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8.7 Resource Location - Content

Patient Administration Work GroupMaturity Level: 3 Trial UseCompartments: Not linked to any defined compartments

Details and position information for a physical place where services are provided and resources and participants may be stored, found, contained or accommodated.

A Location includes both incidental locations (a place which is used for healthcare without prior designation or authorization) and dedicated, formally appointed locations. Locations may be private, public, mobile or fixed and scale from small freezers to full hospital buildings or parking garages.

Examples of Locations are:

  • Building, ward, corridor, room or bed
  • Mobile Clinic
  • Freezer, incubator
  • Vehicle or lift
  • Home, shed, or a garage
  • Road, parking place, a park
  • Ambulance (generic)
  • Ambulance (specific)
  • Patient's Home (generic)
  • Jurisdiction

These locations are not intended to cover locations on a patient where something occurred (i.e. a patient's broken leg), but can hapily cover the location where the patient broke the leg (the playground)

Locations and Organizations are very closely related resources and can often be mixed/matched/confused.
The Location is intended to describe the more physical structures managed/operated by an organization, whereas the Organization is intended to represent the more conceptual hierarchies, such as a ward.

A Location is valid without an address in cases where it could be purely described by a geo-coded location in remote areas, or when recorded by a device. Locations with a mode = "kind" would also likely not have an address, as they are just a type of location, but could also have an address where they can be found at the address.

Another use of location could be for describing a Jurisdiction. This jurisdiction may be considered a classified boundary which could be a combination of a physical boundary, and some other discriminator(s):

  • Nation - Country wide community or Federal Government (Ministry of Health)
  • Province or State (community or Government)
  • Business (throughout an enterprise)
  • Business scope (CDC/FDA)
  • Business segment (UK Pharmacy)

This resource is referenced by Account, ActivityDefinition, AdverseEvent, Appointment, AppointmentResponse, AuditEvent, CarePlan, Claim, Contract, Device, DeviceRequest, DiagnosticReport, EligibilityRequest, Encounter, ExplanationOfBenefit, Flag, HealthcareService, Immunization, List, MedicationDispense, Observation, PractitionerRole, Procedure, ProcedureRequest, Provenance, ResearchStudy, Schedule, SupplyDelivery and SupplyRequest

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Location DomainResourceDetails and position information for a physical place
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierUnique code or number identifying the location to its users
... status ?!Σ0..1codeactive | suspended | inactive
LocationStatus (Required)
... operationalStatus Σ0..1CodingThe Operational status of the location (typically only for a bed/room)
v2 Bed Status (Preferred)
... name Σ0..1stringName of the location as used by humans
... alias 0..*stringA list of alternate names that the location is known as, or was known as in the past
... description Σ0..1stringAdditional details about the location that could be displayed as further information to identify the location beyond its name
... mode ?!Σ0..1codeinstance | kind
LocationMode (Required)
... type Σ0..1CodeableConceptType of function performed
ServiceDeliveryLocationRoleType (Extensible)
... telecom 0..*ContactPointContact details of the location
... address 0..1AddressPhysical location
... physicalType Σ0..1CodeableConceptPhysical form of the location
LocationType (Example)
... position 0..1BackboneElementThe absolute geographic location
.... longitude 1..1decimalLongitude with WGS84 datum
.... latitude 1..1decimalLatitude with WGS84 datum
.... altitude 0..1decimalAltitude with WGS84 datum
... managingOrganization Σ0..1Reference(Organization)Organization responsible for provisioning and upkeep
... partOf 0..1Reference(Location)Another Location this one is physically part of
... endpoint 0..*Reference(Endpoint)Technical endpoints providing access to services operated for the location

doco Documentation for this format

UML Diagram (Legend)

