http://hl7.org/fhir/us/eltss/Bundle/2039212f3fa5406bb4ffd4a
type: Bundle
node role: treeRoot
id:
  v: 2039212f3fa5406bb4ffd4a
type:
  v: collection
link:
  relation:
    v: self
  url:
    v: https://example.com/base/CarePlan/253/$all-eltss-careplan
entry:
  full url:
    v: https://hl7.org/fhir/Patient/patientBSJ1
  resource: patientBSJ1
entry:
  full url:
    v: https://hl7.org/fhir/CarePlan/careplan1
  resource: careplan1
entry:
  full url:
    v: https://hl7.org/fhir/Task/Task1
  resource: Task1
entry:
  full url:
    v: https://hl7.org/fhir/Task/Task2
  resource: Task2
entry:
  full url:
    v: https://hl7.org/fhir/Goal/goal2
  resource: goal2
entry:
  full url:
    v: https://hl7.org/fhir/Goal/goal1
  resource: goal1
entry:
  full url:
    v: https://hl7.org/fhir/Practitioner/planner1
  resource: planner1
entry:
  full url:
    v: https://hl7.org/fhir/ServiceRequest/service2
  resource: service2
entry:
  full url:
    v: https://hl7.org/fhir/ServiceRequest/service3
  resource: service3
entry:
  full url:
    v: https://hl7.org/fhir/ServiceRequest/service4
  resource: service4
entry:
  full url:
    v: https://hl7.org/fhir/RelatedPerson/son1
  resource: son1
entry:
  full url:
    v: https://hl7.org/fhir/Observation/strength1
  resource: strength1
entry:
  full url:
    v: https://hl7.org/fhir/Observation/strength2
  resource: strength2
entry:
  full url:
    v: https://hl7.org/fhir/Practitioner/caremgr1
  resource: caremgr1
entry:
  full url:
    v: https://hl7.org/fhir/CarePlan/careplan2
  resource: careplan2
entry:
  full url:
    v: https://hl7.org/fhir/Claim/claim1
  resource: claim1
entry:
  full url:
    v: https://hl7.org/fhir/Claim/claim2
  resource: claim2
entry:
  full url:
    v: https://hl7.org/fhir/Claim/claim3
  resource: claim3
entry:
  full url:
    v: https://hl7.org/fhir/Contract/contract1
  resource: contract1
entry:
  full url:
    v: https://hl7.org/fhir/Coverage/coverage1
  resource: coverage1
entry:
  full url:
    v: https://hl7.org/fhir/EpisodeOfCare/episode1
  resource: episode1
entry:
  full url:
    v: https://hl7.org/fhir/Organization/funding1
  resource: funding1
entry:
  full url:
    v: https://hl7.org/fhir/RelatedPerson/guardian1
  resource: guardian1
entry:
  full url:
    v: https://hl7.org/fhir/Location/location1
  resource: location1
entry:
  full url:
    v: https://hl7.org/fhir/Condition/need1
  resource: need1
entry:
  full url:
    v: https://hl7.org/fhir/Condition/need2
  resource: need2
entry:
  full url:
    v: https://hl7.org/fhir/Condition/need3
  resource: need3
entry:
  full url:
    v: https://hl7.org/fhir/Condition/need4
  resource: need4
entry:
  full url:
    v: https://hl7.org/fhir/Observation/pref1
  resource: pref1
entry:
  full url:
    v: https://hl7.org/fhir/Organization/provider2a
  resource: provider2a
entry:
  full url:
    v: https://hl7.org/fhir/Practitioner/provider2b
  resource: provider2b
entry:
  full url:
    v: https://hl7.org/fhir/Practitioner/provider3
  resource: provider3
entry:
  full url:
    v: https://hl7.org/fhir/Practitioner/provider4
  resource: provider4
entry:
  full url:
    v: https://hl7.org/fhir/PractitionerRole/PractitionerRole-1
  resource: PractitionerRole-1
entry:
  full url:
    v: https://hl7.org/fhir/Location/communitysite
  resource: communitysite
entry:
  full url:
    v: https://hl7.org/fhir/Questionnaire/questionnaire1
  resource: questionnaire1
entry:
  full url:
    v: https://hl7.org/fhir/QuestionnaireResponse/questionnaireresponse1
  resource: questionnaireresponse1
entry:
  full url:
    v: https://hl7.org/fhir/RiskAssessment/risk1
  resource: risk1
entry:
  full url:
    v: https://hl7.org/fhir/ServiceRequest/service1
  resource: service1

