension="POCD_HD000040" root="2.16.840.1.113883.1.3"/>
+  <!-- [C-CDA R1.1] US Realm Header -->
+  <templateId root="2.16.840.1.113883.10.20.22.1.1"/>
+  <!-- [C-CDA R2.1] US Realm Header (V3) -->
+  <templateId root="2.16.840.1.113883.10.20.22.1.1" extension="2015-08-01"/>
+  <!-- [eICR R2 STU3] Initial Public Health Case Report Document (eICR) (V5) -->
+  <templateId root="2.16.840.1.113883.10.20.15.2" extension="2022-05-01"/>
+  <!-- Globally unique document ID (extension) is scoped by vendor/software -->
+  <templateId root="2.16.840.1.113883.10.20.15.2.1.3" extension="2025-11-01"/>
+  <id root="dca02d8c-8b32-507c-91da-0ce03d64700b" assigningAuthorityName="ecr-refiner"/>
+  <!-- Document Code -->
+  <code code="55751-2" codeSystem="2.16.840.1.113883.6.1" displayName="Public Health Case Report" codeSystemName="LOINC"/>
+  <title>Initial Public Health Case Report</title>
+  <effectiveTime value="20260101000000+0000"/>
+  <confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25" displayName="Normal"/>
+  <languageCode code="en-US"/>
+  <setId root="d781e627-9a67-5d27-b9aa-8d19b03be0ac" assigningAuthorityName="ecr-refiner"/>
+  <!-- the second in the series -->
+  <versionNumber value="2"/>
+  <!-- recordTarget: The patient -->
+  <recordTarget>
+    <!-- Patient demographic information -->
+    <patientRole>
+      <!-- Fake root for sample -->
+      <id extension="123453" root="2.16.840.1.113883.19.5"/>
+      <!--SSN-->
+      <id extension="444-22-2222" root="2.16.840.1.113883.4.1"/>
+      <!-- For greatest utility to public health, a patient's address 
+        should be a home address if available (PostalAddressUse = 'H' or 'HP'); 
+        would also request a second address, preferably a work address, 
+        (PostalAddressUse='WP') if available. 
+
+        If the patient is homeless, complete as much address information 
+        as possible (city, zip, county, etc.) and use the 
+        Characteristics of Home Environment template in the 
+        Social History Section to indicate that the patient is homeless. -->
+      <addr use="H">
+        <streetAddressLine>2222 Home Street</streetAddressLine>
+        <city>Provo</city>
+        <state>UT</state>
+        <postalCode>84097</postalCode>
+        <country>US</country>
+        <!-- usablePeriod is an optional element
+                     If present and high is missing, this indicates a current addres
+                     If present and high is present, this indicates this address is historical
+                     If present, low indicates the starting period for this address 
+                     The following example indicates a current address-->
+        <useablePeriod xsi:type="IVL_TS">
+          <low value="200007200845"/>
+        </useablePeriod>
+      </addr>
+      <!-- Patient Telcom (phone, email, or fax) -->
+      <telecom use="HP" value="tel:+1-555-555-2003"/>
+      <telecom use="WP" value="tel:+1-555-555-2004"/>
+      <!-- Patient Name -->
+      <patient>
+        <!-- Patient "legal" (known as/conventional/the one you use) name -->
+        <name use="L">
+          <given>Eve</given>
+          <given qualifier="IN">H</given>
+          <family>Everywoman</family>
+        </name>
+        <!-- Patient "artist/stage" (includes writer's pseudonym, stage name, etc) name -->
+        <name use="A">
+          <given>Ruth</given>
+          <given qualifier="IN">L</given>
+          <family>Everywoman</family>
+        </name>
+        <administrativeGenderCode code="F" codeSystem="2.16.840.1.113883.5.1"/>
+        <!-- Patient Birthdate -->
+        <birthTime value="19741124"/>
+        <!-- If sdtc:deceasedInd is true then sdtc:deceasedTime must be present -->
+        <sdtc:deceasedInd value="false"/>
+        <!-- Patient Race -->
+        <raceCode code="2106-3" codeSystem="2.16.840.1.113883.6.238" codeSystemName="Race &amp; Ethnicity - CDC" displayName="White"/>
+        <!-- Patient Ethnicity -->
+        <ethnicGroupCode code="2186-5" codeSystem="2.16.840.1.113883.6.238" codeSystemName="Race &amp; Ethnicity - CDC" displayName="Not Hispanic or Latino"/>
+        <!-- Parent/Guardian information-->
+        <guardian>
+          <!-- Parent/Guardian Address -->
+          <addr use="H">
+            <streetAddressLine>4444 Home Street</streetAddressLine>
+            <city>Provo</city>
+            <state>UT</state>
+            <postalCode>84097</postalCode>
+            <country>US</country>
+          </addr>
+          <!-- Parent/Guardian phone -->
+          <telecom use="HP" value="tel:+1-555-555-2006"/>
+          <!-- Parent/Guardian email -->
+          <telecom value="mailto:mail@guardian.com"/>
+          <guardianPerson>
+            <!-- Parent/guardian name -->
+            <name use="L">
+              <given>Martha</given>
+              <given qualifier="IN">L</given>
+              <family>Mum</family>
+            </name>
+          </guardianPerson>
+        </guardian>
+        <languageCommunication>
+          <languageCode code="en"/>
+          <modeCode code="ESP" codeSystem="2.16.840.1.113883.5.60" codeSystemName="LanguageAbilityMode" displayName="Expressed spoken"/>
+          <proficiencyLevelCode code="G" codeSystem="2.16.840.1.113883.5.61" codeSystemName="LanguageAbilityProficiency" displayName="Good"/>
+          <!-- Preferred Language -->
+          <preferenceInd value="true"/>
+        </languageCommunication>
+      </patient>
+    </patientRole>
+  </recordTarget>
+  <!-- author -->
+  <!-- Where a trigger occurs outside of an encounter the author/assignedAuthor/authorPerson and 
+       author/assignedAuthor/representedOrganization will represent the Provider and Facility for
+  reporting purposes. -->
+  <author>
+    <time value="201209151030-0800"/>
+    <assignedAuthor>
+      <id extension="5555555555" root="2.16.840.1.113883.4.6"/>
+      <code code="163W00000X" displayName="Registered nurse" codeSystem="2.16.840.1.113883.5.53" codeSystemName="Health Care Provider Taxonomy"/>
+      <addr>
+        <streetAddressLine>1004 Healthcare Drive </streetAddressLine>
+        <city>Provo</city>
+        <state>UT</state>
+        <postalCode>84097</postalCode>
+        <country>US</country>
+      </addr>
+      <telecom use="WP" value="tel:+1(555)555-1004"/>
+      <assignedPerson>
+        <name>
+          <given>Patricia</given>
+          <given qualifier="CL">Patty</given>
+          <family>Primary</family>
+          <suffix qualifier="AC">M.D.</suffix>
+        </name>
+      </assignedPerson>
+      <representedOrganization>
+        <id extension="10" root="1.2.840.114350.1.13.306.3.7.2.696570"/>
+        <name>Childrens Hospital of Provo</name>
+        <telecom nullFlavor="NA"/>
+        <addr use="WP">
+          <streetAddressLine>1234 Facility Drive</streetAddressLine>
+          <city>Provo</city>
+          <state>UT</state>
+          <postalCode>78097</postalCode>
+          <county/>
+          <country>US</country>
+        </addr>
+      </representedOrganization>
+    </assignedAuthor>
+  </author>
+  <author>
+    <time value="20240809174011+0000"/>
+    <assignedAuthor>
+      <id root="0cafa72d-33d2-4d43-87fb-5651f5569c39"/>
+      <addr>
+        <streetAddressLine nullFlavor="NI"/>
+        <city nullFlavor="NI"/>
+        <state nullFlavor="NI"/>
+        <postalCode nullFlavor="NI"/>
+        <country nullFlavor="NI"/>
+      </addr>
+      <assignedAuthoringDevice>
+        <manufacturerModelName displayName="athena"/>
+        <softwareName displayName="1.0.0"/>
+      </assignedAuthoringDevice>
+    </assignedAuthor>
+  </author>
+  <author>
+    <time value="20240809174011+0000"/>
+    <assignedAuthor>
+      <id root="02ae519a-f890-41d9-98fb-4eb08ca78ade"/>
+      <addr>
+        <streetAddressLine nullFlavor="NI"/>
+        <city nullFlavor="NI"/>
+        <state nullFlavor="NI"/>
+        <postalCode nullFlavor="NI"/>
+        <country nullFlavor="NI"/>
+      </addr>
+      <assignedAuthoringDevice>
+        <manufacturerModelName displayName="ecrNowApp"/>
+        <softwareName displayName="Version 3.1.X"/>
+      </assignedAuthoringDevice>
+    </assignedAuthor>
+  </author>
+  <author>
+    <time value="20240809174011+0000"/>
+    <assignedAuthor>
+      <id root="7f28ecf9-6409-4eb2-b1fc-e4badb1882bb"/>
+      <addr>
+        <streetAddressLine nullFlavor="NI"/>
+        <city nullFlavor="NI"/>
+        <state nullFlavor="NI"/>
+        <postalCode nullFlavor="NI"/>
+        <country nullFlavor="NI"/>
+      </addr>
+      <assignedAuthoringDevice>
+        <manufacturerModelName displayName="System-Integrator"/>
+        <softwareName displayName="1.0.0"/>
+      </assignedAuthoringDevice>
+    </assignedAuthor>
+  </author>
+  <author>
+    <time value="20260101000000+0000"/>
+    <assignedAuthor>
+      <id nullFlavor="NA"/>
+      <addr nullFlavor="NA"/>
+      <telecom nullFlavor="NA"/>
+      <assignedAuthoringDevice>
+        <softwareName code="ecr-refiner" codeSystem="2.16.840.1.113883.10.20.15.2.7.1" codeSystemName="eCRDataAugmentation" displayName="eCR Refiner"/>
+      </assignedAuthoringDevice>
+    </assignedAuthor>
+  </author>
+  <!-- custodian: The custodian of the CDA document is the generator of the document -->
+  <custodian>
+    <assignedCustodian>
+      <representedCustodianOrganization>
+        <id extension="88888888" root="2.16.840.1.113883.4.6"/>
+        <name>Good Health Hospital</name>
+        <telecom use="WP" value="tel:+1(555)555-1212"/>
+        <addr>
+          <streetAddressLine>1000 Hospital Lane</streetAddressLine>
+          <city>Provo</city>
+          <state>UT</state>
+          <postalCode>84097</postalCode>
+          <country>US</country>
+        </addr>
+      </representedCustodianOrganization>
+    </assignedCustodian>
+  </custodian>
+  <!-- relatedDocument: the document with which to replace this document -->
+  <!-- Replace version 1 of this document -->
+  <relatedDocument typeCode="RPLC">
+    <parentDocument>
+      <!-- ClinicalDocument/id of the document to replace -->
+      <id root="2.16.840.1.113883.9.9.9.9.9" extension="db734647-fc99-424c-a864-7e3cda82e704"/>
+      <!-- setId of the document to replace -->
+      <setId root="2.16.840.1.113883.3.117.1.1.5.2.1.1.1" extension="31"/>
+      <!-- versionNumber of the document to replace -->
+      <versionNumber value="1"/>
+    </parentDocument>
+  </relatedDocument>
+  <!-- componentOf: contains the encompassingEncouter and the provider and facility infomation for
+  the case -->
+  <relatedDocument typeCode="XFRM">
+    <parentDocument>
+      <id root="2.16.840.1.113883.9.9.9.9.9" extension="db734647-fc99-424c-a864-7e3cda82e704" assigningAuthorityName="original-document"/>
+      <setId root="2.16.840.1.113883.3.117.1.1.5.2.1.1.1" extension="31" assigningAuthorityName="original-document"/>
+      <versionNumber value="2"/>
+    </parentDocument>
+  </relatedDocument>
+  <componentOf>
+    <encompassingEncounter>
+      <!-- Encounter iD-->
+      <id extension="9937012" root="2.16.840.1.113883.19"/>
+      <!-- Where a trigger occurs outside of an encounter use 
+              code="PHC2237" | 
+              codeSystem="2.16.840.1.114222.4.5.274" | 
+              codeSystemName="PHIN VS (CDC Local Coding System)" 
+              (External Historical Encounter) 
+           and set effectiveTime/low/@nullFlavor="NA" and omit responsibleParty and location. -->
+      <!-- Encounter Type -->
+      <code code="AMB" codeSystem="2.16.840.1.113883.5.4" codeSystemName="HL7 ActEncounterCode" displayName="Ambulatory"/>
+      <!-- Use the following if this is an external encounter -->
+      <!-- <code code="PHC2237" codeSystem="2.16.840.1.114222.4.5.274" codeSystemName="PHIN VS (CDC
+      Local Coding System)" displayName="External Historical Encounter">-->
+      <effectiveTime>
+        <!-- Admission Date/Time (inpatient) OR Visit Date/Time (outpatient) -->
+        <low value="20201107084421-0500"/>
+        <!-- Discharge Date/Time (if missing, the encounter is still in progress)  -->
+        <high value="20201108112103-0500"/>
+      </effectiveTime>
+      <!-- Provider: Provider responsible for the patient's care when the case was triggered -->
+      <responsibleParty>
+        <assignedEntity>
+          <id extension="6666666666666" root="2.16.840.1.113883.4.6"/>
+          <!-- Provider Address: Address of the provider responsibe for the patient's care when the
+          case was triggered -->
+          <addr>
+            <streetAddressLine>1002 Healthcare Drive</streetAddressLine>
+            <city>Provo</city>
+            <state>UT</state>
+            <postalCode>84097</postalCode>
+            <country>US</country>
+          </addr>
+          <!-- Provider Telecom: A telecom address (phone, email, fax, etc.) for the provider
+          responsibe for the patient's care when the case was triggered -->
+          <!-- Provider Phone -->
+          <telecom use="WP" value="tel:+1(555)555-1003"/>
+          <!-- Provider Fax -->
+          <telecom use="WP" value="fax:+1(555)555-1234"/>
+          <!-- Provider Email -->
+          <telecom use="WP" value="mailto:mail@provider_domain.com"/>
+          <assignedPerson>
+            <!-- Provider Name: Name of the provider responsibe for the patient's care when the case
+            was triggered -->
+            <name>
+              <given>Henry</given>
+              <family>Seven</family>
+              <suffix qualifier="AC">M.D.</suffix>
+            </name>
+          </assignedPerson>
+          <!-- Provider Facility/Office: The office or facility of the provider responsible for the
+          patient's care when the case was triggered (not necessarily where care was provided to the
+          patient) -->
+          <representedOrganization>
+            <!-- Provider Facility/Office Name: The name of the office or facility of the provider
+            responsible for the patient's care when the case was triggered (not necessarily where
+            care was provided to the patient) -->
+            <name>Community Health and Hospitals</name>
+            <!-- Provider Facility/Office Address: The address of the office or facility of the
+            provider responsible for the patient's care when the case was triggered (not necessarily
+            where care was provided to the patient) -->
+            <addr>
+              <streetAddressLine>1002 Healthcare Drive</streetAddressLine>
+              <city>Provo</city>
+              <state>UT</state>
+              <postalCode>84097</postalCode>
+              <country>US</country>
+            </addr>
+          </representedOrganization>
+        </assignedEntity>
+      </responsibleParty>
+      <!-- Information about the facility in which care was provided when the case was triggered -->
+      <location>
+        <!-- Facility: The facility in which care was provided when the case was triggered -->
+        <healthCareFacility>
+          <!-- Facility Id: Identification code for the facility in which care was provided when the
+          case was triggered (if available, the NPI SHALL be provided) -->
+          <id extension="77777777777" root="2.16.840.1.113883.4.6"/>
+          <!-- Facility Type: The type of facility in which care was provided when the case was
+          triggered -->
+          <code code="OF" codeSystem="2.16.840.1.113883.5.111" displayName="Outpatient facility"/>
+          <!-- Facility Address: The physical location of the facility in which care was provided
+          when the case was triggered (location within larger healthcare organization e.g Kaiser
+          Vacaville within Kaiser North) -->
+          <location>
+            <addr>
+              <streetAddressLine>1000 Hospital Lane</streetAddressLine>
+              <city>Provo</city>
+              <state>UT</state>
+              <postalCode>84097</postalCode>
+              <country>US</country>
+            </addr>
+          </location>
+          <!-- Facility Contact: Contact information for the facility in which care was provided
+          when the case was triggered -->
+          <serviceProviderOrganization>
+            <!-- Facility Contact Name: The contact name for the facility in which care was provided
+            when the case was triggered -->
+            <name>Good Health Hospital</name>
+            <!-- Facility Contact Telecom: A contact telecom address (phone, email, fax,etc.) for
+            the facility in which care was provided when the case was triggered -->
+            <!-- Facility Phone -->
+            <telecom use="WP" value="tel: 1+(555)-555-1212"/>
+            <!-- Facility Fax -->
+            <telecom use="WP" value="fax: 1+(555)-555-3333"/>
+            <!-- Facility Contact Address: The contact address of the facility in which care was
+            provided when the case was triggered -->
+            <addr>
+              <streetAddressLine>1000 Hospital Lane</streetAddressLine>
+              <city>Provo</city>
+              <state>UT</state>
+              <postalCode>84097</postalCode>
+              <country>US</country>
+            </addr>
+          </serviceProviderOrganization>
+        </healthCareFacility>
+      </location>
+    </encompassingEncounter>
+  </componentOf>
+  <component>
+    <structuredBody>
+      <!-- Plan of Treatment Section (V2) -->
+      <component>
+        <section>
+          <templateId root="2.16.840.1.113883.10.20.22.2.22.10"/>
+          <templateId root="2.16.840.1.113883.10.20.22.2.22.10" extension="2014-06-09"/>
+          <code code="18776-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Plan of Treatment"/>
+          <title>Plan of Treatment</title>
+          <text>
+            <table>
+              <thead>
+                <tr>
+                  <th>Initial Case Report Trigger<br/>Code Lab Test Order</th>
+                  <th>Trigger Code</th>
+                  <th>Trigger Code codeSystem</th>
+                  <th>RCTC OID</th>
+                  <th>RCTC Version</th>
+                  <th>Ordered Date</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr ID="id_b52bee94-c34b-4e2c-8c15-5ad9d6def205_ref">
+                  <td>Zika virus envelope (E) gene [Presence] in Serum<br/>by Probe and target
+                    amplification method</td>
+                  <td>80825-3</td>
+                  <td>LOINC</td>
+                  <td>2.16.840.1.114222.4.11.7508</td>
+                  <td>19/05/2020</td>
+                  <td>NOV 8, 2020</td>
+                </tr>
+              </tbody>
+            </table>
+            <footnote ID="ecr-refiner-18776-5-20260101000000">
+              <paragraph>
+                <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
+              </paragraph>
+              <table border="1">
+                <thead>
+                  <tr>
+                    <th>Section (LOINC)</th>
+                    <th>Section Name</th>
+                    <th>Included</th>
+                    <th>Action</th>
+                    <th>Retain Narrative</th>
+                    <th>Config Version</th>
+                    <th>Source</th>
+                    <th>Outcome</th>
+                  </tr>
+                </thead>
+                <tbody>
+                  <tr>
+                    <td>18776-5</td>
+                    <td>Plan of Treatment Section</td>
+                    <td>Yes</td>
+                    <td>refine</td>
+                    <td>Yes</td>
+                    <td>v9</td>
+                    <td>Configured by jurisdiction</td>
+                    <td>Refined; matches found</td>
+                  </tr>
+                </tbody>
+              </table>
+            </footnote>
+          </text>
+          <!-- eCR Refiner matched: code[105066-5] 'SARS-CoV+SARS-CoV-2 (COVID-19) Ag [Presence] in Specimen' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
+          <entry typeCode="DRIV">
+            <observation classCode="OBS" moodCode="RQO">
+              <templateId root="2.16.840.1.113883.10.20.22.4.44"/>
+              <templateId root="2.16.840.1.113883.10.20.22.4.44" extension="2014-06-09"/>
+              <templateId root="2.16.840.1.113883.10.20.15.2.3.4" extension="2019-04-01"/>
+              <id root="b52bee94-c34b-4e2c-8c15-5ad9d6def205"/>
+              <code code="105066-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="SARS-CoV+SARS-CoV-2 (COVID-19) Ag [Presence] in Specimen" sdtc:valueSet="2.16.840.1.114222.4.11.7508" sdtc:valueSetVersion="2020-11-13"/>
+              <statusCode code="active"/>
+              <effectiveTime value="20201108"/>
+              <performer>
+                <assignedEntity>
+                  <id root="2.16.840.1.113883.19" extension="1234"/>
+                  <addr>
+                    <streetAddressLine>1001 Village Avenue</streetAddressLine>
+                    <city>Provo</city>
+                    <state>UT</state>
+                    <postalCode>84097</postalCode>
+                    <country>US</country>
+                  </addr>
+                  <telecom use="WP" value="tel: +1(555)-555-5000"/>
+                  <representedOrganization>
+                    <id root="2.16.840.1.113883.19.5"/>
+                    <name>Community Health and Hospitals</name>
+                    <telecom use="WP" value="tel:+1(555)-555-5000"/>
+                    <addr>
+                      <city>Provo</city>
+                      <state>UT</state>
+                      <postalCode>84097</postalCode>
+                      <country>US</country>
+                    </addr>
+                  </representedOrganization>
+                </assignedEntity>
+              </performer>
+              <author>
+                <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
+                <time value="201308011235-0800"/>
+                <assignedAuthor>
+                  <id root="20cf14fb-b65c-4c8c-a54d-b0cca834c18c"/>
+                  <code code="163W00000X" codeSystem="2.16.840.1.113883.5.53" codeSystemName="Health                     Care Provider Taxonomy" displayName="Registered nurse"/>
+                  <assignedPerson>
+                    <name>
+                      <given>Nurse</given>
+                      <family>Nightingale</family>
+                      <suffix>RN</suffix>
+                    </name>
+                  </assignedPerson>
+                  <representedOrganization>
+                    <id root="2.16.840.1.113883.19.5"/>
+                    <name>Good Health Hospital</name>
+                  </representedOrganization>
+                </assignedAuthor>
+              </author>
+            </observation>
+          </entry>
+        </section>
+      </component>
+      <!--  Encounters Section (entries required) (V3) -->
+      <component>
+        <section>
+          <templateId root="2.16.840.1.113883.10.20.22.2.22"/>
+          <templateId root="2.16.840.1.113883.10.20.22.2.22" extension="2015-08-01"/>
+          <templateId root="2.16.840.1.113883.10.20.22.2.22.1"/>
+          <templateId root="2.16.840.1.113883.10.20.22.2.22.1" extension="2015-08-01"/>
+          <code code="46240-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="History of encounters"/>
+          <title>Encounters</title>
+          <text>
+            <table>
+              <thead>
+                <tr>
+                  <th>Encounter</th>
+                  <th>Date(s)</th>
+                  <th>Location</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr ID="id_2a620155-9d11-439e-92b3-5d9815ff4de8_ref">
+                  <td>Office outpatient visit 15 minutes</td>
+                  <td>NOV 7, 2020</td>
+                  <td>
+                    <list styleCode="none">
+                      <item>
+                        <content styleCode="Italics">Urgent Care Center</content>
+                      </item>
+                    </list>
+                  </td>
+                </tr>
+                <tr>
+                  <td colspan="20">
+                    <list styleCode="none">
+                      <item>
+                        <table>
+                          <thead>
+                            <tr>
+                              <th>Encounter Diagnosis Type</th>
+                            </tr>
+                          </thead>
+                          <tbody>
+                            <tr>
+                              <td>Diagnosis</td>
+                            </tr>
+                            <tr>
+                              <td colspan="20">
+                                <list styleCode="none">
+                                  <item>
+                                    <table>
+                                      <thead>
+                                        <tr>
+                                          <th>Initial Case Report Trigger<br/>Code Problem
+                                            Observation </th>
+                                          <th>Problem</th>
+                                          <th>Trigger Code</th>
+                                          <th>Trigger Code codeSystem</th>
+                                          <th>RCTC OID</th>
+                                          <th>RCTC Version</th>
