<?xml version="1.0" encoding="UTF-8"?><Procedure xmlns="http://hl7.org/fhir">
  <id value="HCBS"/>
  <meta>
    <security>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
      <code value="HTEST"/>
      <display value="test health data"/>
    </security>
  </meta>
  <text>
    <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml">
			<p>
				<b> Personal care services provided at person's home</b>
			</p>
			<p>
				<b> Based On</b> : Peter's Long Term Services and Supports (LTSS) care plan</p>
			<p>
				<b> Status</b> : completed</p>
			<p>
				<b> Beneficiary</b> : Peter James</p>
			<p>
				<b> Service Name/Code</b> : Personal care services <span> (Details : {HCPCS code 'T1019' = 'Personal care services, per 15 minutes'})</span>
			</p>
			<p>
				<b> Service Date</b> : Apr 5, 2018</p>
			<p>
				<b> Service Provider</b> : Adam Careful</p>
			<p>
				<b> Service Delivery Address</b> : Peter's home</p>
			<p>
				<b> Service Comment</b> : Assisted with bathing and dressing, doing laundry, and meal preparation</p>
		</div>
  </text>
  <basedOn>
    <!--  <reference value="CarePlan/example-HCBS"/>    -->
    <display value="Peter's Long Term Service and Supports (LTSS) Care Plan"/>
  </basedOn>
  <status value="completed"/>
  <code>
    <coding>
      <system value="https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/Alpha-Numeric-HCPCS.html"/>
      <code value="T1019"/>
      <display value="Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment."/>
    </coding>
    <text value="Personal care services"/>
  </code>
  <subject>
    <reference value="Patient/example"/>
    <display value="Peter James"/>
  </subject>
  <occurrenceDateTime value="2018-04-05"/>
  <performer>
    <actor>
      <reference value="Practitioner/example"/>
      <display value="Adam Careful"/>
    </actor>
  </performer>
  <location>
    <reference value="Location/ph"/>
    <display value="Peter's Home"/>
  </location>
  <note>
    <text value="Assisted with bathing and dressing, doing laundry, and meal preparation"/>
  </note>
</Procedure>