patientBSJ1
type: Patient
id:
  v: patientBSJ1
meta:
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Patient-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Patient-eltss
text:
  status:
    v: extensions
  div: Generated Narrative: Patient ResourcePatient "patientBSJ1" Profile: Patient_eltss US Core Race Extension url ombCategory value: White (Details: CDC Race and Ethnicity code 2106-3 = ' White , stated as White ') url text value: White US Core Ethnicity Extension url ombCategory value: Not Hispanic or Latino (Details: CDC Race and Ethnicity code 2186-5 = ' Not Hispanic or Latino , stated as Not Hispanic or Latino ') url text value: Not Hispanic or Latino identifier: Medical Record Number/10A3D58WH1600 (use: usual) active: true name: Betsy Smith-Johnson telecom: ph: 210-222-1111(MOBILE) gender: female birthDate: 1950-11-01 address: 111 Maple Ct, San Antonio, TX 78212 maritalStatus: Not married (MaritalStatus#U "unmarried") contact relationship: Son (RoleCode#SONC), Emergency Contact (contactRole2#C), Guardian (RoleCode#GUARD) name: Charles Johnson telecom: ph: (210) 222-3333 address: 100 Montana St., San Antonio, TX 78203 contact relationship: Daughter (RoleCode#DAUC) name: Debra Johnson telecom: ph: (410) 444-5555 address: 333 W. Camden St., Baltimore, MD 21201 Communications - Language Preferred * US (Tags for the Identification of Languages#en "English") true
extension:
  extension:
    url:
      v: ombCategory
    value: Coding
      system:
        v: urn:oid:2.16.840.1.113883.6.238
      code:
        v: 2106-3
      display:
        v: White
  extension:
    url:
      v: text
    value:
      v: White
  url:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race
extension:
  extension:
    url:
      v: ombCategory
    value: Coding
      system:
        v: urn:oid:2.16.840.1.113883.6.238
      code:
        v: 2186-5
      display:
        v: Not Hispanic or Latino
  extension:
    url:
      v: text
    value:
      v: Not Hispanic or Latino
  url:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
identifier:
  use:
    v: usual
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: MR
      display:
        v: Medical Record Number
  system:
    v: http://hl7.org/fhir/sid/us-medicare
  value:
    v: 10A3D58WH1600
active:
  v: true
name:
  text:
    v: Betsy Smith-Johnson
  family:
    v: Smith-Johnson
  given:
    v: Betsy
telecom:
  system:
    v: phone
  value:
    v: 210-222-1111
  use:
    v: mobile
gender:
  v: female
birth date:
  v: 1950-11-01
address:
  text:
    v: 111 Maple Ct, San Antonio, TX 78212
  line:
    v: 111 Maple Ct
  city:
    v: San Antonio
  district:
    v: Bexar
  state:
    v: TX
  postal code:
    v: 78212
marital status:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/v3-MaritalStatus
    code:
      v: U
    display:
      v: unmarried
  text:
    v: Not married
contact:
  relationship:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v3-RoleCode
      code:
        v: SONC
      display:
        v: Son
  relationship:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0131
      code:
        v: C
      display:
        v: Emergency Contact
  relationship:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v3-RoleCode
      code:
        v: GUARD
      display:
        v: Guardian
  name:
    text:
      v: Charles Johnson
    family:
      v: Johnson
    given:
      v: Charles
  telecom:
    system:
      v: phone
    value:
      v: (210) 222-3333
  address:
    text:
      v: 100 Montana St., San Antonio, TX 78203
contact:
  relationship:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v3-RoleCode
      code:
        v: DAUC
      display:
        v: Daughter
  name:
    text:
      v: Debra Johnson
    family:
      v: Johnson
    given:
      v: Debra
  telecom:
    system:
      v: phone
    value:
      v: (410) 444-5555
  address:
    text:
      v: 333 W. Camden St., Baltimore, MD 21201
communication:
  language:
    coding:
      system:
        v: urn:ietf:bcp:47
      code:
        v: en
      display:
        v: English
    text:
      v: US
  preferred:
    v: true