+                                          <th>Date(s)</th>
+                                        </tr>
+                                      </thead>
+                                      <tbody>
+                                        <tr ID="id_db734647-fc99-424c-a864-7e3cda82e705_ref">
+                                          <td>Diagnosis</td>
+                                          <td>Pertussis (disorder)</td>
+                                          <td>27836007</td>
+                                          <td>SNOMED CT</td>
+                                          <td>2.16.840.1.114222.4.11.7508</td>
+                                          <td>19/05/2020</td>
+                                          <td>NOV 7, 2020</td>
+                                        </tr>
+                                      </tbody>
+                                    </table>
+                                    <table>
+                                      <thead>
+                                        <tr>
+                                          <th>Encounter Diagnosis Type</th>
+                                        </tr>
+                                      </thead>
+                                      <tbody>
+                                        <tr>
+                                          <td>Diagnosis</td>
+                                        </tr>
+                                        <tr>
+                                          <td colspan="20">
+                                            <list styleCode="none">
+                                              <item>
+                                                <table>
+                                                  <thead>
+                                                    <tr>
+                                                      <th>Problem Type</th>
+                                                      <th>Problem</th>
+                                                      <th>Date(s)</th>
+                                                    </tr>
+                                                  </thead>
+                                                  <tbody>
+                                                    <tr ID="id_db734647-fc99-424c-a864-7e3cda82e704_ref">
+                                                      <td>Diagnosis</td>
+                                                      <td>A non-trigger code diagnosis (disorder)</td>
+                                                      <td>NOV 7, 2020</td>
+                                                    </tr>
+                                                  </tbody>
+                                                </table>
+                                              </item>
+                                            </list>
+                                          </td>
+                                        </tr>
+                                      </tbody>
+                                    </table>
+                                  </item>
+                                </list>
+                              </td>
+                            </tr>
+                          </tbody>
+                        </table>
+                      </item>
+                    </list>
+                  </td>
+                </tr>
+              </tbody>
+            </table>
+            <footnote ID="ecr-refiner-46240-8-20260101000000">
+              <paragraph>
+                <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
+              </paragraph>
+              <table border="1">
+                <thead>
+                  <tr>
+                    <th>Section (LOINC)</th>
+                    <th>Section Name</th>
+                    <th>Included</th>
+                    <th>Action</th>
+                    <th>Retain Narrative</th>
+                    <th>Config Version</th>
+                    <th>Source</th>
+                    <th>Outcome</th>
+                  </tr>
+                </thead>
+                <tbody>
+                  <tr>
+                    <td>46240-8</td>
+                    <td>Encounters Section</td>
+                    <td>Yes</td>
+                    <td>refine</td>
+                    <td>Yes</td>
+                    <td>v9</td>
+                    <td>Configured by jurisdiction</td>
+                    <td>Refined; matches found</td>
+                  </tr>
+                </tbody>
+              </table>
+            </footnote>
+          </text>
+          <!-- eCR Refiner matched: value[1017214008] 'Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
+          <entry typeCode="DRIV">
+            <encounter classCode="ENC" moodCode="EVN">
+              <templateId root="2.16.840.1.113883.10.20.22.4.49"/>
+              <templateId root="2.16.840.1.113883.10.20.22.4.49" extension="2015-08-01"/>
+              <id root="2a620155-9d11-439e-92b3-5d9815ff4de8"/>
+              <code code="99213" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="Office outpatient visit 15 minutes"/>
+              <effectiveTime value="20201107"/>
+              <performer>
+                <assignedEntity>
+                  <id root="2.16.840.1.113883.19" extension="1234"/>
+                  <addr>
+                    <streetAddressLine>1001 Village Avenue</streetAddressLine>
+                    <city>Provo</city>
+                    <state>UT</state>
+                    <postalCode>84097</postalCode>
+                    <country>US</country>
+                  </addr>
+                  <telecom use="WP" value="tel: +1(555)-555-5000"/>
+                  <representedOrganization>
+                    <id root="2.16.840.1.113883.19.5"/>
+                    <name>Community Health and Hospitals</name>
+                    <telecom use="WP" value="tel:+1(555)-555-5000"/>
+                    <addr>
+                      <streetAddressLine>1001 Village Avenue</streetAddressLine>
+                      <city>Provo</city>
+                      <state>UT</state>
+                      <postalCode>84097</postalCode>
+                      <country>US</country>
+                    </addr>
+                  </representedOrganization>
+                </assignedEntity>
+              </performer>
+              <participant typeCode="LOC">
+                <participantRole classCode="SDLOC">
+                  <templateId root="2.16.840.1.113883.10.20.22.4.32"/>
+                  <code code="1160-1" codeSystem="2.16.840.1.113883.6.259" codeSystemName="HealthcareServiceLocation" displayName="Urgent Care Center"/>
+                  <addr>
+                    <streetAddressLine>17 Daws Rd.</streetAddressLine>
+                    <city>Blue Bell</city>
+                    <state>MA</state>
+                    <postalCode>02368</postalCode>
+                    <country>US</country>
+                  </addr>
+                  <telecom use="WP" value="tel:+1(555)555-5000"/>
+                  <playingEntity classCode="PLC">
+                    <name>Community Health and Hospitals</name>
+                  </playingEntity>
+                </participantRole>
+              </participant>
+              <entryRelationship typeCode="COMP">
+                <act classCode="ACT" moodCode="EVN">
+                  <templateId root="2.16.840.1.113883.10.20.22.4.80"/>
+                  <templateId root="2.16.840.1.113883.10.20.22.4.80" extension="2015-08-01"/>
+                  <code code="29308-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Diagnosis"/>
+                  <entryRelationship typeCode="SUBJ">
+                    <observation classCode="OBS" moodCode="EVN">
+                      <templateId root="2.16.840.1.113883.10.20.22.4.4"/>
+                      <templateId root="2.16.840.1.113883.10.20.22.4.4" extension="2015-08-01"/>
+                      <id root="db734647-fc99-424c-a864-7e3cda82e704"/>
+                      <code code="29308-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Diagnosis">
+                        <translation code="282291009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Diagnosis"/>
+                      </code>
+                      <statusCode code="completed"/>
+                      <effectiveTime>
+                        <low value="20201107"/>
+                      </effectiveTime>
+                      <value xsi:type="CD" code="1017214008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)"/>
+                      <author>
+                        <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
+                        <time value="201308011235-0800"/>
+                        <assignedAuthor>
+                          <id root="20cf14fb-b65c-4c8c-a54d-b0cca834c18c"/>
+                          <code code="163W00000X" codeSystem="2.16.840.1.113883.5.53" codeSystemName="Health                             Care Provider Taxonomy" displayName="Registered nurse"/>
+                          <assignedPerson>
+                            <name>
+                              <given>Nurse</given>
+                              <family>Nightingale</family>
+                              <suffix>RN</suffix>
+                            </name>
+                          </assignedPerson>
+                          <representedOrganization>
+                            <id root="2.16.840.1.113883.19.5"/>
+                            <name>Good Health Hospital</name>
+                          </representedOrganization>
+                        </assignedAuthor>
+                      </author>
+                    </observation>
+                  </entryRelationship>
+                </act>
+              </entryRelationship>
+            </encounter>
+          </entry>
+        </section>
+      </component>
+      <!-- History of Present Illness Section -->
+      <component>
+        <section>
+          <templateId root="1.3.6.1.4.1.19376.1.5.3.1.3.4"/>
+          <code code="10164-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="HISTORY OF PRESENT ILLNESS"/>
+          <title>History of Present Illness</title>
+          <text mediaType="text/x-hl7-text+xml">
+            <paragraph> Persistent Cough REPORTED starting on 2020/10/05<br/> Whooping Respiration
+              not reported<br/> Paroxysms Of Coughing REPORTED starting on 2020/11/04<br/>
+              Post-tussive vomiting not reported<br/>
+            </paragraph>
+            <footnote ID="ecr-refiner-10164-2-20260101000000">
+              <paragraph>
+                <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
+              </paragraph>
+              <table border="1">
+                <thead>
+                  <tr>
+                    <th>Section (LOINC)</th>
+                    <th>Section Name</th>
+                    <th>Included</th>
+                    <th>Action</th>
+                    <th>Retain Narrative</th>
+                    <th>Config Version</th>
+                    <th>Source</th>
+                    <th>Outcome</th>
+                  </tr>
+                </thead>
+                <tbody>
+                  <tr>
+                    <td>10164-2</td>
+                    <td>History of Present Illness Section</td>
+                    <td>Yes</td>
+                    <td>retain</td>
+                    <td>Yes</td>
+                    <td>v9</td>
+                    <td>Configured by jurisdiction</td>
+                    <td>Narrative-only section; narrative retained</td>
+                  </tr>
+                </tbody>
+              </table>
+            </footnote>
+          </text>
+        </section>
+      </component>
+      <!-- ** History of Past Illness Section ** -->
+      <component>
+        <section nullFlavor="NI">
+          <templateId root="2.16.840.1.113883.10.20.22.2.20" extension="2015-08-01"/>
+          <code codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" code="11348-0" displayName="HISTORY OF PAST ILLNESS"/>
+          <title>PAST MEDICAL HISTORY</title>
+          <text>
+            <table border="1">
+              <caption>Output from CDC eCR Refiner application by request of jurisdiction.</caption>
+              <thead>
+                <tr>
+                  <th>Status</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>No clinical information matches the configured code sets for this condition.</td>
+                </tr>
+              </tbody>
+            </table>
+            <footnote ID="ecr-refiner-11348-0-20260101000000">
+              <paragraph>
+                <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
+              </paragraph>
+              <table border="1">
+                <thead>
+                  <tr>
+                    <th>Section (LOINC)</th>
+                    <th>Section Name</th>
+                    <th>Included</th>
+                    <th>Action</th>
+                    <th>Retain Narrative</th>
+                    <th>Config Version</th>
+                    <th>Source</th>
+                    <th>Outcome</th>
+                  </tr>
+                </thead>
+                <tbody>
+                  <tr>
+                    <td>11348-0</td>
+                    <td>Past Medical History Section</td>
+                    <td>Yes</td>
+                    <td>refine</td>
+                    <td>Yes</td>
+                    <td>v9</td>
+                    <td>Configured by jurisdiction</td>
+                    <td>Refined; no matches found</td>
+                  </tr>
+                </tbody>
+              </table>
+            </footnote>
+          </text>
+        </section>
+      </component>
+      <!--  Medications Administered Section (V2) -->
+      <component>
+        <section>
+          <templateId root="2.16.840.1.113883.10.20.22.2.38"/>
+          <templateId root="2.16.840.1.113883.10.20.22.2.38" extension="2014-06-09"/>
+          <code code="29549-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Medications Administered"/>
+          <title>Medications Administered</title>
+          <text>
+            <table>
+              <thead>
+                <tr>
+                  <th>Medication</th>
+                  <th>Dose</th>
+                  <th>Duration</th>
+                  <th>Route</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr ID="id_6c844c75-aa34-411c-b7bd-5e4a9f206e29_ref">
+                  <td>Azithromycin 500 MG Oral Tablet</td>
+                  <td>1 g</td>
+                  <td>NOV 7, 2020 11:59</td>
+                  <td>ORAL</td>
+                </tr>
+              </tbody>
+            </table>
+            <footnote ID="ecr-refiner-29549-3-20260101000000">
+              <paragraph>
+                <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
+              </paragraph>
+              <table border="1">
+                <thead>
+                  <tr>
+                    <th>Section (LOINC)</th>
+                    <th>Section Name</th>
+                    <th>Included</th>
+                    <th>Action</th>
+                    <th>Retain Narrative</th>
+                    <th>Config Version</th>
+                    <th>Source</th>
+                    <th>Outcome</th>
+                  </tr>
+                </thead>
+                <tbody>
+                  <tr>
+                    <td>29549-3</td>
+                    <td>Medications Administered Section</td>
+                    <td>Yes</td>
+                    <td>refine</td>
+                    <td>Yes</td>
+                    <td>v9</td>
+                    <td>Configured by jurisdiction</td>
+                    <td>Refined; matches found</td>
+                  </tr>
+                </tbody>
+              </table>
+            </footnote>
+          </text>
+          <!--
+  eCR Refiner matched: code[1165486] 'ritonavir Oral Product' (any code system) Entry match fired for: rule 1 (T1) [hl7:code]
+  eCR Refiner matched: code[1165486] 'ritonavir Oral Product' (any code system) Entry match fired for: rule 1 (T1) [hl7:code]
+-->
+          <entry typeCode="DRIV">
+            <substanceAdministration classCode="SBADM" moodCode="EVN">
+              <templateId root="2.16.840.1.113883.10.20.22.4.16"/>
+              <templateId root="2.16.840.1.113883.10.20.22.4.16" extension="2014-06-09"/>
+              <id root="6c844c75-aa34-411c-b7bd-5e4a9f206e29"/>
+              <statusCode code="completed"/>
+              <effectiveTime xsi:type="PIVL_TS" operator="A" value="202011071159-0700"/>
+              <routeCode code="C38288" codeSystem="2.16.840.1.113883.3.26.1.1" codeSystemName="NCI Thesaurus" displayName="ORAL"/>
+              <doseQuantity value="1" unit="g"/>
+              <consumable>
+                <manufacturedProduct classCode="MANU">
+                  <templateId root="2.16.840.1.113883.10.20.22.4.23" extension="2014-06-09"/>
+                  <templateId root="2.16.840.1.113883.10.20.15.2.3.36" extension="2019-04-01"/>
+                  <id root="2a620155-9d11-439e-92b3-5d9815ff4ee8"/>
+                  <manufacturedMaterial>
+                    <code code="1165486" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm" displayName="ritonavir Oral Product" sdtc:valueSet="2.16.840.1.114222.4.11.7508" sdtc:valueSetVersion="2020-11-13"/>
+                  </manufacturedMaterial>
+                </manufacturedProduct>
+              </consumable>
+              <entryRelationship typeCode="CAUS">
+                <observation classCode="OBS" moodCode="EVN">
+                  <templateId root="2.16.840.1.113883.10.20.22.4.9" extension="2014-06-09"/>
+                  <id root="4adc1020-7b14-11db-9fe1-0800200c9a64"/>
+                  <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
+                  <text>
+                    <reference value="#reaction1"/>
+                  </text>
+                  <statusCode code="completed"/>
+                  <effectiveTime>
+                    <low value="200802260805-0800"/>
+                    <high value="200802281205-0800"/>
+                  </effectiveTime>
+                  <value xsi:type="CD" code="422587007" codeSystem="2.16.840.1.113883.6.96" displayName="Nausea"/>
+                  <entryRelationship typeCode="RSON" inversionInd="true">
+                    <substanceAdministration classCode="SBADM" moodCode="EVN">
+                      <templateId root="2.16.840.1.113883.10.20.22.4.16" extension="2014-06-09"/>
+                      <id root="6c844c75-aa34-411c-b7bd-5e4a9f206e29"/>
+                      <statusCode code="active"/>
+                      <effectiveTime xsi:type="IVL_TS">
+                        <low value="20120318"/>
+                      </effectiveTime>
+                      <effectiveTime xsi:type="PIVL_TS" institutionSpecified="true" operator="A">
+                        <period value="12" unit="h"/>
+                      </effectiveTime>
+                      <routeCode code="C38288" codeSystem="2.16.840.1.113883.3.26.1.1" codeSystemName="NCI Thesaurus" displayName="ORAL"/>
+                      <doseQuantity value="1"/>
+                      <consumable>
+                        <manufacturedProduct classCode="MANU">
+                          <templateId root="2.16.840.1.113883.10.20.22.4.23" extension="2014-06-09"/>
+                          <id root="2a620155-9d11-439e-92b3-5d9815ff4ee8"/>
+                          <manufacturedMaterial>
+                            <code code="197380" displayName="Atenolol 25 MG Oral Tablet" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm"/>
+                          </manufacturedMaterial>
+                        </manufacturedProduct>
+                      </consumable>
+                    </substanceAdministration>
+                  </entryRelationship>
+                  <entryRelationship typeCode="RSON">
+                    <procedure classCode="PROC" moodCode="EVN">
+                      <templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09"/>
+                      <templateId root="2.16.840.1.113883.10.20.22.4.14"/>
+                      <id root="d68b7e32-7810-4f5b-9cc2-acd54b0fd85d"/>
+                      <code code="73761001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Colonoscopy"/>
+                      <statusCode code="completed"/>
+                      <effectiveTime value="20201115"/>
+                      <author>
+                        <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
+                        <time value="201308011235-0800"/>
+                        <assignedAuthor>
+                          <id root="20cf14fb-b65c-4c8c-a54d-b0cca834c18c"/>
+                          <code code="163W00000X" codeSystem="2.16.840.1.113883.5.53" codeSystemName="Health                             Care Provider Taxonomy" displayName="Registered nurse"/>
+                          <assignedPerson>
+                            <name>
+                              <given>Nurse</given>
+                              <family>Nightingale</family>
+                              <suffix>RN</suffix>
+                            </name>
+                          </assignedPerson>
+                          <representedOrganization>
+                            <id root="2.16.840.1.113883.19.5"/>
+                            <name>Good Health Hospital</name>
+                          </representedOrganization>
+                        </assignedAuthor>
+                      </author>
+                      <participant typeCode="DEV">
+                        <participantRole classCode="MANU">
+                          <templateId root="2.16.840.1.113883.10.20.22.4.37"/>
+                          <id root="2.16.840.1.113883.3.3719" extension="(01)51022222233336(11)141231(17)150707(10)A213B1(21)1234" assigningAuthorityName="FDA"/>
+                          <playingDevice>
+                            <code code="90412006" codeSystem="2.16.840.1.113883.6.96" displayName="Colonoscope"/>
+                          </playingDevice>
+                          <scopingEntity>
+                            <id root="2.16.840.1.113883.3.3719"/>
+                          </scopingEntity>
+                        </participantRole>
+                      </participant>
+                      <participant typeCode="LOC">
+                        <participantRole classCode="SDLOC">
+                          <templateId root="2.16.840.1.113883.10.20.22.4.32"/>
+                          <code code="1160-1" codeSystem="2.16.840.1.113883.6.259" codeSystemName="HealthcareServiceLocation" displayName="Urgent Care Center"/>
+                          <addr>
+                            <streetAddressLine>17 Daws Rd.</streetAddressLine>
+                            <city>Blue Bell</city>
+                            <state>MA</state>
+                            <postalCode>02368</postalCode>
+                            <country>US</country>
+                          </addr>
+                          <telecom use="WP" value="tel:+1(555)555-5000"/>
+                          <playingEntity classCode="PLC">
+                            <name>Community Health and Hospitals</name>
+                          </playingEntity>
+                        </participantRole>
+                      </participant>
+                      <entryRelationship typeCode="COMP">
+                        <substanceAdministration classCode="SBADM" moodCode="EVN">
+                          <templateId root="2.16.840.1.113883.10.20.22.4.16"/>
+                          <templateId root="2.16.840.1.113883.10.20.22.4.16" extension="2014-06-09"/>
+                          <id root="6c844c75-aa34-411c-b7bd-5e4a9f206e29"/>
+                          <statusCode code="completed"/>
+                          <effectiveTime xsi:type="PIVL_TS" operator="A" value="202011071159-0700"/>
+                          <routeCode code="C38288" codeSystem="2.16.840.1.113883.3.26.1.1" codeSystemName="NCI Thesaurus" displayName="ORAL"/>
+                          <doseQuantity value="1" unit="g"/>
+                          <consumable>
+                            <manufacturedProduct classCode="MANU">
+                              <templateId root="2.16.840.1.113883.10.20.22.4.23" extension="2014-06-09"/>
+                              <templateId root="2.16.840.1.113883.10.20.15.2.3.36" extension="2019-04-01"/>
+                              <id root="2a620155-9d11-439e-92b3-5d9815ff4ee8"/>
+                              <manufacturedMaterial>
+                                <code code="1165486" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm" displayName="ritonavir Oral Product" sdtc:valueSet="2.16.840.1.114222.4.11.7508" sdtc:valueSetVersion="2020-11-13"/>
+                              </manufacturedMaterial>
+                            </manufacturedProduct>
+                          </consumable>
+                          <author>
+                            <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
+                            <time value="201308011235-0800"/>
+                            <assignedAuthor>
+                              <id root="20cf14fb-b65c-4c8c-a54d-b0cca834c18c"/>