Location (DomainResource)Unique code or number identifying the location to its usersidentifier : Identifier [0..*]The status property covers the general availability of the resource, not the current value which may be covered by the operationStatus, or by a schedule/slots if they are configured for the location (this element modifies the meaning of other elements)status : code [0..1] Indicates whether the location is still in use. (Strength=Required)LocationStatus! The Operational status covers operation values most relevant to beds (but can also apply to rooms/units/chair/etc such as an isolation unit/dialisys chair). This typically covers concepts such as contamination, housekeeping and other activitieslike maintenanceoperationalStatus : Coding [0..1] The operational status if the location (where typically a bed/room) (Strength=Preferred)v2 Bed Status? Name of the location as used by humans. Does not need to be uniquename : string [0..1]A list ofalternate names that the location is known as, or was known as in the pastalias : string [0..*]Description of the Location, which helps in finding or referencing the placedescription : string [0..1]Indicates whether a resource instance represents a specific location or a class of locations (this element modifies the meaning of other elements)mode : code [0..1] Indicates whether a resource instance represents a specific location or a class of locations. (Strength=Required)LocationMode! Indicates the type of function performed at the locationtype : CodeableConcept [0..1] Indicates the type of function performed at the location. (Strength=Extensible)ServiceDeliveryLocationRoleTy...+ The contact details of communication devices available at the location. This can include phone numbers, fax numbers, mobile numbers, email addresses and web sitestelecom : ContactPoint [0..*]Physical locationaddress : Address [0..1]Physical form of the location, e.g. building, room, vehicle, roadphysicalType : CodeableConcept [0..1] Physical form of the location (Strength=Example)LocationType?? The organization responsible for the provisioning and upkeep of the locationmanagingOrganization : Reference [0..1] Organization Another Location which this Location is physically part ofpartOf : Reference [0..1] Location Technical endpoints providing access to services operated for the locationendpoint : Reference [0..*] Endpoint PositionLongitude. The value domain and the interpretation are the same as for the text of the longitude element in KML (see notes below)longitude : decimal [1..1]Latitude. The value domain and the interpretation are the same as for the text of the latitude element in KML (see notes below)latitude : decimal [1..1]Altitude. The value domain and the interpretation are the same as for the text of the altitude element in KML (see notes below)altitude : decimal [0..1]The absolute geographic location of the Location, expressed using the WGS84 datum (This is the same co-ordinate system used in KML)position[0..1]

XML Template

<Location xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Unique code or number identifying the location to its users --></identifier>
 <status value="[code]"/><!-- 0..1 active | suspended | inactive -->
 <operationalStatus><!-- 0..1 Coding The Operational status of the location (typically only for a bed/room) --></operationalStatus>
 <name value="[string]"/><!-- 0..1 Name of the location as used by humans -->
 <alias value="[string]"/><!-- 0..* A list of alternate names that the location is known as, or was known as in the past -->
 <description value="[string]"/><!-- 0..1 Additional details about the location that could be displayed as further information to identify the location beyond its name -->
 <mode value="[code]"/><!-- 0..1 instance | kind -->
 <type><!-- 0..1 CodeableConcept Type of function performed --></type>
 <telecom><!-- 0..* ContactPoint Contact details of the location --></telecom>
 <address><!-- 0..1 Address Physical location --></address>
 <physicalType><!-- 0..1 CodeableConcept Physical form of the location --></physicalType>
 <position>  <!-- 0..1 The absolute geographic location -->
  <longitude value="[decimal]"/><!-- 1..1 Longitude with WGS84 datum -->
  <latitude value="[decimal]"/><!-- 1..1 Latitude with WGS84 datum -->
  <altitude value="[decimal]"/><!-- 0..1 Altitude with WGS84 datum -->
 </position>
 <managingOrganization><!-- 0..1 Reference(Organization) Organization responsible for provisioning and upkeep --></managingOrganization>
 <partOf><!-- 0..1 Reference(Location) Another Location this one is physically part of --></partOf>
 <endpoint><!-- 0..* Reference(Endpoint) Technical endpoints providing access to services operated for the location --></endpoint>
</Location>