careplan1
type: CarePlan
id:
  v: careplan1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/CarePlan-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/CarePlan-eltss
text:
  status:
    v: generated
  div: Generated Narrative: CarePlan ResourceCarePlan "careplan1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: CarePlan_eltss status: active intent: plan category: Assessment and Plan of Treatment (US Core CarePlan Category Extension Codes#assess-plan) title: Betsy Smith Johnson's Services and Supports Plan description: A service and support plan that outlines Betsy's assessed needs, goals, strengths, preferences, and services/providers to meet those needs and goals. subject: See on this page: Patient/patientBSJ1 period: 2020-05-01 --> 2020-12-31 author: See on this page: Practitioner/planner1 addresses: See on this page: Condition/need1 See on this page: Condition/need2 See on this page: Condition/need3 See on this page: Condition/need4 supportingInfo: See on this page: Observation/strength1 See on this page: Observation/strength2 See on this page: Observation/pref1 See on this page: QuestionnaireResponse/questionnaireresponse1 See on this page: Contract/contract1 See on this page: RiskAssessment/risk1 goal: See on this page: Goal/goal1 See on this page: Goal/goal2 activity reference: See on this page: ServiceRequest/service1: Service 1 activity reference: See on this page: ServiceRequest/service2: Service 2 activity reference: See on this page: ServiceRequest/service3: Service 3 activity reference: See on this page: ServiceRequest/service4: Service 4 activity progress: Betsy will start doing balance exercises ( @2020-05-10) reference: See on this page: Task/Task1: Task1 activity progress: Betsy working on mobility to dance at son's upcoming wedding ( @2020-05-10) reference: See on this page: Task/Task2: Task2
status:
  v: active
intent:
  v: plan
category:
  coding:
    system:
      v: http://hl7.org/fhir/us/core/CodeSystem/careplan-category
    code:
      v: assess-plan
title:
  v: Betsy Smith Johnson's Services and Supports Plan
description:
  v: A service and support plan that outlines Betsy's assessed needs, goals, strengths, preferences, and services/providers to meet those needs and goals.
subject:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
period:
  start:
    v: 2020-05-01
  end:
    v: 2020-12-31
author:
  link: http://hl7.org/fhir/us/eltss/Practitioner/planner1
  reference:
    v: Practitioner/planner1
addresses:
  link: http://hl7.org/fhir/us/eltss/Condition/need1
  reference:
    v: Condition/need1
addresses:
  link: http://hl7.org/fhir/us/eltss/Condition/need2
  reference:
    v: Condition/need2
addresses:
  link: http://hl7.org/fhir/us/eltss/Condition/need3
  reference:
    v: Condition/need3
addresses:
  link: http://hl7.org/fhir/us/eltss/Condition/need4
  reference:
    v: Condition/need4
supporting info:
  link: http://hl7.org/fhir/us/eltss/Observation/strength1
  reference:
    v: Observation/strength1
supporting info:
  link: http://hl7.org/fhir/us/eltss/Observation/strength2
  reference:
    v: Observation/strength2
supporting info:
  link: http://hl7.org/fhir/us/eltss/Observation/pref1
  reference:
    v: Observation/pref1
supporting info:
  link: http://hl7.org/fhir/us/eltss/QuestionnaireResponse/questionnaireresponse1
  reference:
    v: QuestionnaireResponse/questionnaireresponse1
supporting info:
  link: http://hl7.org/fhir/us/eltss/Contract/contract1
  reference:
    v: Contract/contract1
supporting info:
  link: http://hl7.org/fhir/us/eltss/RiskAssessment/risk1
  reference:
    v: RiskAssessment/risk1
goal:
  link: http://hl7.org/fhir/us/eltss/Goal/goal1
  reference:
    v: Goal/goal1
goal:
  link: http://hl7.org/fhir/us/eltss/Goal/goal2
  reference:
    v: Goal/goal2
activity:
  reference:
    link: http://hl7.org/fhir/us/eltss/ServiceRequest/service1
    reference:
      v: ServiceRequest/service1
    display:
      v: Service 1
activity:
  reference:
    link: http://hl7.org/fhir/us/eltss/ServiceRequest/service2
    reference:
      v: ServiceRequest/service2
    display:
      v: Service 2
activity:
  reference:
    link: http://hl7.org/fhir/us/eltss/ServiceRequest/service3
    reference:
      v: ServiceRequest/service3
    display:
      v: Service 3
activity:
  reference:
    link: http://hl7.org/fhir/us/eltss/ServiceRequest/service4
    reference:
      v: ServiceRequest/service4
    display:
      v: Service 4
activity:
  progress:
    time:
      v: 2020-05-10
    text:
      v: Betsy will start doing balance exercises
  reference:
    link: http://hl7.org/fhir/us/eltss/Task/Task1
    reference:
      v: Task/Task1
    display:
      v: Task1
activity:
  progress:
    time:
      v: 2020-05-10
    text:
      v: Betsy working on mobility to dance at son's upcoming wedding
  reference:
    link: http://hl7.org/fhir/us/eltss/Task/Task2
    reference:
      v: Task/Task2
    display:
      v: Task2