+                              <code code="163W00000X" codeSystem="2.16.840.1.113883.5.53" codeSystemName="Health                                 Care Provider Taxonomy" displayName="Registered nurse"/>
+                              <assignedPerson>
+                                <name>
+                                  <given>Nurse</given>
+                                  <family>Nightingale</family>
+                                  <suffix>RN</suffix>
+                                </name>
+                              </assignedPerson>
+                              <representedOrganization>
+                                <id root="2.16.840.1.113883.19.5"/>
+                                <name>Good Health Hospital</name>
+                              </representedOrganization>
+                            </assignedAuthor>
+                          </author>
+                          <entryRelationship typeCode="REFR">
+                            <supply classCode="SPLY" moodCode="EVN">
+                              <templateId root="2.16.840.1.113883.10.20.22.4.18" extension="2014-06-09"/>
+                              <id root="2.16.840.1.113883.19.5"/>
+                              <statusCode code="completed"/>
+                              <effectiveTime value="200802260805-0800"/>
+                              <product>
+                                <manufacturedProduct classCode="MANU">
+                                  <templateId root="2.16.840.1.113883.10.20.22.4.23" extension="2014-06-09"/>
+                                  <id root="2a620155-9d11-439e-92b3-5d9815ff4ee8"/>
+                                  <manufacturedMaterial>
+                                    <code code="248656" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm" displayName="Azithromycin 500 MG Oral Tablet" sdtc:valueSet="2.16.840.1.114222.4.11.7508" sdtc:valueSetVersion="2020-11-13"/>
+                                  </manufacturedMaterial>
+                                </manufacturedProduct>
+                              </product>
+                            </supply>
+                          </entryRelationship>
+                          <entryRelationship typeCode="CAUS">
+                            <observation classCode="OBS" moodCode="EVN">
+                              <templateId root="2.16.840.1.113883.10.20.15.2.3.37" extension="2019-04-01"/>
+                              <id root="ab1791b0-5c71-11db-b0de-0800200c9a55"/>
+                              <code code="67540-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Response to medication"/>
+                              <statusCode code="completed"/>
+                              <effectiveTime>
+                                <low value="20201101"/>
+                              </effectiveTime>
+                              <value code="268910001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Patient's condition improved (finding)" xsi:type="CD"/>
+                            </observation>
+                          </entryRelationship>
+                        </substanceAdministration>
+                      </entryRelationship>
+                      <entryRelationship typeCode="RSON">
+                        <observation classCode="OBS" moodCode="EVN">
+                          <templateId root="2.16.840.1.113883.10.20.22.4.9" extension="2014-06-09"/>
+                          <id root="4adc1020-7b14-11db-9fe1-0800200c9a64"/>
+                          <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
+                          <text>
+                            <reference value="#reaction1"/>
+                          </text>
+                          <statusCode code="completed"/>
+                          <effectiveTime>
+                            <low value="200802260805-0800"/>
+                            <high value="200802281205-0800"/>
+                          </effectiveTime>
+                          <value xsi:type="CD" code="422587007" codeSystem="2.16.840.1.113883.6.96" displayName="Nausea"/>
+                          <entryRelationship typeCode="RSON" inversionInd="true">
+                            <substanceAdministration classCode="SBADM" moodCode="EVN">
+                              <templateId root="2.16.840.1.113883.10.20.22.4.16" extension="2014-06-09"/>
+                              <id root="6c844c75-aa34-411c-b7bd-5e4a9f206e29"/>
+                              <statusCode code="active"/>
+                              <effectiveTime xsi:type="IVL_TS">
+                                <low value="20120318"/>
+                              </effectiveTime>
+                              <effectiveTime xsi:type="PIVL_TS" institutionSpecified="true" operator="A">
+                                <period value="12" unit="h"/>
+                              </effectiveTime>
+                              <routeCode code="C38288" codeSystem="2.16.840.1.113883.3.26.1.1" codeSystemName="NCI Thesaurus" displayName="ORAL"/>
+                              <doseQuantity value="1"/>
+                              <consumable>
+                                <manufacturedProduct classCode="MANU">
+                                  <templateId root="2.16.840.1.113883.10.20.22.4.23" extension="2014-06-09"/>
+                                  <id root="2a620155-9d11-439e-92b3-5d9815ff4ee8"/>
+                                  <manufacturedMaterial>
+                                    <code code="197380" displayName="Atenolol 25 MG Oral Tablet" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm"/>
+                                  </manufacturedMaterial>
+                                </manufacturedProduct>
+                              </consumable>
+                              <author>
+                                <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
+                                <time value="201308011235-0800"/>
+                                <assignedAuthor>
+                                  <id root="20cf14fb-b65c-4c8c-a54d-b0cca834c18c"/>
+                                  <code code="163W00000X" codeSystem="2.16.840.1.113883.5.53" codeSystemName="Health                                     Care Provider Taxonomy" displayName="Registered nurse"/>
+                                  <assignedPerson>
+                                    <name>
+                                      <given>Nurse</given>
+                                      <family>Nightingale</family>
+                                      <suffix>RN</suffix>
+                                    </name>
+                                  </assignedPerson>
+                                  <representedOrganization>
+                                    <id root="2.16.840.1.113883.19.5"/>
+                                    <name>Good Health Hospital</name>
+                                  </representedOrganization>
+                                </assignedAuthor>
+                              </author>
+                            </substanceAdministration>
+                          </entryRelationship>
+                        </observation>
+                      </entryRelationship>
+                    </procedure>
+                  </entryRelationship>
+                </observation>
+              </entryRelationship>
+            </substanceAdministration>
+          </entry>
+        </section>
+      </component>
+      <!--**MEDICATION
+      SECTION (coded entries required) ** -->
+      <component>
+        <section>
+          <templateId root="2.16.840.1.113883.10.20.22.2.1.1" extension="2014-06-09"/>
+          <templateId root="2.16.840.1.113883.10.20.22.2.1" extension="2014-06-09"/>
+          <code code="10160-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="HISTORY OF MEDICATION USE"/>
+          <title>MEDICATIONS</title>
+          <text>
+            Narrative Text
+          <footnote ID="ecr-refiner-10160-0-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>10160-0</td><td>Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v9</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <!-- eCR Refiner matched: code[1165486] 'ritonavir Oral Product' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
+          <entry>
+            <substanceAdministration classCode="SBADM" moodCode="EVN">
+              <templateId root="2.16.840.1.113883.10.20.22.4.16" extension="2014-06-09"/>
+              <id root="6c844c75-aa34-411c-b7bd-5e4a9f206e29"/>
+              <statusCode code="active"/>
+              <effectiveTime xsi:type="IVL_TS">
+                <low value="20120318"/>
+              </effectiveTime>
+              <effectiveTime xsi:type="PIVL_TS" institutionSpecified="true" operator="A">
+                <period value="12" unit="h"/>
+              </effectiveTime>
+              <routeCode code="C38288" codeSystem="2.16.840.1.113883.3.26.1.1" codeSystemName="NCI Thesaurus" displayName="ORAL"/>
+              <doseQuantity value="1"/>
+              <consumable>
+                <manufacturedProduct classCode="MANU">
+                  <templateId root="2.16.840.1.113883.10.20.22.4.23" extension="2014-06-09"/>
+                  <id root="2a620155-9d11-439e-92b3-5d9815ff4ee8"/>
+                  <manufacturedMaterial>
+                    <code code="1165486" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm" displayName="ritonavir Oral Product"/>
+                  </manufacturedMaterial>
+                </manufacturedProduct>
+              </consumable>
+              <author>
+                <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
+                <time value="201308011235-0800"/>
+                <assignedAuthor>
+                  <id root="20cf14fb-b65c-4c8c-a54d-b0cca834c18c"/>
+                  <code code="163W00000X" codeSystem="2.16.840.1.113883.5.53" codeSystemName="Health                     Care Provider Taxonomy" displayName="Registered nurse"/>
+                  <assignedPerson>
+                    <name>
+                      <given>Nurse</given>
+                      <family>Nightingale</family>
+                      <suffix>RN</suffix>
+                    </name>
+                  </assignedPerson>
+                  <representedOrganization>
+                    <id root="2.16.840.1.113883.19.5"/>
+                    <name>Good Health Hospital</name>
+                  </representedOrganization>
+                </assignedAuthor>
+              </author>
+            </substanceAdministration>
+          </entry>
+        </section>
+      </component>
+      <!--**Admission
+      MEDICATION SECTION (coded entries required) ** -->
+      <component>
+        <section>
+          <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.2.44"/>
+          <code code="42346-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
+          <title>Admission Medications</title>
+          <text>Some text here<footnote ID="ecr-refiner-42346-7-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>42346-7</td><td>Admission Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v9</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <!-- eCR Refiner matched: code[1165486] 'ritonavir Oral Product' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
+          <entry>
+            <act classCode="ACT" moodCode="EVN">
+              <templateId root="2.16.840.1.113883.10.20.22.4.36" extension="2014-06-09"/>
+              <code code="42346-7" codeSystem="2.16.840.1.113883.6.1"/>
+              <entryRelationship typeCode="SUBJ">
+                <substanceAdministration classCode="SBADM" moodCode="EVN">
+                  <templateId root="2.16.840.1.113883.10.20.22.4.16" extension="2014-06-09"/>
+                  <id root="6c844c75-aa34-411c-b7bd-5e4a9f206e29"/>
+                  <statusCode code="completed"/>
+                  <effectiveTime xsi:type="PIVL_TS" operator="A" value="202011071159-0700"/>
+                  <routeCode code="C38288" codeSystem="2.16.840.1.113883.3.26.1.1" codeSystemName="NCI Thesaurus" displayName="ORAL"/>
+                  <doseQuantity value="1" unit="g"/>
+                  <consumable>
+                    <manufacturedProduct classCode="MANU">
+                      <templateId root="2.16.840.1.113883.10.20.22.4.23" extension="2014-06-09"/>
+                      <id root="2a620155-9d11-439e-92b3-5d9815ff4ee8"/>
+                      <manufacturedMaterial>
+                        <code code="1165486" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm" displayName="ritonavir Oral Product"/>
+                      </manufacturedMaterial>
+                    </manufacturedProduct>
+                  </consumable>
+                  <author>
+                    <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
+                    <time value="201308011235-0800"/>
+                    <assignedAuthor>
+                      <id root="20cf14fb-b65c-4c8c-a54d-b0cca834c18c"/>
+                      <code code="163W00000X" codeSystem="2.16.840.1.113883.5.53" codeSystemName="Health                         Care Provider Taxonomy" displayName="Registered nurse"/>
+                      <assignedPerson>
+                        <name>
+                          <given>Nurse</given>
+                          <family>Nightingale</family>
+                          <suffix>RN</suffix>
+                        </name>
+                      </assignedPerson>
+                      <representedOrganization>
+                        <id root="2.16.840.1.113883.19.5"/>
+                        <name>Good Health Hospital</name>
+                      </representedOrganization>
+                    </assignedAuthor>
+                  </author>
+                  <entryRelationship typeCode="REFR">
+                    <supply classCode="SPLY" moodCode="EVN">
+                      <templateId root="2.16.840.1.113883.10.20.22.4.18" extension="2014-06-09"/>
+                      <id root="2.16.840.1.113883.19.5"/>
+                      <statusCode code="completed"/>
+                      <effectiveTime value="200802260805-0800"/>
+                      <product>
+                        <manufacturedProduct classCode="MANU">
+                          <templateId root="2.16.840.1.113883.10.20.22.4.23" extension="2014-06-09"/>
+                          <id root="2a620155-9d11-439e-92b3-5d9815ff4ee8"/>
+                          <manufacturedMaterial>
+                            <code code="248656" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm" displayName="Azithromycin 500 MG Oral Tablet" sdtc:valueSet="2.16.840.1.114222.4.11.7508" sdtc:valueSetVersion="2020-11-13"/>
+                          </manufacturedMaterial>
+                        </manufacturedProduct>
+                      </product>
+                    </supply>
+                  </entryRelationship>
+                  <entryRelationship typeCode="CAUS">
+                    <observation classCode="OBS" moodCode="EVN">
+                      <templateId root="2.16.840.1.113883.10.20.15.2.3.37" extension="2019-04-01"/>
+                      <id root="ab1791b0-5c71-11db-b0de-0800200c9a55"/>
+                      <code code="67540-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Response to medication"/>
+                      <statusCode code="completed"/>
+                      <effectiveTime>
+                        <low value="20201101"/>
+                      </effectiveTime>
+                      <value code="268910001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Patient's condition improved (finding)" xsi:type="CD"/>
+                    </observation>
+                  </entryRelationship>
+                </substanceAdministration>
+              </entryRelationship>
+            </act>
+          </entry>
+        </section>
+      </component>
+      <!--**Admission
+      diagnosis section (coded entries required) ** -->
+      <component>
+        <section>
+          <templateId root="2.16.840.1.113883.10.20.22.2.43" extension="2015-08-01"/>
+          <code code="46241-6" codeSystem="2.16.840.1.113883.6.1" displayName="Hospital Admission             Diagnosis">
+            <translation code="42347-5" codeSystem="2.16.840.1.113883.6.1" displayName="Admission Diagnosis"/>
+          </code>
+          <title>HOSPITAL ADMISSION DIAGNOSIS</title>
+          <text>Appendicitis<footnote ID="ecr-refiner-46241-6-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>46241-6</td><td>Admission Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v9</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <!-- eCR Refiner matched: value[1017214008] 'Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
+          <entry>
+            <act classCode="ACT" moodCode="EVN">
+              <templateId root="2.16.840.1.113883.10.20.22.4.34" extension="2015-08-01"/>
+              <id root="5a784260-6856-4f38-9638-80c751aff2fb"/>
+              <code code="46241-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Hospital Admission Diagnosis"/>
+              <statusCode code="active"/>
+              <effectiveTime>
+                <low value="20090303"/>
+              </effectiveTime>
+              <entryRelationship typeCode="SUBJ" inversionInd="false">
+                <observation classCode="OBS" moodCode="EVN" negationInd="false">
+                  <templateId root="2.16.840.1.113883.10.20.22.4.4"/>
+                  <templateId root="2.16.840.1.113883.10.20.22.4.4" extension="2015-08-01"/>
+                  <id root="db734647-fc99-424c-a864-7e3cda82e705"/>
+                  <code code="29308-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Diagnosis">
+                    <translation code="282291009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Diagnosis"/>
+                  </code>
+                  <statusCode code="completed"/>
+                  <effectiveTime>
+                    <low value="20201107"/>
+                  </effectiveTime>
+                  <value xsi:type="CD" code="1017214008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)"/>
+                  <author>
+                    <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
+                    <time value="201308011235-0800"/>
+                    <assignedAuthor>
+                      <id root="20cf14fb-b65c-4c8c-a54d-b0cca834c18c"/>
+                      <code code="163W00000X" codeSystem="2.16.840.1.113883.5.53" codeSystemName="Health                           Care Provider Taxonomy" displayName="Registered nurse"/>
+                      <assignedPerson>
+                        <name>
+                          <given>Nurse</given>
+                          <family>Nightingale</family>
+                          <suffix>RN</suffix>
+                        </name>
+                      </assignedPerson>
+                      <representedOrganization>
+                        <id root="2.16.840.1.113883.19.5"/>
+                        <name>Good Health Hospital</name>
+                        <telecom use="HP" value="tel:+1-555-555-2003"/>
+                        <addr>
+                          <streetAddressLine>1000 Hospital Lane</streetAddressLine>
+                          <city>Ann Arbor</city>
+                          <state>MI</state>
+                          <postalCode>99999</postalCode>
+                          <country>US</country>
+                        </addr>
+                      </representedOrganization>
+                    </assignedAuthor>
+                  </author>
+                  <entryRelationship typeCode="REFR">
+                    <observation classCode="OBS" moodCode="EVN">
+                      <templateId root="2.16.840.1.113883.10.20.22.4.6"/>
+                      <code code="33999-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Diagnosis Status"/>
+                      <statusCode code="completed"/>
+                      <value xsi:type="CD" code="413322009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Problem Resolved (finding)"/>
+                    </observation>
+                  </entryRelationship>
+                </observation>
+              </entryRelationship>
+            </act>
+          </entry>
+        </section>
+      </component>
+      <!-- Discharge Diagnosis Section -->
+      <component>
+        <section>
+          <templateId root="2.16.840.1.113883.10.20.22.2.24" extension="2015-08-01"/>
+          <code code="11535-2" displayName="Hospital Discharge Diagnosis" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC">
+            <translation code="78375-3" displayName="Discharge Diagnosis" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
+          </code>
+          <title>Discharge Diagnosis</title>
+          <text>Some text here<footnote ID="ecr-refiner-11535-2-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>11535-2</td><td>Discharge Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v9</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <!-- eCR Refiner matched: value[1017214008] 'Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
+          <entry>
+            <act classCode="ACT" moodCode="EVN">
+              <templateId root="2.16.840.1.113883.10.20.22.4.33" extension="2015-08-01"/>
+              <id root="5a784260-6856-4f38-9638-80c751aff2fb"/>
+              <code code="11535-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="HOSPITAL DISCHARGE DIAGNOSIS"/>
+              <statusCode code="active"/>
+              <effectiveTime>
+                <low value="201209091904-0400"/>
+              </effectiveTime>
+              <entryRelationship typeCode="SUBJ" inversionInd="false">
+                <observation classCode="OBS" moodCode="EVN" negationInd="false">
+                  <templateId root="2.16.840.1.113883.10.20.22.4.4"/>
+                  <templateId root="2.16.840.1.113883.10.20.22.4.4" extension="2015-08-01"/>
+                  <id root="db734647-fc99-424c-a864-7e3cda82e705"/>
+                  <code code="29308-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Diagnosis">
+                    <translation code="282291009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Diagnosis"/>
+                  </code>
+                  <statusCode code="completed"/>
+                  <effectiveTime>
+                    <low value="20201107"/>
+                  </effectiveTime>
+                  <value xsi:type="CD" code="1017214008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)"/>
+                  <author>
+                    <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
+                    <time value="201308011235-0800"/>
+                    <assignedAuthor>
+                      <id root="20cf14fb-b65c-4c8c-a54d-b0cca834c18c"/>
+                      <code code="163W00000X" codeSystem="2.16.840.1.113883.5.53" codeSystemName="Health                         Care Provider Taxonomy" displayName="Registered nurse"/>
+                      <assignedPerson>
+                        <name>
+                          <given>Nurse</given>
+                          <family>Nightingale</family>
+                          <suffix>RN</suffix>
+                        </name>
+                      </assignedPerson>
+                      <representedOrganization>
+                        <id root="2.16.840.1.113883.19.5"/>
+                        <name>Good Health Hospital</name>
+                        <telecom use="HP" value="tel:+1-555-555-2003"/>
+                        <addr>
+                          <streetAddressLine>1000 Hospital Lane</streetAddressLine>
+                          <city>Ann Arbor</city>
+                          <state>MI</state>
+                          <postalCode>99999</postalCode>
+                          <country>US</country>
+                        </addr>
+                      </representedOrganization>
+                    </assignedAuthor>
+                  </author>
+                  <entryRelationship typeCode="REFR">
+                    <observation classCode="OBS" moodCode="EVN">
+                      <templateId root="2.16.840.1.113883.10.20.22.4.6"/>
+                      <code code="33999-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Diagnosis Status"/>
+                      <statusCode code="completed"/>
+                      <value xsi:type="CD" code="413322009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Problem Resolved (finding)"/>
+                    </observation>
+                  </entryRelationship>
+                </observation>
+              </entryRelationship>
+            </act>
+          </entry>
+        </section>
+      </component>
+      <!-- Review of systems section -->
+      <component>
+        <section>
+          <templateId root="1.3.6.1.4.1.19376.1.5.3.1.3.18"/>
+          <code code="10187-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="REVIEW OF SYSTEMS"/>
+          <title>REVIEW OF SYSTEMS</title>
+          <text>
+            <paragraph>
+              Patient denies recent history of fever or malaise. Positive
+              For weakness and shortness of breath. One episode of melena. No recent
+              headaches. Positive for osteoarthritis in hips, knees and hands.