JSON Template

{doco
  "resourceType" : "Location",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Unique code or number identifying the location to its users
  "status" : "<code>", // active | suspended | inactive
  "operationalStatus" : { Coding }, // The Operational status of the location (typically only for a bed/room)
  "name" : "<string>", // Name of the location as used by humans
  "alias" : ["<string>"], // A list of alternate names that the location is known as, or was known as in the past
  "description" : "<string>", // Additional details about the location that could be displayed as further information to identify the location beyond its name
  "mode" : "<code>", // instance | kind
  "type" : { CodeableConcept }, // Type of function performed
  "telecom" : [{ ContactPoint }], // Contact details of the location
  "address" : { Address }, // Physical location
  "physicalType" : { CodeableConcept }, // Physical form of the location
  "position" : { // The absolute geographic location
    "longitude" : <decimal>, // R!  Longitude with WGS84 datum
    "latitude" : <decimal>, // R!  Latitude with WGS84 datum
    "altitude" : <decimal> // Altitude with WGS84 datum
  },
  "managingOrganization" : { Reference(Organization) }, // Organization responsible for provisioning and upkeep
  "partOf" : { Reference(Location) }, // Another Location this one is physically part of
  "endpoint" : [{ Reference(Endpoint) }] // Technical endpoints providing access to services operated for the location
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Location;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Location.identifier [ Identifier ], ... ; # 0..* Unique code or number identifying the location to its users
  fhir:Location.status [ code ]; # 0..1 active | suspended | inactive
  fhir:Location.operationalStatus [ Coding ]; # 0..1 The Operational status of the location (typically only for a bed/room)
  fhir:Location.name [ string ]; # 0..1 Name of the location as used by humans
  fhir:Location.alias [ string ], ... ; # 0..* A list of alternate names that the location is known as, or was known as in the past
  fhir:Location.description [ string ]; # 0..1 Additional details about the location that could be displayed as further information to identify the location beyond its name
  fhir:Location.mode [ code ]; # 0..1 instance | kind
  fhir:Location.type [ CodeableConcept ]; # 0..1 Type of function performed
  fhir:Location.telecom [ ContactPoint ], ... ; # 0..* Contact details of the location
  fhir:Location.address [ Address ]; # 0..1 Physical location
  fhir:Location.physicalType [ CodeableConcept ]; # 0..1 Physical form of the location
  fhir:Location.position [ # 0..1 The absolute geographic location
    fhir:Location.position.longitude [ decimal ]; # 1..1 Longitude with WGS84 datum
    fhir:Location.position.latitude [ decimal ]; # 1..1 Latitude with WGS84 datum
    fhir:Location.position.altitude [ decimal ]; # 0..1 Altitude with WGS84 datum
  ];
  fhir:Location.managingOrganization [ Reference(Organization) ]; # 0..1 Organization responsible for provisioning and upkeep
  fhir:Location.partOf [ Reference(Location) ]; # 0..1 Another Location this one is physically part of
  fhir:Location.endpoint [ Reference(Endpoint) ], ... ; # 0..* Technical endpoints providing access to services operated for the location
]

Changes since DSTU2

Location
Location.operationalStatus
  • Added Element
Location.alias
  • Added Element
Location.endpoint
  • Added Element

See the Full Difference for further information

This analysis is available as XML or JSON.

See R2 <--> R3 Conversion Maps (status = 6 tests that all execute ok. All tests pass round-trip testing and all r3 resources are valid.).

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Location DomainResourceDetails and position information for a physical place
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierUnique code or number identifying the location to its users
... status ?!Σ0..1codeactive | suspended | inactive
LocationStatus (Required)
... operationalStatus Σ0..1CodingThe Operational status of the location (typically only for a bed/room)
v2 Bed Status (Preferred)
... name Σ0..1stringName of the location as used by humans
... alias 0..*stringA list of alternate names that the location is known as, or was known as in the past
... description Σ0..1stringAdditional details about the location that could be displayed as further information to identify the location beyond its name
... mode ?!Σ0..1codeinstance | kind
LocationMode (Required)
... type Σ0..1CodeableConceptType of function performed
ServiceDeliveryLocationRoleType (Extensible)
... telecom 0..*ContactPointContact details of the location
... address 0..1AddressPhysical location
... physicalType Σ0..1CodeableConceptPhysical form of the location
LocationType (Example)
... position 0..1BackboneElementThe absolute geographic location
.... longitude 1..1decimalLongitude with WGS84 datum
.... latitude 1..1decimalLatitude with WGS84 datum
.... altitude 0..1decimalAltitude with WGS84 datum
... managingOrganization Σ0..1Reference(Organization)Organization responsible for provisioning and upkeep
... partOf 0..1Reference(Location)Another Location this one is physically part of
... endpoint 0..*Reference(Endpoint)Technical endpoints providing access to services operated for the location

doco Documentation for this format

UML Diagram (Legend)