Task1
type: Task
id:
  v: Task1
text:
  status:
    v: extensions
  div: Generated Narrative: Task ResourceTask "Task1" ServiceRequest Pertains To Goal: See on this page: Goal/goal1 status: ready intent: order priority: routine code: Fulfill the focal request (Task Codes#fulfill) description: Perform exercises to improve balance skills. for: See on this page: Patient/patientBSJ1: Betsy requester: See on this page: Practitioner/planner1: Mark Planner owner: See on this page: Patient/patientBSJ1: Betsy
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
  value: Reference
    link: http://hl7.org/fhir/us/eltss/Goal/goal1
    reference:
      v: Goal/goal1
status:
  v: ready
intent:
  v: order
priority:
  v: routine
code:
  coding:
    system:
      v: http://hl7.org/fhir/CodeSystem/task-code
    code:
      v: fulfill
    display:
      v: Fulfill the focal request
description:
  v: Perform exercises to improve balance skills.
for:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
  display:
    v: Betsy
requester:
  link: http://hl7.org/fhir/us/eltss/Practitioner/planner1
  reference:
    v: Practitioner/planner1
  display:
    v: Mark Planner
owner:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
  display:
    v: Betsy

Task2
type: Task
id:
  v: Task2
text:
  status:
    v: extensions
  div: Generated Narrative: Task ResourceTask "Task2" ServiceRequest Pertains To Goal: See on this page: Goal/goal2 status: ready intent: order priority: routine code: Fulfill the focal request (Task Codes#fulfill) description: Son working with Besty to work on mobility to dance at son's upcoming wedding. for: See on this page: Patient/patientBSJ1: Betsy requester: See on this page: Practitioner/planner1: Mark Planner owner: See on this page: RelatedPerson/son1: Charles - Betsy's son
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
  value: Reference
    link: http://hl7.org/fhir/us/eltss/Goal/goal2
    reference:
      v: Goal/goal2
status:
  v: ready
intent:
  v: order
priority:
  v: routine
code:
  coding:
    system:
      v: http://hl7.org/fhir/CodeSystem/task-code
    code:
      v: fulfill
    display:
      v: Fulfill the focal request
description:
  v: Son working with Besty to work on mobility to dance at son's upcoming wedding.
for:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
  display:
    v: Betsy
requester:
  link: http://hl7.org/fhir/us/eltss/Practitioner/planner1
  reference:
    v: Practitioner/planner1
  display:
    v: Mark Planner
owner:
  link: http://hl7.org/fhir/us/eltss/RelatedPerson/son1
  reference:
    v: RelatedPerson/son1
  display:
    v: Charles - Betsy's son