+            </paragraph>
+            <footnote ID="ecr-refiner-10187-3-20260101000000">
+              <paragraph>
+                <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
+              </paragraph>
+              <table border="1">
+                <thead>
+                  <tr>
+                    <th>Section (LOINC)</th>
+                    <th>Section Name</th>
+                    <th>Included</th>
+                    <th>Action</th>
+                    <th>Retain Narrative</th>
+                    <th>Config Version</th>
+                    <th>Source</th>
+                    <th>Outcome</th>
+                  </tr>
+                </thead>
+                <tbody>
+                  <tr>
+                    <td>10187-3</td>
+                    <td>Review of Systems Section</td>
+                    <td>Yes</td>
+                    <td>retain</td>
+                    <td>Yes</td>
+                    <td>v9</td>
+                    <td>Configured by jurisdiction</td>
+                    <td>Narrative-only section; narrative retained</td>
+                  </tr>
+                </tbody>
+              </table>
+            </footnote>
+          </text>
+        </section>
+      </component>
+      <!-- Problem Section (entries required) (V3) -->
+      <component>
+        <section>
+          <templateId root="2.16.840.1.113883.10.20.22.2.5"/>
+          <templateId root="2.16.840.1.113883.10.20.22.2.5" extension="2015-08-01"/>
+          <templateId root="2.16.840.1.113883.10.20.22.2.5.1"/>
+          <templateId root="2.16.840.1.113883.10.20.22.2.5.1" extension="2015-08-01"/>
+          <code code="11450-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Problem List"/>
+          <title>Problems</title>
+          <text>
+            <table>
+              <thead>
+                <tr>
+                  <th>Concern</th>
+                  <th>Concern Status</th>
+                  <th>Date(s)</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr ID="id_ec8a6ff8-ed4b-4f7e-82c3-e98e58b45de7_ref">
+                  <td>Problem</td>
+                  <td>active</td>
+                  <td>NOV 7, 2020</td>
+                </tr>
+                <tr>
+                  <td colspan="20">
+                    <list styleCode="none">
+                      <item>
+                        <table>
+                          <thead>
+                            <tr>
+                              <th>Problem Type</th>
+                              <th>Problem</th>
+                              <th>Date(s)</th>
+                            </tr>
+                          </thead>
+                          <tbody>
+                            <tr ID="id_ab1791b0-5c71-11db-b0de-0800200c9a66_ref">
+                              <td>Symptom</td>
+                              <td>Dark stools (finding)</td>
+                              <td>NOV 1, 2020</td>
+                            </tr>
+                            <tr ID="id_ab1791b0-5c71-11db-b0de-0800200c9a67_ref">
+                              <td>Complaint</td>
+                              <td>Paroxysmal cough (finding)</td>
+                              <td>NOV 4, 2020</td>
+                            </tr>
+                          </tbody>
+                        </table>
+                      </item>
+                    </list>
+                  </td>
+                </tr>
+              </tbody>
+            </table>
+            <table>
+              <thead>
+                <tr>
+                  <th>Concern</th>
+                  <th>Concern Status</th>
+                  <th>Date(s)</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr ID="id_ec8a6ff8-ed4b-4f7e-82c3-e98e58b45de8_ref">
+                  <td>Problem</td>
+                  <td>active</td>
+                  <td>MAY 23, 2020</td>
+                </tr>
+              </tbody>
+            </table>
+            <footnote ID="ecr-refiner-11450-4-20260101000000">
+              <paragraph>
+                <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
+              </paragraph>
+              <table border="1">
+                <thead>
+                  <tr>
+                    <th>Section (LOINC)</th>
+                    <th>Section Name</th>
+                    <th>Included</th>
+                    <th>Action</th>
+                    <th>Retain Narrative</th>
+                    <th>Config Version</th>
+                    <th>Source</th>
+                    <th>Outcome</th>
+                  </tr>
+                </thead>
+                <tbody>
+                  <tr>
+                    <td>11450-4</td>
+                    <td>Problem Section</td>
+                    <td>Yes</td>
+                    <td>refine</td>
+                    <td>Yes</td>
+                    <td>v9</td>
+                    <td>Configured by jurisdiction</td>
+                    <td>Refined; matches found</td>
+                  </tr>
+                </tbody>
+              </table>
+            </footnote>
+          </text>
+          <!-- eCR Refiner matched: value[1119303003] 'Post-acute COVID-19 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
+          <entry typeCode="DRIV">
+            <act classCode="ACT" moodCode="EVN">
+              <templateId root="2.16.840.1.113883.10.20.22.4.3"/>
+              <templateId root="2.16.840.1.113883.10.20.22.4.3" extension="2015-08-01"/>
+              <id root="ec8a6ff8-ed4b-4f7e-82c3-e98e58b45de7"/>
+              <code code="CONC" codeSystem="2.16.840.1.113883.5.6" displayName="Concern"/>
+              <statusCode code="active"/>
+              <effectiveTime>
+                <low value="20201107"/>
+              </effectiveTime>
+              <entryRelationship typeCode="SUBJ">
+                <observation classCode="OBS" moodCode="EVN">
+                  <templateId root="2.16.840.1.113883.10.20.22.4.4"/>
+                  <templateId root="2.16.840.1.113883.10.20.22.4.4" extension="2015-08-01"/>
+                  <id root="ab1791b0-5c71-11db-b0de-0800200c9a67"/>
+                  <code code="75322-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Complaint">
+                    <translation code="409586006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Complaint"/>
+                  </code>
+                  <statusCode code="completed"/>
+                  <effectiveTime>
+                    <low value="20201104"/>
+                  </effectiveTime>
+                  <value code="1119303003" codeSystem="2.16.840.1.113883.6.96" displayName="Post-acute COVID-19 (disorder)" xsi:type="CD"/>
+                </observation>
+              </entryRelationship>
+            </act>
+          </entry>
+        </section>
+      </component>
+      <!-- Chief Complaint Section -->
+      <component>
+        <section>
+          <templateId root="1.3.6.1.4.1.19376.1.5.3.1.1.13.2.1"/>
+          <code code="10154-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Chief complaint Narrative - Reported"/>
+          <title>Chief Complaint</title>
+          <text>
+            <paragraph>Chief Complaint (the patient's own description): Headache and rash</paragraph>
+            <footnote ID="ecr-refiner-10154-3-20260101000000">
+              <paragraph>
+                <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
+              </paragraph>
+              <table border="1">
+                <thead>
+                  <tr>
+                    <th>Section (LOINC)</th>
+                    <th>Section Name</th>
+                    <th>Included</th>
+                    <th>Action</th>
+                    <th>Retain Narrative</th>
+                    <th>Config Version</th>
+                    <th>Source</th>
+                    <th>Outcome</th>
+                  </tr>
+                </thead>
+                <tbody>
+                  <tr>
+                    <td>10154-3</td>
+                    <td>Chief Complaint Section</td>
+                    <td>Yes</td>
+                    <td>retain</td>
+                    <td>Yes</td>
+                    <td>v9</td>
+                    <td>Configured by jurisdiction</td>
+                    <td>Narrative-only section; narrative retained</td>
+                  </tr>
+                </tbody>
+              </table>
+            </footnote>
+          </text>
+        </section>
+      </component>
+      <!-- Reason for Visit Section-->
+      <component>
+        <section>
+          <templateId root="2.16.840.1.113883.10.20.22.2.12"/>
+          <code code="29299-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Reason for visit Narrative"/>
+          <title>Reason for Visit</title>
+          <text>
+            <paragraph>Reason for Visit (as documented by provider): Headache, rash, and fever</paragraph>
+            <footnote ID="ecr-refiner-29299-5-20260101000000">
+              <paragraph>
+                <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
+              </paragraph>
+              <table border="1">
+                <thead>
+                  <tr>
+                    <th>Section (LOINC)</th>
+                    <th>Section Name</th>
+                    <th>Included</th>
+                    <th>Action</th>
+                    <th>Retain Narrative</th>
+                    <th>Config Version</th>
+                    <th>Source</th>
+                    <th>Outcome</th>
+                  </tr>
+                </thead>
+                <tbody>
+                  <tr>
+                    <td>29299-5</td>
+                    <td>Reason for Visit Section</td>
+                    <td>Yes</td>
+                    <td>retain</td>
+                    <td>Yes</td>
+                    <td>v9</td>
+                    <td>Configured by jurisdiction</td>
+                    <td>Narrative-only section; narrative retained</td>
+                  </tr>
+                </tbody>
+              </table>
+            </footnote>
+          </text>
+        </section>
+      </component>
+      <!-- Results Section (entries required) (V3) -->
+      <component>
+        <section>
+          <templateId root="2.16.840.1.113883.10.20.22.2.3"/>
+          <templateId root="2.16.840.1.113883.10.20.22.2.3" extension="2015-08-01"/>
+          <templateId root="2.16.840.1.113883.10.20.22.2.3.1"/>
+          <templateId root="2.16.840.1.113883.10.20.22.2.3.1" extension="2015-08-01"/>
+          <code code="30954-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Relevant diagnostic tests and/or laboratory data"/>
+          <title>Results</title>
+          <text>
+            <!-- Narrative reconstructed by the eCR Refiner from surviving clinical entries: machine-derived, not clinician-attested. -->
+            <table border="1">
+              <thead>
+                <tr>
+                  <th>Panel</th>
+                  <th>Specimen</th>
+                  <th>Test</th>
+                  <th>Result</th>
+                  <th>Interpretation</th>
+                  <th>Date</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>SARS-CoV+SARS-CoV-2 (COVID-19) Ag [Presence] in Specimen</td>
+                  <td/>
+                  <td>SARS-CoV+SARS-CoV-2 (COVID-19) Ag [Presence] in Specimen</td>
+                  <td>Detected (qualifier value) (260373001)</td>
+                  <td>Abnormal (A)</td>
+                  <td>20201107</td>
+                </tr>
+              </tbody>
+            </table>
+            <footnote ID="ecr-refiner-30954-2-20260101000000">
+              <paragraph>
+                <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
+              </paragraph>
+              <table border="1">
+                <thead>
+                  <tr>
+                    <th>Section (LOINC)</th>
+                    <th>Section Name</th>
+                    <th>Included</th>
+                    <th>Action</th>
+                    <th>Retain Narrative</th>
+                    <th>Config Version</th>
+                    <th>Source</th>
+                    <th>Outcome</th>
+                  </tr>
+                </thead>
+                <tbody>
+                  <tr>
+                    <td>30954-2</td>
+                    <td>Results Section</td>
+                    <td>Yes</td>
+                    <td>refine</td>
+                    <td>No</td>
+                    <td>v9</td>
+                    <td>Configured by jurisdiction</td>
+                    <td>Refined; narrative reconstructed</td>
+                  </tr>
+                </tbody>
+              </table>
+            </footnote>
+          </text>
+          <!-- eCR Refiner matched: code[105066-5] 'SARS-CoV+SARS-CoV-2 (COVID-19) Ag [Presence] in Specimen' (LOINC) Entry match fired for: rule 1 (T1) [hl7:code] -->
+          <entry typeCode="DRIV">
+            <organizer classCode="BATTERY" moodCode="EVN">
+              <templateId root="2.16.840.1.113883.10.20.22.4.1"/>
+              <templateId root="2.16.840.1.113883.10.20.22.4.1" extension="2015-08-01"/>
+              <templateId root="2.16.840.1.113883.10.20.15.2.3.35" extension="2022-05-01"/>
+              <id root="7d5a02b0-67a4-11db-bd13-0800200c9a66"/>
+              <code displayName="SARS-CoV+SARS-CoV-2 (COVID-19) Ag [Presence] in Specimen" code="105066-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" sdtc:valueSet="2.16.840.1.114222.4.11.7508" sdtc:valueSetVersion="2020-11-13"/>
+              <statusCode code="completed"/>
+              <effectiveTime>
+                <low value="20201107"/>
+                <high value="20201107"/>
+              </effectiveTime>
+              <component>
+                <observation classCode="OBS" moodCode="EVN">
+                  <templateId root="2.16.840.1.113883.10.20.22.4.2"/>
+                  <templateId root="2.16.840.1.113883.10.20.22.4.2" extension="2015-08-01"/>
+                  <id root="7c0704bb-9c40-41b5-9c7d-26b2d59e234f"/>
+                  <code code="105066-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="SARS-CoV+SARS-CoV-2 (COVID-19) Ag [Presence] in Specimen"/>
+                  <statusCode code="completed"/>
+                  <effectiveTime value="20201107"/>
+                  <value code="260373001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED-CT" displayName="Detected (qualifier value)" xsi:type="CD"/>
+                  <interpretationCode code="A" codeSystem="2.16.840.1.113883.5.83" displayName="Abnormal"/>
+                </observation>
+              </component>
+            </organizer>
+          </entry>
+        </section>
+      </component>
+      <!-- Prcoedures Section (entries required) (V2) -->
+      <component>
+        <section nullFlavor="NI">
+          <templateId root="2.16.840.1.113883.10.20.22.2.7.1" extension="2014-06-09"/>
+          <templateId root="2.16.840.1.113883.10.20.22.2.7.1"/>
+          <code code="47519-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="History of Procedures"/>
+          <title>Procedures</title>
+          <text>
+            <table border="1">
+              <caption>Output from CDC eCR Refiner application by request of jurisdiction.</caption>
+              <thead>
+                <tr>
+                  <th>Status</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>No clinical information matches the configured code sets for this condition.</td>
+                </tr>
+              </tbody>
+            </table>
+            <footnote ID="ecr-refiner-47519-4-20260101000000">
+              <paragraph>
+                <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
+              </paragraph>
+              <table border="1">
+                <thead>
+                  <tr>
+                    <th>Section (LOINC)</th>
+                    <th>Section Name</th>
+                    <th>Included</th>
+                    <th>Action</th>
+                    <th>Retain Narrative</th>
+                    <th>Config Version</th>
+                    <th>Source</th>
+                    <th>Outcome</th>
+                  </tr>
+                </thead>
+                <tbody>
+                  <tr>
+                    <td>47519-4</td>
+                    <td>Procedures Section</td>
+                    <td>Yes</td>
+                    <td>refine</td>
+                    <td>Yes</td>
+                    <td>v9</td>
+                    <td>Configured by jurisdiction</td>
+                    <td>Refined; no matches found</td>
+                  </tr>
+                </tbody>
+              </table>
+            </footnote>
+          </text>
+        </section>
+      </component>
+      <!-- Immunizations Section (entries required)(V3) -->
+      <component>
+        <section>
+          <templateId root="2.16.840.1.113883.10.20.22.2.2.1" extension="2015-08-01"/>
+          <code code="11369-6" displayName="Hx of Immunization" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
+          <title>Immunizations</title>
+          <text>
+            <table>
+              <thead>
+                <tr>
+                  <th>Immunization</th>
+                  <th>Immunization Date</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>diphtheria, tetanus toxoids and acellular<br/>pertussis vaccine, 5 pertussis
+                    antigens</td>
+                  <td>NOV 11, 2020</td>
+                </tr>
+              </tbody>
+            </table>
+            <table>
+              <thead>
+                <tr>
+                  <th>Initial Case Report Trigger Code<br/>Immunization Medication Activity</th>
+                  <th>Immunization Date</th>
+                  <th>Trigger<br/>Code</th>
+                  <th>Trigger Code<br/>codeSystem</th>
+                  <th>RCTC OID</th>
+                  <th>RCTC<br/>Version</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>influenza virus vaccine, unspecified formulation</td>
+                  <td>NOV 11, 2020</td>
+                  <td>88</td>
+                  <td>CVX</td>
+                  <td>2.16.840.1.114222.4.11.7508</td>
+                  <td>19/05/2020</td>
+                </tr>
+              </tbody>
+            </table>
+            <table>
+              <thead>
+                <tr>
+                  <th>Vaccinne Credential Patient Assertion</th>
+                  <th>Assertion Date</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>Yes</td>
+                  <td>NOV 11, 2020</td>
+                </tr>
+              </tbody>
+            </table>
+            <footnote ID="ecr-refiner-11369-6-20260101000000">
+              <paragraph>
+                <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
+              </paragraph>
+              <table border="1">
+                <thead>
+                  <tr>
+                    <th>Section (LOINC)</th>
+                    <th>Section Name</th>
+                    <th>Included</th>
+                    <th>Action</th>
+                    <th>Retain Narrative</th>
+                    <th>Config Version</th>
+                    <th>Source</th>
+                    <th>Outcome</th>
+                  </tr>
+                </thead>
+                <tbody>
+                  <tr>
+                    <td>11369-6</td>
+                    <td>Immunizations Section</td>
+                    <td>Yes</td>
+                    <td>refine</td>
+                    <td>Yes</td>
+                    <td>v9</td>
+                    <td>Configured by jurisdiction</td>
+                    <td>Refined; matches found</td>
+                  </tr>
+                </tbody>
+              </table>
+            </footnote>
+          </text>
+          <!-- eCR Refiner matched: code[2468230] 'SARS-CoV-2 (COVID-19) vaccine, mRNA-BNT162b2' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
+          <entry>
+            <substanceAdministration classCode="SBADM" moodCode="EVN" negationInd="false">
+              <templateId root="2.16.840.1.113883.10.20.22.4.52" extension="2015-08-01"/>
+              <id root="00000000-5CF3-EC63-0513-4A4838595787" extension="11369-6_2-1_1.3.6.1.4.1.22812.11.2016.163.1_14168"/>
+              <statusCode code="completed"/>
+              <effectiveTime value="20201107"/>
+              <routeCode nullFlavor="NI"/>
+              <doseQuantity nullFlavor="NI"/>
+              <consumable>
+                <manufacturedProduct classCode="MANU">
+                  <templateId root="2.16.840.1.113883.10.20.22.4.54" extension="2014-06-09"/>
+                  <templateId root="2.16.840.1.113883.10.20.15.2.3.38" extension="2019-04-01"/>
+                  <manufacturedMaterial>
+                    <code code="2468230" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm" sdtc:valueSet="2.16.840.1.114222.4.11.7508" sdtc:valueSetVersion="2020-11-13" displayName="SARS-CoV-2 (COVID-19) vaccine, mRNA-BNT162b2"/>
+                    <lotNumberText nullFlavor="NI"/>
+                  </manufacturedMaterial>
+                </manufacturedProduct>
+              </consumable>
+            </substanceAdministration>
+          </entry>
+        </section>
+      </component>
+      <!-- Social History Section (V3) -->
+      <component>
+        <section>
+          <templateId root="2.16.840.1.113883.10.20.22.2.17"/>
+          <templateId root="2.16.840.1.113883.10.20.22.2.17" extension="2015-08-01"/>
+          <templateId root="2.16.840.1.113883.10.20.22.2.17" extension="2020-09-01"/>
+          <code code="29762-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Social History"/>