Location (DomainResource)Unique code or number identifying the location to its usersidentifier : Identifier [0..*]The status property covers the general availability of the resource, not the current value which may be covered by the operationStatus, or by a schedule/slots if they are configured for the location (this element modifies the meaning of other elements)status : code [0..1] Indicates whether the location is still in use. (Strength=Required)LocationStatus! The Operational status covers operation values most relevant to beds (but can also apply to rooms/units/chair/etc such as an isolation unit/dialisys chair). This typically covers concepts such as contamination, housekeeping and other activitieslike maintenanceoperationalStatus : Coding [0..1] The operational status if the location (where typically a bed/room) (Strength=Preferred)v2 Bed Status? Name of the location as used by humans. Does not need to be uniquename : string [0..1]A list ofalternate names that the location is known as, or was known as in the pastalias : string [0..*]Description of the Location, which helps in finding or referencing the placedescription : string [0..1]Indicates whether a resource instance represents a specific location or a class of locations (this element modifies the meaning of other elements)mode : code [0..1] Indicates whether a resource instance represents a specific location or a class of locations. (Strength=Required)LocationMode! Indicates the type of function performed at the locationtype : CodeableConcept [0..1] Indicates the type of function performed at the location. (Strength=Extensible)ServiceDeliveryLocationRoleTy...+ The contact details of communication devices available at the location. This can include phone numbers, fax numbers, mobile numbers, email addresses and web sitestelecom : ContactPoint [0..*]Physical locationaddress : Address [0..1]Physical form of the location, e.g. building, room, vehicle, roadphysicalType : CodeableConcept [0..1] Physical form of the location (Strength=Example)LocationType?? The organization responsible for the provisioning and upkeep of the locationmanagingOrganization : Reference [0..1] Organization Another Location which this Location is physically part ofpartOf : Reference [0..1] Location Technical endpoints providing access to services operated for the locationendpoint : Reference [0..*] Endpoint PositionLongitude. The value domain and the interpretation are the same as for the text of the longitude element in KML (see notes below)longitude : decimal [1..1]Latitude. The value domain and the interpretation are the same as for the text of the latitude element in KML (see notes below)latitude : decimal [1..1]Altitude. The value domain and the interpretation are the same as for the text of the altitude element in KML (see notes below)altitude : decimal [0..1]The absolute geographic location of the Location, expressed using the WGS84 datum (This is the same co-ordinate system used in KML)position[0..1]

XML Template

<Location xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Unique code or number identifying the location to its users --></identifier>
 <status value="[code]"/><!-- 0..1 active | suspended | inactive -->
 <operationalStatus><!-- 0..1 Coding The Operational status of the location (typically only for a bed/room) --></operationalStatus>
 <name value="[string]"/><!-- 0..1 Name of the location as used by humans -->
 <alias value="[string]"/><!-- 0..* A list of alternate names that the location is known as, or was known as in the past -->
 <description value="[string]"/><!-- 0..1 Additional details about the location that could be displayed as further information to identify the location beyond its name -->
 <mode value="[code]"/><!-- 0..1 instance | kind -->
 <type><!-- 0..1 CodeableConcept Type of function performed --></type>
 <telecom><!-- 0..* ContactPoint Contact details of the location --></telecom>
 <address><!-- 0..1 Address Physical location --></address>
 <physicalType><!-- 0..1 CodeableConcept Physical form of the location --></physicalType>
 <position>  <!-- 0..1 The absolute geographic location -->
  <longitude value="[decimal]"/><!-- 1..1 Longitude with WGS84 datum -->
  <latitude value="[decimal]"/><!-- 1..1 Latitude with WGS84 datum -->
  <altitude value="[decimal]"/><!-- 0..1 Altitude with WGS84 datum -->
 </position>
 <managingOrganization><!-- 0..1 Reference(Organization) Organization responsible for provisioning and upkeep --></managingOrganization>
 <partOf><!-- 0..1 Reference(Location) Another Location this one is physically part of --></partOf>
 <endpoint><!-- 0..* Reference(Endpoint) Technical endpoints providing access to services operated for the location --></endpoint>
</Location>