goal2
type: Goal
id:
  v: goal2
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Goal-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Goal-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Goal ResourceGoal "goal2" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Goal_eltss lifecycleStatus: accepted description: Dance at son's upcoming wedding () subject: See on this page: Patient/patientBSJ1
lifecycle status:
  v: accepted
description:
  text:
    v: Dance at son's upcoming wedding
subject:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1

goal1
type: Goal
id:
  v: goal1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Goal-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Goal-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Goal ResourceGoal "goal1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Goal_eltss lifecycleStatus: accepted description: Improve balance skills () subject: See on this page: Patient/patientBSJ1
lifecycle status:
  v: accepted
description:
  text:
    v: Improve balance skills
subject:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1

planner1
type: Practitioner
id:
  v: planner1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Practitioner ResourcePractitioner "planner1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Practitioner_eltss identifier: United States National Provider Identifier/9941339100, http://www.acme.org/practitioners/25456 name: Mark Planner telecom: ph: (210) 555 1221
identifier:
  system:
    v: http://hl7.org/fhir/sid/us-npi
  value:
    v: 9941339100
identifier:
  system:
    v: http://www.acme.org/practitioners
  value:
    v: 25456
name:
  text:
    v: Mark Planner
  family:
    v: Planner
  given:
    v: Mark
telecom:
  system:
    v: phone
  value:
    v: (210) 555 1221

service2
type: ServiceRequest
id:
  v: service2
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/ServiceRequest-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/ServiceRequest-eltss
text:
  status:
    v: generated
  div: Generated Narrative: ServiceRequest ResourceServiceRequest "service2" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: ServiceRequest_eltss status: active intent: plan code: Non-emergency transportation; encounter/trip (Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes#T2003) quantity: 2 trips (Details: NCI Thesaurus codeC141286 = 'Transportation')/1 month (Details: UCUM codemo = 'mo') subject: See on this page: Patient/patientBSJ1 occurrence: 2020-07-01 --> 2020-12-31 performer: See on this page: Organization/provider2a reasonReference: See on this page: Condition/need1 insurance: See on this page: Coverage/coverage1 supportingInfo: See on this page: Claim/claim1 note: Service provider will provide a reminder the business day before the trip, and will call when on the way.
status:
  v: active
intent:
  v: plan
code:
  coding:
    system:
      v: http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets
    code:
      v: T2003
  text:
    v: Non-emergency transportation; encounter/trip
quantity: Ratio
  numerator:
    value:
      v: 2
    unit:
      v: trips
    system:
      v: http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl
    code:
      v: C141286
  denominator:
    value:
      v: 1
    unit:
      v: month
    system:
      v: http://unitsofmeasure.org
    code:
      v: mo
subject:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
occurrence: Period
  start:
    v: 2020-07-01
  end:
    v: 2020-12-31
performer:
  link: http://hl7.org/fhir/us/eltss/Organization/provider2a
  reference:
    v: Organization/provider2a
reason reference:
  link: http://hl7.org/fhir/us/eltss/Condition/need1
  reference:
    v: Condition/need1
insurance:
  link: http://hl7.org/fhir/us/eltss/Coverage/coverage1
  reference:
    v: Coverage/coverage1
supporting info:
  link: http://hl7.org/fhir/us/eltss/Claim/claim1
  reference:
    v: Claim/claim1
note:
  text:
    v: Service provider will provide a reminder the business day before the trip, and will call when on the way.