+          <title>Social History</title>
+          <text>
+            <table>
+              <thead>
+                <tr>
+                  <th>Birth Sex</th>
+                  <th>Value</th>
+                  <th>Date</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>Sex Assigned At Birth</td>
+                  <td>Female</td>
+                  <td>NOV 24, 1974</td>
+                </tr>
+              </tbody>
+            </table>
+            <table>
+              <thead>
+                <tr>
+                  <th>Gender identity</th>
+                  <th>Date</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>Female-to-male transsexual (finding)</td>
+                  <td>JAN 1, 2020</td>
+                </tr>
+              </tbody>
+            </table>
+            <table>
+              <thead>
+                <tr>
+                  <th>Characteristics of Home Environment</th>
+                  <th>Date</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>Homeless</td>
+                  <td>NOV 9, 2020</td>
+                </tr>
+              </tbody>
+            </table>
+            <table>
+              <thead>
+                <tr>
+                  <th>Exposure/Contact Information</th>
+                  <th>Date</th>
+                  <th>Location</th>
+                  <th>Address</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>Mass Gathering: Football game</td>
+                  <td>November 11, 2020</td>
+                  <td>City Football Stadium</td>
+                  <td>99 Football Stadium Road, My City, AZ, 8562</td>
+                </tr>
+              </tbody>
+            </table>
+            <table>
+              <thead>
+                <tr>
+                  <th>Current Occupation</th>
+                  <th>Current Industry</th>
+                  <th>Current Job Title</th>
+                  <th>Current Employer Name</th>
+                  <th>Current Employer Address</th>
+                  <th>Current Employer Telcom</th>
+                  <th>Occupational Exposure</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>Nursing, psychiatric, and home health aides</td>
+                  <td>Accounting, tax preparation, bookkeeping, and payroll services</td>
+                  <td>Nurse</td>
+                  <td>University Hospital</td>
+                  <td>Peachtree Street, Atlanta, Georgia</td>
+                  <td>555-1212</td>
+                  <td>Nursing care facilities</td>
+                  <td>Asbestos</td>
+                </tr>
+              </tbody>
+            </table>
+            <table>
+              <thead>
+                <tr>
+                  <th>Usual Occupation</th>
+                  <th>Usual Industry</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>Nursing, psychiatric, and home health aides</td>
+                  <td>Nursing care facilities</td>
+                </tr>
+              </tbody>
+            </table>
+            <table>
+              <thead>
+                <tr>
+                  <th>Travel History: Date(s)</th>
+                  <th>Notes</th>
+                  <th>Location</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>1999 to 2007</td>
+                  <td>Spent 8 years in the UK during the BSE outbreak</td>
+                  <td/>
+                </tr>
+                <tr>
+                  <td>In the 3 weeks before NOV 9, 2020</td>
+                  <td/>
+                  <td>
+                    <list styleCode="none">
+                      <item>Brazil</item>
+                    </list>
+                  </td>
+                </tr>
+                <tr>
+                  <td>APR 25, 2020 to APR 30, 2020</td>
+                  <td/>
+                  <td>
+                    <list styleCode="none">
+                      <item>Nadi, FJ</item>
+                    </list>
+                  </td>
+                </tr>
+                <tr>
+                  <td>MAY 6, 2020 to MAY 15, 2020</td>
+                  <td/>
+                  <td>
+                    <list styleCode="none">
+                      <item>Montreal, QC, CA</item>
+                    </list>
+                  </td>
+                </tr>
+                <tr>
+                  <td>JUL 13, 2020 to JUL 15, 2020</td>
+                  <td/>
+                  <td>
+                    <list styleCode="none">
+                      <item>Sydney, NSW, AU</item>
+                    </list>
+                  </td>
+                </tr>
+                <tr>
+                  <td>OCT 22, 2020 to OCT 30, 2020</td>
+                  <td/>
+                  <td>
+                    <list styleCode="none">
+                      <item>1170 N Rancho Robles Rd Oracle, AZ8562, US</item>
+                    </list>
+                  </td>
+                </tr>
+              </tbody>
+            </table>
+            <table>
+              <thead>
+                <tr>
+                  <th>Country of Residence</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>United Kingdom of Great Britain and Northern Ireland</td>
+                </tr>
+              </tbody>
+            </table>
+            <table>
+              <thead>
+                <tr>
+                  <th>Country of Nationality</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>Australia</td>
+                </tr>
+              </tbody>
+            </table>
+            <footnote ID="ecr-refiner-29762-2-20260101000000">
+              <paragraph>
+                <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
+              </paragraph>
+              <table border="1">
+                <thead>
+                  <tr>
+                    <th>Section (LOINC)</th>
+                    <th>Section Name</th>
+                    <th>Included</th>
+                    <th>Action</th>
+                    <th>Retain Narrative</th>
+                    <th>Config Version</th>
+                    <th>Source</th>
+                    <th>Outcome</th>
+                  </tr>
+                </thead>
+                <tbody>
+                  <tr>
+                    <td>29762-2</td>
+                    <td>Social History Section</td>
+                    <td>Yes</td>
+                    <td>refine</td>
+                    <td>Yes</td>
+                    <td>v9</td>
+                    <td>Configured by jurisdiction</td>
+                    <td>Refined; matches found</td>
+                  </tr>
+                </tbody>
+              </table>
+            </footnote>
+          </text>
+          <!-- eCR Refiner matched: value[77386006] 'Pregnancy (finding)' (any code system) Entry match fired for: rule 1 (T3) [hl7:code] -->
+          <entry typeCode="DRIV">
+            <observation classCode="OBS" moodCode="EVN" negationInd="true">
+              <templateId root="2.16.840.1.113883.10.20.15.3.8"/>
+              <id extension="123456789" root="2.16.840.1.113883.19"/>
+              <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
+              <statusCode code="completed"/>
+              <effectiveTime>
+                <low value="20160101"/>
+                <high value="20161107"/>
+              </effectiveTime>
+              <value xsi:type="CD" code="77386006" displayName="Pregnant" codeSystem="2.16.840.1.113883.6.96"/>
+              <entryRelationship typeCode="REFR">
+                <observation classCode="OBS" moodCode="EVN">
+                  <templateId root="2.16.840.1.113883.10.20.15.3.1"/>
+                  <code code="11778-8" codeSystem="2.16.840.1.113883.6.1" displayName="Estimated date of delivery"/>
+                  <statusCode code="completed"/>
+                  <value xsi:type="TS" value="20110919"/>
+                </observation>
+              </entryRelationship>
+            </observation>
+          </entry>
+        </section>
+      </component>
+      <!-- Pregnancy Section -->
+      <component>
+        <section>
+          <templateId root="2.16.840.1.113883.10.20.22.2.80" extension="2020-04-01"/>
+          <code code="90767-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Pregnancy summary Document"/>
+          <title>Pregnancy Section</title>
+          <text xmlns:voc="http://www.lantanagroup.com/voc">
+            <table>
+              <thead>
+                <tr>
+                  <th>Pregnancy Status</th>
+                  <th>Date(s) over which status holds<br/>(if no high date, status was<br/>current
+                    at time of recording)</th>
+                  <th>Determination Method</th>
+                  <th>Determination Date</th>
+                  <th>Recorded Date</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>Pregnant</td>
+                  <td>AUG 26, 2017</td>
+                  <td>Diagnostic ultrasonography</td>
+                  <td>OCT 1, 2017</td>
+                  <td>OCT 1, 2017 10:35</td>
+                </tr>
+                <tr>
+                  <td colspan="20">
+                    <list styleCode="none">
+                      <item>
+                        <table>
+                          <thead>
+                            <tr>
+                              <th>Estimated Date of Delivery</th>
+                              <th>EDD</th>
+                              <th>EDD Determination Date</th>
+                            </tr>
+                          </thead>
+                          <tbody>
+                            <tr>
+                              <td>Delivery date estimated from ovulation date</td>
+                              <td>MAY 22, 2017</td>
+                              <td>OCT 1, 2017 10:15</td>
+                            </tr>
+                          </tbody>
+                        </table>
+                        <table>
+                          <thead>
+                            <tr>
+                              <th>Estimated Gestational Age of Pregnancy</th>
+                              <th>Days</th>
+                              <th>Determination Date</th>
+                            </tr>
+                          </thead>
+                          <tbody>
+                            <tr>
+                              <td>Gestational age Estimated from selected delivery date</td>
+                              <td>143 d</td>
+                              <td>OCT 1, 2017 10:15</td>
+                            </tr>
+                            <tr>
+                              <td colspan="20">
+                                <list styleCode="none">
+                                  <item>
+                                    <table>
+                                      <thead>
+                                        <tr>
+                                          <th>Reference to selected delivery date</th>
+                                        </tr>
+                                      </thead>
+                                      <tbody>
+                                        <tr>
+                                          <td>
+                                            <linkHtml href="#id_f3dfc576-2329-4f71-af3f-d500cab1146b_ref">Link
+                                              to referenced entry</linkHtml>
+                                          </td>
+                                        </tr>
+                                      </tbody>
+                                    </table>
+                                  </item>
+                                </list>
+                              </td>
+                            </tr>
+                          </tbody>
+                        </table>
+                        <table>
+                          <thead>
+                            <tr>
+                              <th>Pregnancy Outcome</th>
+                              <th>Birth Order</th>
+                              <th>Time</th>
+                              <th>Method of Delivery</th>
+                            </tr>
+                          </thead>
+                          <tbody>
+                            <tr>
+                              <td>Stillbirth (finding)</td>
+                              <td>1</td>
+                              <td>JAN 5, 2020 08:50</td>
+                              <td>Breech delivery (procedure)</td>
+                            </tr>
+                            <tr>
+                              <td>Term birth of newborn (finding)</td>
+                              <td>2</td>
+                              <td>JAN 5, 2020 10:05</td>
+                              <td>Breech delivery (procedure)</td>
+                            </tr>
+                          </tbody>
+                        </table>
+                      </item>
+                    </list>
+                  </td>
+                </tr>
+              </tbody>
+            </table>
+            <table>
+              <thead>
+                <tr>
+                  <th>Last menstrual period start date</th>
+                  <th>Observation Date</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>AUG 1, 2017</td>
+                  <td>JAN 5, 2020 10:15</td>
+                </tr>
+              </tbody>
+            </table>
+            <table>
+              <thead>
+                <tr>
+                  <th>Postpartum Status</th>
+                  <th>Observation date</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>Mid postpartum state (finding)</td>
+                  <td>JAN 5, 2020 10:15</td>
+                </tr>
+              </tbody>
+            </table>
+            <footnote ID="ecr-refiner-90767-5-20260101000000">
+              <paragraph>
+                <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
+              </paragraph>
+              <table border="1">
+                <thead>
+                  <tr>
+                    <th>Section (LOINC)</th>
+                    <th>Section Name</th>
+                    <th>Included</th>
+                    <th>Action</th>
+                    <th>Retain Narrative</th>
+                    <th>Config Version</th>
+                    <th>Source</th>
+                    <th>Outcome</th>
+                  </tr>
+                </thead>
+                <tbody>
+                  <tr>
+                    <td>90767-5</td>
+                    <td>Pregnancy Section</td>
+                    <td>Yes</td>
+                    <td>refine</td>
+                    <td>Yes</td>
+                    <td>v9</td>
+                    <td>Configured by jurisdiction</td>
+                    <td>Refined; matches found</td>
+                  </tr>
+                </tbody>
+              </table>
+            </footnote>
+          </text>
+          <!-- eCR Refiner matched: value[77386006] 'Pregnancy (finding)' (any code system) Entry match fired for: rule 1 (T1) [hl7:value] -->
+          <entry typeCode="DRIV">
+            <observation classCode="OBS" moodCode="EVN">
+              <templateId root="2.16.840.1.113883.10.20.15.3.8"/>
+              <templateId root="2.16.840.1.113883.10.20.22.4.293" extension="2020-04-01"/>
+              <id root="bab77407-f76d-4a51-a2ed-980c8a59fe28"/>
+              <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
+              <statusCode code="completed"/>
+              <effectiveTime>
+                <low value="20170826"/>
+              </effectiveTime>
+              <value xsi:type="CD" code="77386006" displayName="Pregnant" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
+              <methodCode code="16310003" displayName="Diagnostic ultrasonography (procedure)" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
+              <performer>
+                <time value="20171001"/>
+                <assignedEntity>
+                  <id nullFlavor="NA"/>
+                </assignedEntity>
+              </performer>
+              <author>
+                <time value="201710011035"/>
+                <assignedAuthor>
+                  <id nullFlavor="NA"/>
+                </assignedAuthor>
+              </author>
+              <entryRelationship typeCode="REFR">
+                <observation classCode="OBS" moodCode="EVN">
+                  <templateId root="2.16.840.1.113883.10.20.22.4.297" extension="2020-04-01"/>
+                  <id root="f3dfc576-2329-4f71-af3f-d500cab1146b"/>
+                  <code code="11780-4" codeSystem="2.16.840.1.113883.6.1" displayName="Delivery date estimated from ovulation date" codeSystemName="LOINC"/>
+                  <statusCode code="completed"/>
+                  <effectiveTime value="201710011015"/>
+                  <value xsi:type="TS" value="20170522"/>
+                </observation>
+              </entryRelationship>
+              <entryRelationship typeCode="REFR">
+                <observation classCode="OBS" moodCode="EVN">
+                  <templateId root="2.16.840.1.113883.10.20.22.4.280" extension="2020-04-01"/>
+                  <id root="9ae62b42-0e67-4ddc-8ef7-909d03732292"/>
+                  <code code="11887-7" codeSystem="2.16.840.1.113883.6.1" displayName="Gestational age Estimated from selected delivery date" codeSystemName="LOINC"/>
+                  <statusCode code="completed"/>
+                  <effectiveTime value="201710011015"/>
+                  <value xsi:type="PQ" unit="d" value="143"/>
+                  <entryRelationship typeCode="REFR">
+                    <act classCode="ACT" moodCode="EVN">
+                      <templateId root="2.16.840.1.113883.10.20.22.4.122"/>
+                      <id root="f3dfc576-2329-4f71-af3f-d500cab1146b"/>
+                      <code nullFlavor="NP"/>
+                      <statusCode code="completed"/>
+                    </act>
+                  </entryRelationship>
+                </observation>
+              </entryRelationship>
+              <entryRelationship typeCode="COMP">
+                <sequenceNumber value="1"/>
+                <observation classCode="OBS" moodCode="EVN">
+                  <templateId root="2.16.840.1.113883.10.20.22.4.284" extension="2020-04-01"/>
+                  <id root="6df3e951-e6f8-441d-a298-d9d6d3f405db"/>
+                  <code code="63893-2" codeSystem="2.16.840.1.113883.6.1" displayName="Outcome of Pregnancy" codeSystemName="LOINC"/>
+                  <statusCode code="completed"/>
+                  <effectiveTime value="202001050850"/>
+                  <value xsi:type="CD" code="237364002" codeSystem="2.16.840.1.113883.6.96" displayName="Stillbirth (finding)" codeSystemName="SNOMED CT"/>
+                </observation>
+              </entryRelationship>
+            </observation>
+          </entry>
+        </section>
+      </component>
+      <!-- Vital Signs Section (entries required) (V3) -->
+      <component>
+        <section>
+          <templateId root="2.16.840.1.113883.10.20.22.2.4.1" extension="2015-08-01"/>
+          <code code="8716-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Vital Signs"/>
+          <title>Vital Signs (Last Filed)</title>
+          <text>
+            <table>
+              <thead>
+                <tr>
+                  <th>Date</th>
+                  <th>Blood Pressure</th>
+                  <th>Pulse</th>
+                  <th>Temperature</th>
+                  <th>Respiratory Rate</th>
+                  <th>Height</th>
+                  <th>Weight</th>
+                  <th>BMI</th>
+                  <th>SpO2</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>05/20/2014 7:36pm</td>
+                  <td><content ID="SystolicBP_2">120</content>/<content ID="DiastolicBP_2">80</content>
+                    mm[Hg] </td>
+                  <td ID="Pulse_2">80 /min</td>
+                  <td ID="Temp_2">99.0 F</td>
+                  <td ID="RespRate_2">18 /min</td>
+                  <td ID="Height_2">5'7 (67 inches)</td>
+                  <td ID="Weight_2">239.9 lbs</td>
+                  <td ID="BMI_2">37.58 kg/m2</td>
+                  <td ID="SPO2_2">98%</td>
+                </tr>
+              </tbody>
+            </table>
+            <footnote ID="ecr-refiner-8716-3-20260101000000">
+              <paragraph>
+                <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
+              </paragraph>
+              <table border="1">
+                <thead>
+                  <tr>
+                    <th>Section (LOINC)</th>
+                    <th>Section Name</th>
+                    <th>Included</th>
+                    <th>Action</th>
+                    <th>Retain Narrative</th>
+                    <th>Config Version</th>
+                    <th>Source</th>
+                    <th>Outcome</th>
+                  </tr>
+                </thead>
+                <tbody>
+                  <tr>
+                    <td>8716-3</td>
+                    <td>Vital Signs Section</td>
+                    <td>Yes</td>
+                    <td>refine</td>
+                    <td>Yes</td>
+                    <td>v9</td>
+                    <td>Configured by jurisdiction</td>
+                    <td>Refined; matches found</td>
+                  </tr>
+                </tbody>
+              </table>
+            </footnote>
+          </text>
+          <!-- eCR Refiner matched: code[8310-5] 'Body temperature' (LOINC) Entry match fired for: rule 1 (T1) [hl7:code] -->
+          <entry typeCode="DRIV">
+            <organizer classCode="CLUSTER" moodCode="EVN">
+              <templateId root="2.16.840.1.113883.10.20.22.4.26"/>