JSON Template

{doco
  "resourceType" : "Location",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Unique code or number identifying the location to its users
  "status" : "<code>", // active | suspended | inactive
  "operationalStatus" : { Coding }, // The Operational status of the location (typically only for a bed/room)
  "name" : "<string>", // Name of the location as used by humans
  "alias" : ["<string>"], // A list of alternate names that the location is known as, or was known as in the past
  "description" : "<string>", // Additional details about the location that could be displayed as further information to identify the location beyond its name
  "mode" : "<code>", // instance | kind
  "type" : { CodeableConcept }, // Type of function performed
  "telecom" : [{ ContactPoint }], // Contact details of the location
  "address" : { Address }, // Physical location
  "physicalType" : { CodeableConcept }, // Physical form of the location
  "position" : { // The absolute geographic location
    "longitude" : <decimal>, // R!  Longitude with WGS84 datum
    "latitude" : <decimal>, // R!  Latitude with WGS84 datum
    "altitude" : <decimal> // Altitude with WGS84 datum
  },
  "managingOrganization" : { Reference(Organization) }, // Organization responsible for provisioning and upkeep
  "partOf" : { Reference(Location) }, // Another Location this one is physically part of
  "endpoint" : [{ Reference(Endpoint) }] // Technical endpoints providing access to services operated for the location
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Location;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Location.identifier [ Identifier ], ... ; # 0..* Unique code or number identifying the location to its users
  fhir:Location.status [ code ]; # 0..1 active | suspended | inactive
  fhir:Location.operationalStatus [ Coding ]; # 0..1 The Operational status of the location (typically only for a bed/room)
  fhir:Location.name [ string ]; # 0..1 Name of the location as used by humans
  fhir:Location.alias [ string ], ... ; # 0..* A list of alternate names that the location is known as, or was known as in the past
  fhir:Location.description [ string ]; # 0..1 Additional details about the location that could be displayed as further information to identify the location beyond its name
  fhir:Location.mode [ code ]; # 0..1 instance | kind
  fhir:Location.type [ CodeableConcept ]; # 0..1 Type of function performed
  fhir:Location.telecom [ ContactPoint ], ... ; # 0..* Contact details of the location
  fhir:Location.address [ Address ]; # 0..1 Physical location
  fhir:Location.physicalType [ CodeableConcept ]; # 0..1 Physical form of the location
  fhir:Location.position [ # 0..1 The absolute geographic location
    fhir:Location.position.longitude [ decimal ]; # 1..1 Longitude with WGS84 datum
    fhir:Location.position.latitude [ decimal ]; # 1..1 Latitude with WGS84 datum
    fhir:Location.position.altitude [ decimal ]; # 0..1 Altitude with WGS84 datum
  ];
  fhir:Location.managingOrganization [ Reference(Organization) ]; # 0..1 Organization responsible for provisioning and upkeep
  fhir:Location.partOf [ Reference(Location) ]; # 0..1 Another Location this one is physically part of
  fhir:Location.endpoint [ Reference(Endpoint) ], ... ; # 0..* Technical endpoints providing access to services operated for the location
]

Changes since DSTU2

Location
Location.operationalStatus
  • Added Element
Location.alias
  • Added Element
Location.endpoint
  • Added Element

See the Full Difference for further information

This analysis is available as XML or JSON.

See R2 <--> R3 Conversion Maps (status = 6 tests that all execute ok. All tests pass round-trip testing and all r3 resources are valid.).

 

Alternate definitions: Master Definition (XML, JSON), XML Schema/Schematron + JSON Schema, ShEx (for Turtle)

PathDefinitionTypeReference
Location.status Indicates whether the location is still in use.RequiredLocationStatus
Location.operationalStatus The operational status if the location (where typically a bed/room)Preferredv2 Bed Status
Location.mode Indicates whether a resource instance represents a specific location or a class of locations.RequiredLocationMode
Location.type Indicates the type of function performed at the location.ExtensibleServiceDeliveryLocationRoleType
Location.physicalType Physical form of the locationExampleLocationType

  • Multiple Organizations or Practitioners may provide services at a Location. These references are not kept in Location, but can be found in the models for Organization and Practitioner instead.
  • Locations may range from whole buildings to cabinets; it is possible to relate smaller Locations to their containing bigger Location using the Location.partOf element.
  • Location.position is expressed using the same syntax, datum and reference system as used in Google Earth's KML files, see Google/OGS's KML .

The Location.mode element can be used to indicate whether a Location resource represents a specific (potentially identifiable) Location ('instance'), or a class of Locations ('kind'). Especially Resources capturing orders, resource scheduling, plans and definitions may refer to Locations in 'kind' mode. For these domains, it is often not necessary to refer to a specific Location, but rather to a class of Locations. An example of this is found in planning, where we need to allocate an "isolation room" for a patient, or need to dispatch "an ambulance" at a certain time. In these cases it is not important exactly which isolation room or ambulance is allocated, and it is sufficient to just indicate a 'kind' of Location.