service3
type: ServiceRequest
id:
  v: service3
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/ServiceRequest-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/ServiceRequest-eltss
text:
  status:
    v: generated
  div: Generated Narrative: ServiceRequest ResourceServiceRequest "service3" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: ServiceRequest_eltss status: active intent: plan code: Diabetes outpatient self-management training services, individual, per 30 minutes (Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes#G0108) quantity: 1 visit (Details: NCI Thesaurus codeC25716 = 'Visit')/1 week (Details: UCUM codewk = 'wk') subject: See on this page: Patient/patientBSJ1 occurrence: 2020-05-01 --> 2020-08-01 performer: See on this page: Practitioner/provider3 reasonReference: See on this page: Condition/need2 supportingInfo: See on this page: Claim/claim2
status:
  v: active
intent:
  v: plan
code:
  coding:
    system:
      v: http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets
    code:
      v: G0108
  text:
    v: Diabetes outpatient self-management training services, individual, per 30 minutes
quantity: Ratio
  numerator:
    value:
      v: 1
    unit:
      v: visit
    system:
      v: http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl
    code:
      v: C25716
  denominator:
    value:
      v: 1
    unit:
      v: week
    system:
      v: http://unitsofmeasure.org
    code:
      v: wk
subject:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
occurrence: Period
  start:
    v: 2020-05-01
  end:
    v: 2020-08-01
performer:
  link: http://hl7.org/fhir/us/eltss/Practitioner/provider3
  reference:
    v: Practitioner/provider3
reason reference:
  link: http://hl7.org/fhir/us/eltss/Condition/need2
  reference:
    v: Condition/need2
supporting info:
  link: http://hl7.org/fhir/us/eltss/Claim/claim2
  reference:
    v: Claim/claim2

service4
type: ServiceRequest
id:
  v: service4
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/ServiceRequest-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/ServiceRequest-eltss
text:
  status:
    v: generated
  div: Generated Narrative: ServiceRequest ResourceServiceRequest "service4" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: ServiceRequest_eltss status: active intent: plan code: therapeutic exercises to improve balance skills (Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes#97110) quantity: 1 visit (Details: NCI Thesaurus codeC25716 = 'Visit')/1 week (Details: UCUM codewk = 'wk') subject: See on this page: Patient/patientBSJ1 occurrence: 2020-05-01 --> 2020-08-01 performer: See on this page: Practitioner/provider4 reasonReference: See on this page: Condition/need1 supportingInfo: See on this page: Goal/goal1 See on this page: Goal/goal2 See on this page: Claim/claim3
status:
  v: active
intent:
  v: plan
code:
  coding:
    system:
      v: http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets
    code:
      v: 97110
  text:
    v: therapeutic exercises to improve balance skills
quantity: Ratio
  numerator:
    value:
      v: 1
    unit:
      v: visit
    system:
      v: http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl
    code:
      v: C25716
  denominator:
    value:
      v: 1
    unit:
      v: week
    system:
      v: http://unitsofmeasure.org
    code:
      v: wk
subject:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
occurrence: Period
  start:
    v: 2020-05-01
  end:
    v: 2020-08-01
performer:
  link: http://hl7.org/fhir/us/eltss/Practitioner/provider4
  reference:
    v: Practitioner/provider4
reason reference:
  link: http://hl7.org/fhir/us/eltss/Condition/need1
  reference:
    v: Condition/need1
supporting info:
  link: http://hl7.org/fhir/us/eltss/Goal/goal1
  reference:
    v: Goal/goal1
supporting info:
  link: http://hl7.org/fhir/us/eltss/Goal/goal2
  reference:
    v: Goal/goal2
supporting info:
  link: http://hl7.org/fhir/us/eltss/Claim/claim3
  reference:
    v: Claim/claim3