+              <templateId root="2.16.840.1.113883.10.20.22.4.26" extension="2015-08-01"/>
+              <id root="e421f5c8-29c2-4798-9cb5-7988c236e49d"/>
+              <code code="46680005" displayName="Vital Signs" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT">
+                <translation code="74728-7" displayName="Vital signs, weight, height, head circumference, oximetry, BMI, and BSA panel " codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
+              </code>
+              <statusCode code="completed"/>
+              <effectiveTime value="20140520193605-0500"/>
+              <author>
+                <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
+                <time value="201308011235-0800"/>
+                <assignedAuthor>
+                  <id root="20cf14fb-b65c-4c8c-a54d-b0cca834c18c"/>
+                  <code code="163W00000X" codeSystem="2.16.840.1.113883.5.53" codeSystemName="Health                     Care Provider Taxonomy" displayName="Registered nurse"/>
+                  <assignedPerson>
+                    <name>
+                      <given>Nurse</given>
+                      <family>Nightingale</family>
+                      <suffix>RN</suffix>
+                    </name>
+                  </assignedPerson>
+                  <representedOrganization>
+                    <id root="2.16.840.1.113883.19.5"/>
+                    <name>Good Health Hospital</name>
+                  </representedOrganization>
+                </assignedAuthor>
+              </author>
+              <component>
+                <observation classCode="OBS" moodCode="EVN">
+                  <templateId root="2.16.840.1.113883.10.20.22.4.27"/>
+                  <templateId root="2.16.840.1.113883.10.20.22.4.27" extension="2014-06-09"/>
+                  <id root="85f5784f-2958-4321-b7b6-3030d1577dc0"/>
+                  <code code="8310-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="BODY TEMPERATURE"/>
+                  <text>
+                    <reference value="#Temp_2"/>
+                  </text>
+                  <statusCode code="completed"/>
+                  <effectiveTime value="20140520193605-0500"/>
+                  <value xsi:type="PQ" value="99.0" unit="[degF]"/>
+                  <methodCode code="272394005" displayName="Technique" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
+                  <targetSiteCode code="442083009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Anatomical or acquired body structure"/>
+                  <author>
+                    <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
+                    <time value="201308011235-0800"/>
+                    <assignedAuthor>
+                      <id root="20cf14fb-b65c-4c8c-a54d-b0cca834c18c"/>
+                      <code code="163W00000X" codeSystem="2.16.840.1.113883.5.53" codeSystemName="Health                         Care Provider Taxonomy" displayName="Registered nurse"/>
+                      <assignedPerson>
+                        <name>
+                          <given>Nurse</given>
+                          <family>Nightingale</family>
+                          <suffix>RN</suffix>
+                        </name>
+                      </assignedPerson>
+                      <representedOrganization>
+                        <id root="2.16.840.1.113883.19.5"/>
+                        <name>Good Health Hospital</name>
+                      </representedOrganization>
+                    </assignedAuthor>
+                  </author>
+                </observation>
+              </component>
+            </organizer>
+          </entry>
+        </section>
+      </component>
+      <!-- Emergency Outbreak Information Section -->
+      <component>
+        <section>
+          <!-- [eICR R2 STU3] Emergency Outbreak Information Section -->
+          <templateId root="2.16.840.1.113883.10.20.15.2.2.4" extension="2021-01-01"/>
+          <code code="83910-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Public health Note"/>
+          <title>Emergency Outbreak Information Section</title>
+          <text>
+            <table>
+              <thead>
+                <tr>
+                  <th>Information Type</th>
+                  <th>Information Date</th>
+                  <th>Result</th>
+                </tr>
+              </thead>
+              <tbody>
+                <tr>
+                  <td>Employee desk distance from mail sorter</td>
+                  <td>1 November 2020</td>
+                  <td>2 meters</td>
+                </tr>
+              </tbody>
+            </table>
+            <footnote ID="ecr-refiner-83910-0-20260101000000">
+              <paragraph>
+                <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
+              </paragraph>
+              <table border="1">
+                <thead>
+                  <tr>
+                    <th>Section (LOINC)</th>
+                    <th>Section Name</th>
+                    <th>Included</th>
+                    <th>Action</th>
+                    <th>Retain Narrative</th>
+                    <th>Config Version</th>
+                    <th>Source</th>
+                    <th>Outcome</th>
+                  </tr>
+                </thead>
+                <tbody>
+                  <tr>
+                    <td>83910-0</td>
+                    <td>Emergency Outbreak Information Section</td>
+                    <td>Yes</td>
+                    <td>retain</td>
+                    <td>Yes</td>
+                    <td>v9</td>
+                    <td>System rule — always retained</td>
+                    <td>Retained as-is</td>
+                  </tr>
+                </tbody>
+              </table>
+            </footnote>
+          </text>
+          <!-- [eICR R2 STU3] Emergency Outbreak Information Observation -->
+          <entry typeCode="DRIV">
+            <observation classCode="OBS" moodCode="EVN">
+              <templateId root="2.16.840.1.113883.10.20.15.2.3.40" extension="2021-01-01"/>
+              <id root="ab1791b0-5c71-11db-b0de-0800200c9a54"/>
+              <code nullFlavor="OTH">
+                <originalText>Employee desk distance from mail sorter</originalText>
+              </code>
+              <statusCode code="completed"/>
+              <effectiveTime>
+                <low value="20201101"/>
+              </effectiveTime>
+              <value xsi:type="PQ" value="2" unit="m"/>
+              <entryRelationship typeCode="REFR">
+                <observation classCode="OBS" moodCode="EVN">
+                  <templateId root="2.16.840.1.113883.10.20.15.2.3.40" extension="2021-01-01"/>
+                  <id root="ab1791b0-5c71-11db-b0de-0800200c9a54"/>
+                  <code nullFlavor="OTH">
+                    <originalText>Location of sorter</originalText>
+                  </code>
+                  <statusCode code="completed"/>
+                  <effectiveTime>
+                    <low value="20201101"/>
+                  </effectiveTime>
+                  <value xsi:type="ST">north side of building room 205</value>
+                </observation>
+              </entryRelationship>
+            </observation>
+          </entry>
+          <entry typeCode="DRIV">
+            <observation classCode="OBS" moodCode="EVN">
+              <templateId root="2.16.840.1.113883.10.20.15.2.3.40" extension="2021-01-01"/>
+              <id root="ab1791b0-5c71-11db-b0de-0800200c9a54"/>
+              <code nullFlavor="OTH">
+                <originalText>Number of mail pieces through sorter per hour</originalText>
+              </code>
+              <statusCode code="completed"/>
+              <effectiveTime>
+                <low value="20201101"/>
+              </effectiveTime>
+              <value xsi:type="PQ" value="1000" unit="h"/>
+              <entryRelationship typeCode="REFR">
+                <observation classCode="OBS" moodCode="EVN">
+                  <templateId root="2.16.840.1.113883.10.20.15.2.3.40" extension="2021-01-01"/>
+                  <id root="ab1791b0-5c71-11db-b0de-0800200c9a54"/>
+                  <code nullFlavor="OTH">
+                    <originalText>sorter ID</originalText>
+                  </code>
+                  <statusCode code="completed"/>
+                  <effectiveTime>
+                    <low value="20201101"/>
+                  </effectiveTime>
+                  <value xsi:type="ST">205B</value>
+                </observation>
+              </entryRelationship>
+            </observation>
+          </entry>
+        </section>
+      </component>
+    </structuredBody>
+  </component>
+</ClinicalDocument>
diff --git a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_results_reconstruction/expected_trace.json b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_results_reconstruction/expected_trace.json
new file mode 100644
index 000000000..ea0453274
--- /dev/null
+++ b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_results_reconstruction/expected_trace.json
@@ -0,0 +1,13 @@
+{
+  "augmented_eicr_id": "dca02d8c-8b32-507c-91da-0ce03d64700b",
+  "augmented_rr_id": "65fbb67d-d377-5c19-838f-7856dcb7f16a",
+  "canonical_url": "https://tes.tools.aimsplatform.org/api/fhir/ValueSet/07221093-b8a1-4b1d-8678-259277bfba64",
+  "configuration_resolved": true,
+  "configuration_version": 9,
+  "eicr_size_reduction_percentage": 55,
+  "error_detail": null,
+  "original_eicr_id": "2.16.840.1.113883.9.9.9.9.9",
+  "original_rr_id": "329b9b59-c1be-4036-8984-42266155b321",
+  "refinement_outcome": "refined",
+  "skip_reason": null
+}
diff --git a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_custom_codes/expected_eICR.xml b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_custom_codes/expected_eICR.xml
index 376156b25..8db9b8b23 100644
--- a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_custom_codes/expected_eICR.xml
+++ b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_custom_codes/expected_eICR.xml
@@ -407,7 +407,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-18776-5-20260101000000">
+            <footnote ID="ecr-refiner-18776-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -674,7 +674,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-46240-8-20260101000000">
+            <footnote ID="ecr-refiner-46240-8-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -812,7 +812,7 @@
               not reported<br/> Paroxysms Of Coughing REPORTED starting on 2020/11/04<br/>
               Post-tussive vomiting not reported<br/>
             </paragraph>
-            <footnote ID="ecr-refinement-10164-2-20260101000000">
+            <footnote ID="ecr-refiner-10164-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -866,7 +866,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11348-0-20260101000000">
+            <footnote ID="ecr-refiner-11348-0-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -926,7 +926,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-29549-3-20260101000000">
+            <footnote ID="ecr-refiner-29549-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1221,7 +1221,7 @@
           <title>MEDICATIONS</title>
           <text>
             Narrative Text
-          <footnote ID="ecr-refinement-10160-0-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>10160-0</td><td>Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v3</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <footnote ID="ecr-refiner-10160-0-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>10160-0</td><td>Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v3</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: code[1165486] 'ritonavir Oral Product' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
           <entry>
             <substanceAdministration classCode="SBADM" moodCode="EVN">
@@ -1275,7 +1275,7 @@
           <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.2.44"/>
           <code code="42346-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
           <title>Admission Medications</title>
-          <text>Some text here<footnote ID="ecr-refinement-42346-7-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>42346-7</td><td>Admission Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v3</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Some text here<footnote ID="ecr-refiner-42346-7-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>42346-7</td><td>Admission Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v3</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: code[1165486] 'ritonavir Oral Product' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1361,7 +1361,7 @@
             <translation code="42347-5" codeSystem="2.16.840.1.113883.6.1" displayName="Admission Diagnosis"/>
           </code>
           <title>HOSPITAL ADMISSION DIAGNOSIS</title>
-          <text>Appendicitis<footnote ID="ecr-refinement-46241-6-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>46241-6</td><td>Admission Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v3</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Appendicitis<footnote ID="ecr-refiner-46241-6-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>46241-6</td><td>Admission Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v3</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: value[1017214008] 'Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1434,7 +1434,7 @@
             <translation code="78375-3" displayName="Discharge Diagnosis" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
           </code>
           <title>Discharge Diagnosis</title>
-          <text>Some text here<footnote ID="ecr-refinement-11535-2-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>11535-2</td><td>Discharge Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v3</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Some text here<footnote ID="ecr-refiner-11535-2-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>11535-2</td><td>Discharge Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v3</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: value[1017214008] 'Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1511,7 +1511,7 @@
               For weakness and shortness of breath. One episode of melena. No recent
               headaches. Positive for osteoarthritis in hips, knees and hands.
             </paragraph>
-            <footnote ID="ecr-refinement-10187-3-20260101000000">
+            <footnote ID="ecr-refiner-10187-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1616,7 +1616,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11450-4-20260101000000">
+            <footnote ID="ecr-refiner-11450-4-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1704,7 +1704,7 @@
           <title>Chief Complaint</title>
           <text>
             <paragraph>Chief Complaint (the patient's own description): Headache and rash</paragraph>
-            <footnote ID="ecr-refinement-10154-3-20260101000000">
+            <footnote ID="ecr-refiner-10154-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1746,7 +1746,7 @@
           <title>Reason for Visit</title>
           <text>
             <paragraph>Reason for Visit (as documented by provider): Headache, rash, and fever</paragraph>
-            <footnote ID="ecr-refinement-29299-5-20260101000000">
+            <footnote ID="ecr-refiner-29299-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1954,7 +1954,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-30954-2-20260101000000">
+            <footnote ID="ecr-refiner-30954-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2037,7 +2037,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-47519-4-20260101000000">
+            <footnote ID="ecr-refiner-47519-4-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2409,7 +2409,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11369-6-20260101000000">
+            <footnote ID="ecr-refiner-11369-6-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2943,7 +2943,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-29762-2-20260101000000">
+            <footnote ID="ecr-refiner-29762-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -3142,7 +3142,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-90767-5-20260101000000">
+            <footnote ID="ecr-refiner-90767-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -3278,7 +3278,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-8716-3-20260101000000">
+            <footnote ID="ecr-refiner-8716-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -3441,7 +3441,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-83910-0-20260101000000">
+            <footnote ID="ecr-refiner-83910-0-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
diff --git a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_multi_vital_sign_codes/expected_eICR.xml b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_multi_vital_sign_codes/expected_eICR.xml
index 1a55af0ed..475d6e2a5 100644
--- a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_multi_vital_sign_codes/expected_eICR.xml
+++ b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_multi_vital_sign_codes/expected_eICR.xml
@@ -407,7 +407,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-18776-5-20260101000000">
+            <footnote ID="ecr-refiner-18776-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -617,7 +617,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-46240-8-20260101000000">
+            <footnote ID="ecr-refiner-46240-8-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -755,7 +755,7 @@
               not reported<br/> Paroxysms Of Coughing REPORTED starting on 2020/11/04<br/>
               Post-tussive vomiting not reported<br/>
             </paragraph>
-            <footnote ID="ecr-refinement-10164-2-20260101000000">
+            <footnote ID="ecr-refiner-10164-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -809,7 +809,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11348-0-20260101000000">
+            <footnote ID="ecr-refiner-11348-0-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -869,7 +869,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-29549-3-20260101000000">
+            <footnote ID="ecr-refiner-29549-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1164,7 +1164,7 @@
           <title>MEDICATIONS</title>
           <text>
             Narrative Text
-          <footnote ID="ecr-refinement-10160-0-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>10160-0</td><td>Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v7</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <footnote ID="ecr-refiner-10160-0-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>10160-0</td><td>Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v7</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: code[1165486] 'ritonavir Oral Product' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
           <entry>
             <substanceAdministration classCode="SBADM" moodCode="EVN">
@@ -1218,7 +1218,7 @@
           <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.2.44"/>
           <code code="42346-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
           <title>Admission Medications</title>
-          <text>Some text here<footnote ID="ecr-refinement-42346-7-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>42346-7</td><td>Admission Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v7</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Some text here<footnote ID="ecr-refiner-42346-7-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>42346-7</td><td>Admission Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v7</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: code[1165486] 'ritonavir Oral Product' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1304,7 +1304,7 @@
             <translation code="42347-5" codeSystem="2.16.840.1.113883.6.1" displayName="Admission Diagnosis"/>
           </code>
           <title>HOSPITAL ADMISSION DIAGNOSIS</title>
-          <text>Appendicitis<footnote ID="ecr-refinement-46241-6-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>46241-6</td><td>Admission Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v7</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Appendicitis<footnote ID="ecr-refiner-46241-6-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>46241-6</td><td>Admission Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v7</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: value[1017214008] 'Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1377,7 +1377,7 @@
             <translation code="78375-3" displayName="Discharge Diagnosis" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
           </code>
           <title>Discharge Diagnosis</title>
-          <text>Some text here<footnote ID="ecr-refinement-11535-2-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>11535-2</td><td>Discharge Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v7</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Some text here<footnote ID="ecr-refiner-11535-2-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>11535-2</td><td>Discharge Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v7</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: value[1017214008] 'Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1454,7 +1454,7 @@
               For weakness and shortness of breath. One episode of melena. No recent
               headaches. Positive for osteoarthritis in hips, knees and hands.