Note that 'kind' should not be used to represent Locations where an actual instance of a Location was involved, but identifying information is missing. E.g. when a patient arrived 'by ambulance', but it is not known by which ambulance, this should be represented using a Location in 'instance' mode with a missing identifier, not a Location of 'kind' ambulance.

Some of Location's data elements are only relevant when mode is 'instance' and should not be used when mode is 'kind':
(however this information could still be included if was relevant, such as when it is a generic item, but not globally generic, e.g. a Burgers MU ambulance)

  • Location.identifier
  • Location.telecom
  • Location.address
  • Location.position
  • Location.status
  • Location.managingOrganization

An example location hierarchy should help give some guidance as to one example of how a location hierarchy could look within a fictitious Hospital.
(The nesting here would be the "part-of" structure of the location)

Hospital A Building C (instance)
    East Wing (instance)
        Level 1 (instance)
            Reception (instance)
            Nurses Station EM-ns1 (instance)
                Medication Cupboard A (instance)
            Room 1 (instance)
                Room 1a (instance) - space in room separatable via a curtain
                    Bed 1a (instance) - always in this room
                Room 1b (instance)
                    Trolley 43 (instance) - moves about
                Room 1d (instance)
                    Trolley 19 (instance) - moves about
                Room 2 (instance)
                    ...
            Theatre EM-TA (instance)
            Coridor (generic)
        Level 2 (instance)
            Reception (instance)
                ...
            Nurses Station EM-ns1 (instance)
                Medication Cupboard A (instance)
            Coridor (generic)
Mobile Services (kind)
    Ambulance (kind)
        Ambulance AMB1 (instance)
        Ambulance AMB2 (instance)
	

Note: Wards/departments are not part of this structure - these would form part of the Organizational Hierarchy.

Searching for locations often require that a facility is within a specified distance of a particular point. For example, to locate healthcare facilities within 2kms of a clients home, or the current geo-coded position of a practitioner travelling between patients (read from a mobile phone or device).

 GET [base]/Location?near=-83.694810:42.256500&near-distance=11.20||km...

Note: The near search parameters are not able to be used with multiples thus the multiple seperator , should not be used with near or near-distance.

The distance between the location and the provided point is often used as one of the determining factors for selection of the location. So this value is included in the results.
However the value cannot be inside the Location resource as it is different depending on the point of reference in the search. So the distance between is included in the search section of the bundle entry.

<entry> 
    <resource>
        <Location>
            <!-- location details -->
        </Location>
    </resource>
    <search>
        <extension url="http://hl7.org/fhir/StructureDefinition/location-distance">
            <valueDistance >
                <!-- The distance that this location resource is from the provided point in the query --<
                </value value="10.5"/>
                </unit value="km"/>
            </valueDistance>
        </extension>
    </search>
</entry> 

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionExpressionIn Common
addressstringA (part of the) address of the locationLocation.address
address-citystringA city specified in an addressLocation.address.city
address-countrystringA country specified in an addressLocation.address.country
address-postalcodestringA postal code specified in an addressLocation.address.postalCode
address-statestringA state specified in an addressLocation.address.state
address-usetokenA use code specified in an addressLocation.address.use
endpointreferenceTechnical endpoints providing access to services operated for the locationLocation.endpoint
(Endpoint)
identifiertokenAn identifier for the locationLocation.identifier
namestringA portion of the location's name or aliasLocation.name | Location.alias
neartokenThe coordinates expressed as [latitude]:[longitude] (using the WGS84 datum, see notes) to find locations near to (servers may search using a square rather than a circle for efficiency) Requires the near-distance parameter to be provided alsoLocation.position
near-distancequantityA distance quantity to limit the near search to locations within a specific distance Requires the near parameter to also be includedLocation.position
operational-statustokenSearches for locations (typically bed/room) that have an operational status (e.g. contaminated, housekeeping)Location.operationalStatus
organizationreferenceSearches for locations that are managed by the provided organizationLocation.managingOrganization
(Organization)
partofreferenceA location of which this location is a partLocation.partOf
(Location)
statustokenSearches for locations with a specific kind of statusLocation.status
typetokenA code for the type of locationLocation.type