             </paragraph>
-            <footnote ID="ecr-refinement-10187-3-20260101000000">
+            <footnote ID="ecr-refiner-10187-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1559,7 +1559,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11450-4-20260101000000">
+            <footnote ID="ecr-refiner-11450-4-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1629,7 +1629,7 @@
           <title>Chief Complaint</title>
           <text>
             <paragraph>Chief Complaint (the patient's own description): Headache and rash</paragraph>
-            <footnote ID="ecr-refinement-10154-3-20260101000000">
+            <footnote ID="ecr-refiner-10154-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1671,7 +1671,7 @@
           <title>Reason for Visit</title>
           <text>
             <paragraph>Reason for Visit (as documented by provider): Headache, rash, and fever</paragraph>
-            <footnote ID="ecr-refinement-29299-5-20260101000000">
+            <footnote ID="ecr-refiner-29299-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1879,7 +1879,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-30954-2-20260101000000">
+            <footnote ID="ecr-refiner-30954-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1961,7 +1961,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-47519-4-20260101000000">
+            <footnote ID="ecr-refiner-47519-4-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2053,7 +2053,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11369-6-20260101000000">
+            <footnote ID="ecr-refiner-11369-6-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2303,7 +2303,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-29762-2-20260101000000">
+            <footnote ID="ecr-refiner-29762-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2502,7 +2502,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-90767-5-20260101000000">
+            <footnote ID="ecr-refiner-90767-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2638,7 +2638,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-8716-3-20260101000000">
+            <footnote ID="ecr-refiner-8716-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2874,7 +2874,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-83910-0-20260101000000">
+            <footnote ID="ecr-refiner-83910-0-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
diff --git a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_procedure_only_code/expected_eICR.xml b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_procedure_only_code/expected_eICR.xml
index 00c202e16..1b554303c 100644
--- a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_procedure_only_code/expected_eICR.xml
+++ b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_procedure_only_code/expected_eICR.xml
@@ -407,7 +407,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-18776-5-20260101000000">
+            <footnote ID="ecr-refiner-18776-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -628,7 +628,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-46240-8-20260101000000">
+            <footnote ID="ecr-refiner-46240-8-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -766,7 +766,7 @@
               not reported<br/> Paroxysms Of Coughing REPORTED starting on 2020/11/04<br/>
               Post-tussive vomiting not reported<br/>
             </paragraph>
-            <footnote ID="ecr-refinement-10164-2-20260101000000">
+            <footnote ID="ecr-refiner-10164-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -820,7 +820,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11348-0-20260101000000">
+            <footnote ID="ecr-refiner-11348-0-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -880,7 +880,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-29549-3-20260101000000">
+            <footnote ID="ecr-refiner-29549-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1175,7 +1175,7 @@
           <title>MEDICATIONS</title>
           <text>
             Narrative Text
-          <footnote ID="ecr-refinement-10160-0-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>10160-0</td><td>Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v8</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <footnote ID="ecr-refiner-10160-0-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>10160-0</td><td>Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v8</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: code[1165486] 'ritonavir Oral Product' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
           <entry>
             <substanceAdministration classCode="SBADM" moodCode="EVN">
@@ -1229,7 +1229,7 @@
           <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.2.44"/>
           <code code="42346-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
           <title>Admission Medications</title>
-          <text>Some text here<footnote ID="ecr-refinement-42346-7-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>42346-7</td><td>Admission Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v8</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Some text here<footnote ID="ecr-refiner-42346-7-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>42346-7</td><td>Admission Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v8</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: code[1165486] 'ritonavir Oral Product' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1315,7 +1315,7 @@
             <translation code="42347-5" codeSystem="2.16.840.1.113883.6.1" displayName="Admission Diagnosis"/>
           </code>
           <title>HOSPITAL ADMISSION DIAGNOSIS</title>
-          <text>Appendicitis<footnote ID="ecr-refinement-46241-6-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>46241-6</td><td>Admission Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v8</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Appendicitis<footnote ID="ecr-refiner-46241-6-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>46241-6</td><td>Admission Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v8</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: value[1017214008] 'Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1388,7 +1388,7 @@
             <translation code="78375-3" displayName="Discharge Diagnosis" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
           </code>
           <title>Discharge Diagnosis</title>
-          <text>Some text here<footnote ID="ecr-refinement-11535-2-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>11535-2</td><td>Discharge Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v8</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Some text here<footnote ID="ecr-refiner-11535-2-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>11535-2</td><td>Discharge Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v8</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: value[1017214008] 'Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1465,7 +1465,7 @@
               For weakness and shortness of breath. One episode of melena. No recent
               headaches. Positive for osteoarthritis in hips, knees and hands.
             </paragraph>
-            <footnote ID="ecr-refinement-10187-3-20260101000000">
+            <footnote ID="ecr-refiner-10187-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1570,7 +1570,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11450-4-20260101000000">
+            <footnote ID="ecr-refiner-11450-4-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1640,7 +1640,7 @@
           <title>Chief Complaint</title>
           <text>
             <paragraph>Chief Complaint (the patient's own description): Headache and rash</paragraph>
-            <footnote ID="ecr-refinement-10154-3-20260101000000">
+            <footnote ID="ecr-refiner-10154-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1682,7 +1682,7 @@
           <title>Reason for Visit</title>
           <text>
             <paragraph>Reason for Visit (as documented by provider): Headache, rash, and fever</paragraph>
-            <footnote ID="ecr-refinement-29299-5-20260101000000">
+            <footnote ID="ecr-refiner-29299-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1890,7 +1890,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-30954-2-20260101000000">
+            <footnote ID="ecr-refiner-30954-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1973,7 +1973,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-47519-4-20260101000000">
+            <footnote ID="ecr-refiner-47519-4-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2226,7 +2226,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11369-6-20260101000000">
+            <footnote ID="ecr-refiner-11369-6-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2476,7 +2476,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-29762-2-20260101000000">
+            <footnote ID="ecr-refiner-29762-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2675,7 +2675,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-90767-5-20260101000000">
+            <footnote ID="ecr-refiner-90767-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2811,7 +2811,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-8716-3-20260101000000">
+            <footnote ID="ecr-refiner-8716-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2936,7 +2936,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-83910-0-20260101000000">
+            <footnote ID="ecr-refiner-83910-0-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
diff --git a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_section_overrides/expected_eICR.xml b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_section_overrides/expected_eICR.xml
index 99901b0ad..5f618c371 100644
--- a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_section_overrides/expected_eICR.xml
+++ b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_section_overrides/expected_eICR.xml
@@ -407,7 +407,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-18776-5-20260101000000">
+            <footnote ID="ecr-refiner-18776-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -617,7 +617,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-46240-8-20260101000000">
+            <footnote ID="ecr-refiner-46240-8-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -764,7 +764,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-10164-2-20260101000000">
+            <footnote ID="ecr-refiner-10164-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -818,7 +818,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11348-0-20260101000000">
+            <footnote ID="ecr-refiner-11348-0-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -878,7 +878,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-29549-3-20260101000000">
+            <footnote ID="ecr-refiner-29549-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1173,7 +1173,7 @@
           <title>MEDICATIONS</title>
           <text>
             Narrative Text
-          <footnote ID="ecr-refinement-10160-0-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>10160-0</td><td>Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v4</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <footnote ID="ecr-refiner-10160-0-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>10160-0</td><td>Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v4</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: code[1165486] 'ritonavir Oral Product' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
           <entry>
             <substanceAdministration classCode="SBADM" moodCode="EVN">
@@ -1227,7 +1227,7 @@
           <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.2.44"/>
           <code code="42346-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
           <title>Admission Medications</title>
-          <text>Some text here<footnote ID="ecr-refinement-42346-7-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>42346-7</td><td>Admission Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v4</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Some text here<footnote ID="ecr-refiner-42346-7-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>42346-7</td><td>Admission Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v4</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: code[1165486] 'ritonavir Oral Product' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1313,7 +1313,7 @@
             <translation code="42347-5" codeSystem="2.16.840.1.113883.6.1" displayName="Admission Diagnosis"/>
           </code>
           <title>HOSPITAL ADMISSION DIAGNOSIS</title>
-          <text>Appendicitis<footnote ID="ecr-refinement-46241-6-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>46241-6</td><td>Admission Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v4</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Appendicitis<footnote ID="ecr-refiner-46241-6-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>46241-6</td><td>Admission Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v4</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: value[1017214008] 'Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1386,7 +1386,7 @@
             <translation code="78375-3" displayName="Discharge Diagnosis" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
           </code>
           <title>Discharge Diagnosis</title>
-          <text>Some text here<footnote ID="ecr-refinement-11535-2-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>11535-2</td><td>Discharge Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v4</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Some text here<footnote ID="ecr-refiner-11535-2-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>11535-2</td><td>Discharge Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v4</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: value[1017214008] 'Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1463,7 +1463,7 @@
               For weakness and shortness of breath. One episode of melena. No recent
               headaches. Positive for osteoarthritis in hips, knees and hands.
             </paragraph>
-            <footnote ID="ecr-refinement-10187-3-20260101000000">
+            <footnote ID="ecr-refiner-10187-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1568,7 +1568,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11450-4-20260101000000">
+            <footnote ID="ecr-refiner-11450-4-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1650,7 +1650,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-10154-3-20260101000000">
+            <footnote ID="ecr-refiner-10154-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1704,7 +1704,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-29299-5-20260101000000">
+            <footnote ID="ecr-refiner-29299-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1749,7 +1749,7 @@
           <title>Results</title>
           <text>
             <paragraph>Section narrative has been removed from this refined document as configured by jurisdiction. Clinical entries are preserved for machine processing.</paragraph>
-            <footnote ID="ecr-refinement-30954-2-20260101000000">
+            <footnote ID="ecr-refiner-30954-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1831,7 +1831,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-47519-4-20260101000000">
+            <footnote ID="ecr-refiner-47519-4-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1923,7 +1923,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11369-6-20260101000000">
+            <footnote ID="ecr-refiner-11369-6-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2176,7 +2176,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-29762-2-20260101000000">
+            <footnote ID="ecr-refiner-29762-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2930,7 +2930,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-90767-5-20260101000000">
+            <footnote ID="ecr-refiner-90767-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -3066,7 +3066,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-8716-3-20260101000000">
+            <footnote ID="ecr-refiner-8716-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -3191,7 +3191,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-83910-0-20260101000000">
+            <footnote ID="ecr-refiner-83910-0-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
diff --git a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_substance_admin_custom_code/expected_eICR.xml b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_substance_admin_custom_code/expected_eICR.xml
index a123fa139..6263a8096 100644
--- a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_substance_admin_custom_code/expected_eICR.xml
+++ b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/covid_with_substance_admin_custom_code/expected_eICR.xml
@@ -407,7 +407,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-18776-5-20260101000000">
+            <footnote ID="ecr-refiner-18776-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -617,7 +617,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-46240-8-20260101000000">
+            <footnote ID="ecr-refiner-46240-8-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -755,7 +755,7 @@
               not reported<br/> Paroxysms Of Coughing REPORTED starting on 2020/11/04<br/>
               Post-tussive vomiting not reported<br/>
             </paragraph>
-            <footnote ID="ecr-refinement-10164-2-20260101000000">
+            <footnote ID="ecr-refiner-10164-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -809,7 +809,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11348-0-20260101000000">
+            <footnote ID="ecr-refiner-11348-0-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -869,7 +869,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-29549-3-20260101000000">
+            <footnote ID="ecr-refiner-29549-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1237,7 +1237,7 @@
           <title>MEDICATIONS</title>
           <text>
             Narrative Text
-          <footnote ID="ecr-refinement-10160-0-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>10160-0</td><td>Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v6</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <footnote ID="ecr-refiner-10160-0-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>10160-0</td><td>Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v6</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: code[1115699] 'Oseltamivir' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
           <entry>
             <substanceAdministration classCode="SBADM" moodCode="EVN">
@@ -1411,7 +1411,7 @@
           <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.2.44"/>
           <code code="42346-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
           <title>Admission Medications</title>
-          <text>Some text here<footnote ID="ecr-refinement-42346-7-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>42346-7</td><td>Admission Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v6</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Some text here<footnote ID="ecr-refiner-42346-7-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>42346-7</td><td>Admission Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v6</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: code[1115699] 'Oseltamivir' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1571,7 +1571,7 @@
             <translation code="42347-5" codeSystem="2.16.840.1.113883.6.1" displayName="Admission Diagnosis"/>
           </code>
           <title>HOSPITAL ADMISSION DIAGNOSIS</title>
-          <text>Appendicitis<footnote ID="ecr-refinement-46241-6-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>46241-6</td><td>Admission Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v6</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Appendicitis<footnote ID="ecr-refiner-46241-6-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>46241-6</td><td>Admission Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v6</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: value[1017214008] 'Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1644,7 +1644,7 @@
             <translation code="78375-3" displayName="Discharge Diagnosis" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
           </code>
           <title>Discharge Diagnosis</title>
-          <text>Some text here<footnote ID="ecr-refinement-11535-2-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>11535-2</td><td>Discharge Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v6</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Some text here<footnote ID="ecr-refiner-11535-2-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>11535-2</td><td>Discharge Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v6</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: value[1017214008] 'Viremia caused by severe acute respiratory syndrome coronavirus 2 (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1721,7 +1721,7 @@
               For weakness and shortness of breath. One episode of melena. No recent
               headaches. Positive for osteoarthritis in hips, knees and hands.
             </paragraph>
-            <footnote ID="ecr-refinement-10187-3-20260101000000">
+            <footnote ID="ecr-refiner-10187-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1826,7 +1826,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11450-4-20260101000000">
+            <footnote ID="ecr-refiner-11450-4-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1896,7 +1896,7 @@
           <title>Chief Complaint</title>
           <text>
             <paragraph>Chief Complaint (the patient's own description): Headache and rash</paragraph>
-            <footnote ID="ecr-refinement-10154-3-20260101000000">
+            <footnote ID="ecr-refiner-10154-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1938,7 +1938,7 @@
           <title>Reason for Visit</title>
           <text>
             <paragraph>Reason for Visit (as documented by provider): Headache, rash, and fever</paragraph>
-            <footnote ID="ecr-refinement-29299-5-20260101000000">
+            <footnote ID="ecr-refiner-29299-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2146,7 +2146,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-30954-2-20260101000000">
+            <footnote ID="ecr-refiner-30954-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2228,7 +2228,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-47519-4-20260101000000">
+            <footnote ID="ecr-refiner-47519-4-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2320,7 +2320,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11369-6-20260101000000">
+            <footnote ID="ecr-refiner-11369-6-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2570,7 +2570,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-29762-2-20260101000000">
+            <footnote ID="ecr-refiner-29762-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2769,7 +2769,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-90767-5-20260101000000">
+            <footnote ID="ecr-refiner-90767-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2905,7 +2905,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-8716-3-20260101000000">
+            <footnote ID="ecr-refiner-8716-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -3030,7 +3030,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-83910-0-20260101000000">
+            <footnote ID="ecr-refiner-83910-0-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
diff --git a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/influenza_baseline/expected_eICR.xml b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/influenza_baseline/expected_eICR.xml
index 0cb71b144..58c1eac5c 100644
--- a/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/influenza_baseline/expected_eICR.xml
+++ b/refiner/tests/integration/scenarios/snapshots/all_sections_covid_influenza/influenza_baseline/expected_eICR.xml
@@ -407,7 +407,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-18776-5-20260101000000">
+            <footnote ID="ecr-refiner-18776-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -617,7 +617,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-46240-8-20260101000000">
+            <footnote ID="ecr-refiner-46240-8-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -756,7 +756,7 @@
               not reported<br/> Paroxysms Of Coughing REPORTED starting on 2020/11/04<br/>
               Post-tussive vomiting not reported<br/>
             </paragraph>
-            <footnote ID="ecr-refinement-10164-2-20260101000000">
+            <footnote ID="ecr-refiner-10164-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -810,7 +810,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11348-0-20260101000000">
+            <footnote ID="ecr-refiner-11348-0-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -870,7 +870,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-29549-3-20260101000000">
+            <footnote ID="ecr-refiner-29549-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -987,7 +987,7 @@
           <title>MEDICATIONS</title>
           <text>
             Narrative Text
-          <footnote ID="ecr-refinement-10160-0-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>10160-0</td><td>Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v2</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <footnote ID="ecr-refiner-10160-0-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>10160-0</td><td>Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v2</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: code[1115699] 'oseltamivir 6 MG/ML [Tamiflu]' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
           <entry>
             <substanceAdministration classCode="SBADM" moodCode="EVN">
@@ -1117,7 +1117,7 @@
           <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.2.44"/>
           <code code="42346-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
           <title>Admission Medications</title>
-          <text>Some text here<footnote ID="ecr-refinement-42346-7-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>42346-7</td><td>Admission Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v2</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Some text here<footnote ID="ecr-refiner-42346-7-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>42346-7</td><td>Admission Medications Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v2</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: code[1115699] 'oseltamivir 6 MG/ML [Tamiflu]' (any code system) Entry match fired for: rule 1 (T1) [hl7:code] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1203,7 +1203,7 @@
             <translation code="42347-5" codeSystem="2.16.840.1.113883.6.1" displayName="Admission Diagnosis"/>
           </code>
           <title>HOSPITAL ADMISSION DIAGNOSIS</title>
-          <text>Appendicitis<footnote ID="ecr-refinement-46241-6-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>46241-6</td><td>Admission Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v2</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Appendicitis<footnote ID="ecr-refiner-46241-6-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>46241-6</td><td>Admission Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v2</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: value[434921000124108] 'Pneumonia due to Influenza A virus (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1277,7 +1277,7 @@
             <translation code="78375-3" displayName="Discharge Diagnosis" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
           </code>
           <title>Discharge Diagnosis</title>
-          <text>Some text here<footnote ID="ecr-refinement-11535-2-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>11535-2</td><td>Discharge Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v2</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
+          <text>Some text here<footnote ID="ecr-refiner-11535-2-20260101000000"><paragraph><content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content></paragraph><table border="1"><thead><tr><th>Section (LOINC)</th><th>Section Name</th><th>Included</th><th>Action</th><th>Retain Narrative</th><th>Config Version</th><th>Source</th><th>Outcome</th></tr></thead><tbody><tr><td>11535-2</td><td>Discharge Diagnosis Section</td><td>Yes</td><td>refine</td><td>Yes</td><td>v2</td><td>Configured by jurisdiction</td><td>Refined; matches found</td></tr></tbody></table></footnote></text>
           <!-- eCR Refiner matched: value[434921000124108] 'Pneumonia due to Influenza A virus (disorder)' (SNOMED) Entry match fired for: rule 1 (T1) [hl7:value] -->
           <entry>
             <act classCode="ACT" moodCode="EVN">
@@ -1355,7 +1355,7 @@
               For weakness and shortness of breath. One episode of melena. No recent
               headaches. Positive for osteoarthritis in hips, knees and hands.
             </paragraph>
-            <footnote ID="ecr-refinement-10187-3-20260101000000">
+            <footnote ID="ecr-refiner-10187-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1460,7 +1460,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11450-4-20260101000000">
+            <footnote ID="ecr-refiner-11450-4-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1530,7 +1530,7 @@
           <title>Chief Complaint</title>
           <text>
             <paragraph>Chief Complaint (the patient's own description): Headache and rash</paragraph>
-            <footnote ID="ecr-refinement-10154-3-20260101000000">
+            <footnote ID="ecr-refiner-10154-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1572,7 +1572,7 @@
           <title>Reason for Visit</title>
           <text>
             <paragraph>Reason for Visit (as documented by provider): Headache, rash, and fever</paragraph>
-            <footnote ID="ecr-refinement-29299-5-20260101000000">
+            <footnote ID="ecr-refiner-29299-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1780,7 +1780,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-30954-2-20260101000000">
+            <footnote ID="ecr-refiner-30954-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1862,7 +1862,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-47519-4-20260101000000">
+            <footnote ID="ecr-refiner-47519-4-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -1954,7 +1954,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-11369-6-20260101000000">
+            <footnote ID="ecr-refiner-11369-6-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2467,7 +2467,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-29762-2-20260101000000">
+            <footnote ID="ecr-refiner-29762-2-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2666,7 +2666,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-90767-5-20260101000000">
+            <footnote ID="ecr-refiner-90767-5-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2802,7 +2802,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-8716-3-20260101000000">
+            <footnote ID="ecr-refiner-8716-3-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
@@ -2927,7 +2927,7 @@
                 </tr>
               </tbody>
             </table>
-            <footnote ID="ecr-refinement-83910-0-20260101000000">
+            <footnote ID="ecr-refiner-83910-0-20260101000000">
               <paragraph>
                 <content styleCode="Bold">eCR Refiner — Jurisdiction Configuration</content>
               </paragraph>
diff --git a/refiner/tests/integration/test_narrative_reconstruction.py b/refiner/tests/integration/test_narrative_reconstruction.py
new file mode 100644
index 000000000..f4fcacc04
--- /dev/null
+++ b/refiner/tests/integration/test_narrative_reconstruction.py
@@ -0,0 +1,70 @@
+from pathlib import Path
+
+from lxml import etree
+
+from app.services.ecr.model import HL7_NS
+from app.services.ecr.narrative.reconstruction import reconstruct_narrative
+
+# NOTE:
+# CDA-VALIDITY OF RECONSTRUCTED NARRATIVE
+# =============================================================================
+# the previous reconstruction attempt was disconnected because its output
+# failed CDA R2 XSD validation (it emitted bare HTML). these tests retest that
+# exact failure mode: take a known-valid eICR, swap the Results section's
+# <text> for reconstruct_narrative's output, and validate the WHOLE document;
+# a reconstructed <text> must be at least as valid as the narrative it
+# replaces--it may not introduce new XSD or schematron errors
+
+_RESULTS_LOINC = "30954-2"
+
+
+def _eicr_with_reconstructed_results(fixtures_path: Path) -> tuple[str, str]:
+    """
+    Return (original_xml, reconstructed_xml) for the all-sections eICR.
+    """
+
+    src = fixtures_path / "eicr_v3_1_1" / "all_sections_CDA_eICR.xml"
+    root = etree.parse(str(src)).getroot()
+    original_xml = etree.tostring(root, encoding="unicode")
+
+    section = root.xpath(
+        f"//hl7:section[hl7:code/@code='{_RESULTS_LOINC}']", namespaces=HL7_NS
+    )[0]
+    new_text = reconstruct_narrative(section)
+    assert new_text is not None, "expected a reconstructed <text> for Results"
+
+    existing_text = section.find("hl7:text", HL7_NS)
+    assert existing_text is not None
+    section.replace(existing_text, new_text)
+
+    reconstructed_xml = etree.tostring(root, encoding="unicode")
+    return original_xml, reconstructed_xml
+
+
+def test_reconstructed_results_is_xsd_valid(fixtures_path, validate_xml_string_xsd):
+    original_xml, reconstructed_xml = _eicr_with_reconstructed_results(fixtures_path)
+
+    original = validate_xml_string_xsd(original_xml)
+    reconstructed = validate_xml_string_xsd(reconstructed_xml)
+
+    # the reconstructed document must not introduce XSD errors
+    assert reconstructed["errors"] <= original["errors"], reconstructed["details"]
+
+
+def test_reconstructed_results_is_schematron_valid(fixtures_path, validate_xml_string):
+    original_xml, reconstructed_xml = _eicr_with_reconstructed_results(fixtures_path)
+
+    original = validate_xml_string(original_xml, "eicr")
+    reconstructed = validate_xml_string(reconstructed_xml, "eicr")
+
+    # swapping in the reconstructed narrative must not add schematron errors
+    assert reconstructed["errors"] <= original["errors"], reconstructed["details"]
+
+
+def test_reconstructed_text_actually_replaced_the_narrative(fixtures_path):
+    _, reconstructed_xml = _eicr_with_reconstructed_results(fixtures_path)
+
+    # the machine-derived provenance marker proves the swap took effect
+    assert "machine-derived" in reconstructed_xml
+    # and a panel displayName from the fixture's Results organizer is present
+    assert "SARS-CoV" in reconstructed_xml
diff --git a/refiner/tests/unit/test_service_format.py b/refiner/tests/unit/test_service_format.py
index d72bc4244..586b073e7 100644
--- a/refiner/tests/unit/test_service_format.py
+++ b/refiner/tests/unit/test_service_format.py
@@ -217,7 +217,7 @@ def _build_eicr_with_subelement_footnote(self) -> str:
         ns = {"hl7": HL7}
         text_el = root.find(".//hl7:section/hl7:text", ns)
         footnote = etree.SubElement(
-            text_el, f"{{{HL7}}}footnote", ID="ecr-refinement-test"
+            text_el, f"{{{HL7}}}footnote", ID="ecr-refiner-test"
         )
         para = etree.SubElement(footnote, f"{{{HL7}}}paragraph")
         content = etree.SubElement(para, f"{{{HL7}}}content", styleCode="Bold")
diff --git a/refiner/tests/unit/test_service_narrative_reconstruction.py b/refiner/tests/unit/test_service_narrative_reconstruction.py
new file mode 100644
index 000000000..ba531a8ce
--- /dev/null
+++ b/refiner/tests/unit/test_service_narrative_reconstruction.py
@@ -0,0 +1,262 @@
+from lxml import etree
+from lxml.etree import _Element
+
+from app.services.ecr.model import HL7_NS
+from app.services.ecr.narrative.reconstruction import (
+    RESULT_FIELDS,
+    FieldSpec,
+    build_table,
+    extract_fields,
+    reconstruct_narrative,
+    reconstruct_results,
+    render_typed_value,
+)
+
+# NOTE:
+# HELPERS
+# =============================================================================
+
+
+def _el(xml: str) -> _Element:
+    return etree.fromstring(xml.encode("utf-8"))
+
+
+_NSDECL = 'xmlns="urn:hl7-org:v3" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"'
+
+
+# NOTE:
+# LAYER 1 — render_typed_value (the closed CDA data-type set)
+# =============================================================================
+
+
+def test_render_none_is_empty():
+    assert render_typed_value(None) == ""
+
+
+def test_render_cd_with_xsi_type():
+    el = _el(f'<value {_NSDECL} xsi:type="CD" code="112283007" displayName="E. coli"/>')
+    assert render_typed_value(el) == "E. coli (112283007)"
+
+
+def test_render_cd_without_xsi_type_is_monomorphic_coded():
+    # interpretationCode carries @code with no xsi:type — still coded
+    el = _el(f'<interpretationCode {_NSDECL} code="A" displayName="Abnormal"/>')
+    assert render_typed_value(el) == "Abnormal (A)"
+
+
+def test_render_cd_code_only_falls_back_to_code():
+    el = _el(f'<value {_NSDECL} xsi:type="CD" code="A"/>')
+    assert render_typed_value(el) == "A"
+
+
+def test_render_pq_with_xsi_type():
+    el = _el(f'<value {_NSDECL} xsi:type="PQ" value="9.2" unit="g/dL"/>')
+    assert render_typed_value(el) == "9.2 g/dL"
+
+
+def test_render_pq_monomorphic_dose_quantity():
+    # doseQuantity is PQ by the CDA model — no xsi:type
+    el = _el(f'<doseQuantity {_NSDECL} value="1" unit="tablet"/>')
+    assert render_typed_value(el) == "1 tablet"
+
+
+def test_render_st():
+    el = _el(f'<value {_NSDECL} xsi:type="ST">free text</value>')
+    assert render_typed_value(el) == "free text"
+
+
+def test_render_ivl_ts_low_and_high():
+    el = _el(
+        f'<effectiveTime {_NSDECL} xsi:type="IVL_TS">'
+        '<low value="20240115"/><high value="20240122"/></effectiveTime>'
+    )
+    assert render_typed_value(el) == "20240115 to 20240122"
+
+
+def test_render_ivl_ts_low_only():
+    el = _el(f'<effectiveTime {_NSDECL}><low value="20240115"/></effectiveTime>')
+    assert render_typed_value(el) == "20240115"
+
+
+def test_render_pivl_ts_frequency():
+    el = _el(
+        f'<effectiveTime {_NSDECL} xsi:type="PIVL_TS">'
+        '<period value="8" unit="h"/></effectiveTime>'
+    )
+    assert render_typed_value(el) == "every 8 h"
+
+
+def test_render_bare_value():
+    el = _el(f'<effectiveTime {_NSDECL} value="20240115"/>')
+    assert render_typed_value(el) == "20240115"
+
+
+# NOTE:
+# LAYER 1 — extract_fields
+# =============================================================================
+
+
+def test_extract_fields_attr_typed_and_missing():
+    obs = _el(
+        f"<observation {_NSDECL}>"
+        '<code displayName="Hemoglobin"/>'
+        '<value xsi:type="PQ" value="9.2" unit="g/dL"/>'
+        "</observation>"
+    )
+    fields = [
+        FieldSpec("Test", "hl7:code/@displayName", "attr"),
+        FieldSpec("Result", "hl7:value", "typed"),
+        FieldSpec("Missing", "hl7:interpretationCode/@code", "attr"),
+    ]
+    assert extract_fields(obs, fields) == {
+        "Test": "Hemoglobin",
+        "Result": "9.2 g/dL",
+        "Missing": "",
+    }
+
+
+# NOTE:
+# LAYER 1 — build_table
+# =============================================================================
+
+
+def test_build_table_structure_and_provenance_marker():
+    text = build_table(["A", "B"], [{"A": "1", "B": "2"}, {"A": "3", "B": ""}])
+
+    # namespace-qualified <text>
+    assert text.tag == "{urn:hl7-org:v3}text"
+
+    # block-level machine-derived marker as an XML comment with no double dash
+    comments = [c for c in text.iter() if isinstance(c, etree._Comment)]
+    assert len(comments) == 1
+    assert "machine-derived" in comments[0].text
+    assert "--" not in comments[0].text
+
+    headers = text.xpath(".//hl7:thead/hl7:tr/hl7:th/text()", namespaces=HL7_NS)
+    assert headers == ["A", "B"]
+
+    body_rows = text.xpath(".//hl7:tbody/hl7:tr", namespaces=HL7_NS)
+    assert len(body_rows) == 2
+    first_cells = body_rows[0].xpath("hl7:td/text()", namespaces=HL7_NS)
+    assert first_cells == ["1", "2"]
+
+
+# NOTE:
+# LAYER 3 — reconstruct_results (the join)
+# =============================================================================
+
+# two organizers; the first holds TWO result observations so the panel and
+# specimen context must fan out across both rows without bleeding into the
+# second organizer's row
+_RESULTS_SECTION = f"""
+<section {_NSDECL}>
+  <code code="30954-2" codeSystem="2.16.840.1.113883.6.1" displayName="Results"/>
+  <title>Results</title>
+  <text>...original clinician narrative...</text>
+  <entry>
+    <organizer classCode="BATTERY" moodCode="EVN">
+      <code displayName="CBC panel"/>
+      <component>
+        <procedure classCode="PROC" moodCode="EVN">
+          <participant typeCode="SBJ"><participantRole><playingEntity>
+            <code displayName="Blood specimen"/>
+          </playingEntity></participantRole></participant>
+        </procedure>
+      </component>
+      <component>
+        <observation classCode="OBS" moodCode="EVN">
+          <code displayName="Hemoglobin"/>
+          <effectiveTime value="20240115"/>
+          <value xsi:type="PQ" value="9.2" unit="g/dL"/>
+          <interpretationCode code="L" displayName="Low"/>
+        </observation>
+      </component>
+      <component>
+        <observation classCode="OBS" moodCode="EVN">
+          <code displayName="Bacteria identified"/>
+          <effectiveTime value="20240115"/>
+          <value xsi:type="CD" code="112283007" displayName="E. coli"/>
+        </observation>
+      </component>
+    </organizer>
+  </entry>
+  <entry>
+    <organizer classCode="BATTERY" moodCode="EVN">
+      <code displayName="Glucose panel"/>
+      <component>
+        <observation classCode="OBS" moodCode="EVN">
+          <code displayName="Glucose"/>
+          <effectiveTime value="20240116"/>
+          <value xsi:type="PQ" value="105" unit="mg/dL"/>
+        </observation>
+      </component>
+    </organizer>
+  </entry>
+</section>
+"""
+
+
+def test_reconstruct_results_columns():
+    columns, _ = reconstruct_results(_el(_RESULTS_SECTION))
+    assert columns == ["Panel", "Specimen", "Test", "Result", "Interpretation", "Date"]
+
+
+def test_reconstruct_results_fans_context_across_rows_without_bleed():
+    _, rows = reconstruct_results(_el(_RESULTS_SECTION))
+
+    assert len(rows) == 3
+
+    # both rows of the first organizer share its panel + specimen context
+    assert rows[0] == {
+        "Panel": "CBC panel",
+        "Specimen": "Blood specimen",
+        "Test": "Hemoglobin",
+        "Result": "9.2 g/dL",
+        "Interpretation": "Low (L)",
+        "Date": "20240115",
+    }
+    assert rows[1]["Panel"] == "CBC panel"
+    assert rows[1]["Specimen"] == "Blood specimen"
+    assert rows[1]["Result"] == "E. coli (112283007)"
+    assert rows[1]["Interpretation"] == ""  # no interpretationCode on this obs
+
+    # the second organizer's row does NOT inherit the first's context
+    assert rows[2]["Panel"] == "Glucose panel"
+    assert rows[2]["Specimen"] == ""  # no procedure in this organizer
+    assert rows[2]["Result"] == "105 mg/dL"
+
+
+# NOTE:
+# DISPATCH — reconstruct_narrative
+# =============================================================================
+
+
+def test_reconstruct_narrative_results_returns_text_table():
+    text = reconstruct_narrative(_el(_RESULTS_SECTION))
+    assert text is not None
+    assert text.tag == "{urn:hl7-org:v3}text"
+    body_rows = text.xpath(".//hl7:tbody/hl7:tr", namespaces=HL7_NS)
+    assert len(body_rows) == 3
+
+
+def test_reconstruct_narrative_unknown_loinc_returns_none():
+    section = _el(
+        f'<section {_NSDECL}><code code="29762-2" displayName="Social History"/>'
+        "<entry/></section>"
+    )
+    assert reconstruct_narrative(section) is None
+
+
+def test_reconstruct_narrative_does_not_mutate_section():
+    section = _el(_RESULTS_SECTION)
+    before = etree.tostring(section)
+    reconstruct_narrative(section)
+    assert etree.tostring(section) == before
+
+
+def test_result_fields_use_typed_interpretation():
+    # guard the design choice: interpretation renders via the typed renderer
+    # so it humanizes (Low (L)) with graceful fallback, not a bare code
+    spec = {f.label: f for f in RESULT_FIELDS}["Interpretation"]
+    assert spec.kind == "typed"
+    assert spec.xpath == "hl7:interpretationCode"
diff --git a/refiner/tests/unit/test_service_refine.py b/refiner/tests/unit/test_service_refine.py
index 6cc5c62bb..6ee40c01c 100644
--- a/refiner/tests/unit/test_service_refine.py
+++ b/refiner/tests/unit/test_service_refine.py
@@ -15,8 +15,8 @@
     SectionProvenanceRecord,
     SectionSource,
 )
+from app.services.ecr.narrative.constants import PROVENANCE_OUTCOME_NOTES
 from app.services.ecr.refine import create_rr_refinement_plan, refine_eicr, refine_rr
-from app.services.ecr.section.constants import PROVENANCE_OUTCOME_NOTES
 from app.services.ecr.specification import load_spec
 from app.services.terminology import ProcessedConfiguration
 from tests.unit.helpers.configuration import create_processed_config
diff --git a/refiner/tests/unit/test_service_section_entry_matching.py b/refiner/tests/unit/test_service_section_entry_matching.py
index b11ce2d1a..29b2e9f0b 100644
--- a/refiner/tests/unit/test_service_section_entry_matching.py
+++ b/refiner/tests/unit/test_service_section_entry_matching.py
@@ -230,9 +230,9 @@ def test_enrichment_populates_displayName(spec_v1_1) -> None:
     assert val.get("displayName") == "SNOMED 840539006 display"
 
 
-def test_narrative_retention_when_include_narrative_true(spec_v1_1) -> None:
+def test_narrative_retention_when_narrative_retain(spec_v1_1) -> None:
     """
-    include_narrative=True leaves the original <text> intact.
+    narrative="retain" leaves the original <text> intact.
     """
 
     section = _build_section(
@@ -259,16 +259,16 @@ def test_narrative_retention_when_include_narrative_true(spec_v1_1) -> None:
         code_system_sets=_make_code_system_sets({"snomed": ["840539006"]}),
         section_specification=spec_v1_1.sections["11450-4"],
         namespaces=HL7_NS,
-        include_narrative=True,
+        narrative="retain",
     )
     assert result.narrative_disposition == "retained"
     text = _find_one(section, "hl7:text")
     assert text is not None and "Original narrative" in (text.text or "")
 
 
-def test_narrative_removal_when_include_narrative_false(spec_v1_1) -> None:
+def test_narrative_removal_when_narrative_remove(spec_v1_1) -> None:
     """
-    include_narrative=False replaces the narrative with a removal notice.
+    narrative="remove" replaces the narrative with a removal notice.
     """
 
     section = _build_section(
@@ -295,7 +295,7 @@ def test_narrative_removal_when_include_narrative_false(spec_v1_1) -> None:
         code_system_sets=_make_code_system_sets({"snomed": ["840539006"]}),
         section_specification=spec_v1_1.sections["11450-4"],
         namespaces=HL7_NS,
-        include_narrative=False,
+        narrative="remove",
     )
     assert result.narrative_disposition == "removed"
     text = _find_one(section, "hl7:text")
@@ -303,6 +303,98 @@ def test_narrative_removal_when_include_narrative_false(spec_v1_1) -> None:
     assert "Original narrative" not in etree.tostring(text, encoding="unicode")
 
 
+def test_narrative_reconstruct_results_rebuilds_text(spec_v1_1) -> None:
+    """
+    narrative="reconstruct" on Results swaps the stale source narrative for
+    a machine-derived table built from the surviving result entries.
+    """
+
+    section = _build_section(
+        """
+        <section xmlns="urn:hl7-org:v3"
+                 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
+            <code code="30954-2"/>
+            <text>Original narrative content here.</text>
+            <entry>
+                <organizer classCode="BATTERY" moodCode="EVN">
+                    <code displayName="CBC panel"/>
+                    <component>
+                        <observation classCode="OBS" moodCode="EVN">
+                            <templateId root="2.16.840.1.113883.10.20.22.4.2"/>
+                            <code code="94533-7" codeSystem="2.16.840.1.113883.6.1"
+                                  displayName="Hemoglobin"/>
+                            <effectiveTime value="20240115"/>
+                            <value xsi:type="PQ" value="9.2" unit="g/dL"/>
+                            <interpretationCode code="L" displayName="Low"/>
+                        </observation>
+                    </component>
+                </organizer>
+            </entry>
+        </section>
+        """
+    )
+    result = process(
+        section=section,
+        code_system_sets=_make_code_system_sets({"loinc": ["94533-7"]}),
+        section_specification=spec_v1_1.sections["30954-2"],
+        namespaces=HL7_NS,
+        narrative="reconstruct",
+    )
+    assert result.matches_found is True
+    assert result.narrative_disposition == "reconstructed"
+
+    text = _find_one(section, "hl7:text")
+    assert text is not None
+    serialized = etree.tostring(text, encoding="unicode")
+    assert "Original narrative" not in serialized
+    assert "machine-derived" in serialized
+    assert "CBC panel" in serialized
+    body_rows = text.xpath(".//hl7:tbody/hl7:tr", namespaces=HL7_NS)
+    assert len(body_rows) == 1
+
+
+def test_narrative_reconstruct_without_reconstructor_falls_back_to_removal(
+    spec_v1_1,
+) -> None:
+    """
+    narrative="reconstruct" on a refinable section with no registered
+    reconstructor (Problems) removes the narrative rather than leaving the
+    stale source text in place.
+    """
+
+    section = _build_section(
+        """
+        <section xmlns="urn:hl7-org:v3">
+            <code code="11450-4"/>
+            <text>Original narrative content here.</text>
+            <entry>
+                <act classCode="ACT" moodCode="EVN">
+                    <templateId root="2.16.840.1.113883.10.20.22.4.3"/>
+                    <entryRelationship typeCode="SUBJ">
+                        <observation classCode="OBS" moodCode="EVN">
+                            <templateId root="2.16.840.1.113883.10.20.22.4.4"/>
+                            <value code="840539006" codeSystem="2.16.840.1.113883.6.96"/>
+                        </observation>
+                    </entryRelationship>
+                </act>
+            </entry>
+        </section>
+        """
+    )
+    result = process(
+        section=section,
+        code_system_sets=_make_code_system_sets({"snomed": ["840539006"]}),
+        section_specification=spec_v1_1.sections["11450-4"],
+        namespaces=HL7_NS,
+        narrative="reconstruct",
+    )
+    assert result.matches_found is True
+    assert result.narrative_disposition == "removed"
+    text = _find_one(section, "hl7:text")
+    assert text is not None
+    assert "Original narrative" not in etree.tostring(text, encoding="unicode")
+
+
 # NOTE:
 # CATEGORY 2: PER-RULE — exercise each section's specific rules
 # =============================================================================