son1
type: RelatedPerson
id:
  v: son1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/RelatedPerson-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/RelatedPerson-eltss
text:
  status:
    v: generated
  div: Generated Narrative: RelatedPerson ResourceRelatedPerson "son1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: eLTSS RelatedPerson Profile active: true patient: See on this page: Patient/patientBSJ1 relationship: son (RoleCode#SONC) name: Charles Johnson
active:
  v: true
patient:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
relationship:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/v3-RoleCode
    code:
      v: SONC
name:
  text:
    v: Charles Johnson
  family:
    v: Charles
  given:
    v: Johnson

strength1
type: Observation
id:
  v: strength1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Observation-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Observation-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Observation ResourceObservation "strength1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Observation_eltss status: final category: Social History (Observation Category Codes#social-history) code: Strength (eLTSS Observation Codes#strength) subject: See on this page: Patient/patientBSJ1 effective: 2013-04-02 10:30:10+0100 issued: Apr 3, 2013, 2:30:10 PM performer: See on this page: Practitioner/caremgr1: Care Manager value: Able to manage her bills.
status:
  v: final
category:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/observation-category
    code:
      v: social-history
    display:
      v: Social History
code:
  coding:
    system:
      v: http://hl7.org/fhir/us/eltss/CodeSystem/eltss-observation-codes-temporary
    code:
      v: strength
    display:
      v: Strength
subject:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
effective:
  v: 2013-04-02T10:30:10+01:00
issued:
  v: 2013-04-03T15:30:10+01:00
performer:
  link: http://hl7.org/fhir/us/eltss/Practitioner/caremgr1
  reference:
    v: Practitioner/caremgr1
  display:
    v: Care Manager
value:
  v: Able to manage her bills.

strength2
type: Observation
id:
  v: strength2
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Observation-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Observation-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Observation ResourceObservation "strength2" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Observation_eltss status: final category: Social History (Observation Category Codes#social-history) code: Strength (eLTSS Observation Codes#strength) subject: See on this page: Patient/patientBSJ1 effective: 2013-04-02 10:30:10+0100 issued: Apr 3, 2013, 2:30:10 PM performer: See on this page: Practitioner/caremgr1: Care Manager value: Independent walking with cane.
status:
  v: final
category:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/observation-category
    code:
      v: social-history
    display:
      v: Social History
code:
  coding:
    system:
      v: http://hl7.org/fhir/us/eltss/CodeSystem/eltss-observation-codes-temporary
    code:
      v: strength
    display:
      v: Strength
subject:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
effective:
  v: 2013-04-02T10:30:10+01:00
issued:
  v: 2013-04-03T15:30:10+01:00
performer:
  link: http://hl7.org/fhir/us/eltss/Practitioner/caremgr1
  reference:
    v: Practitioner/caremgr1
  display:
    v: Care Manager
value:
  v: Independent walking with cane.

caremgr1
type: Practitioner
id:
  v: caremgr1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Practitioner ResourcePractitioner "caremgr1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Practitioner_eltss identifier: United States National Provider Identifier/1144221847, http://www.acme.org/practitioners/25457 name: Sam Monitor telecom: ph: (210) 224 1599
identifier:
  system:
    v: http://hl7.org/fhir/sid/us-npi
  value:
    v: 1144221847
identifier:
  system:
    v: http://www.acme.org/practitioners
  value:
    v: 25457
name:
  text:
    v: Sam Monitor
  family:
    v: Monitor
  given:
    v: Sam
telecom:
  system:
    v: phone
  value:
    v: (210) 224 1599

careplan2
type: CarePlan
id:
  v: careplan2
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/CarePlan-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/CarePlan-eltss
text:
  status:
    v: generated
  div: Generated Narrative: CarePlan ResourceCarePlan "careplan2" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: CarePlan_eltss partOf: See on this page: CarePlan/careplan1 status: active intent: plan category: Assessment and Plan of Treatment (US Core CarePlan Category Extension Codes#assess-plan) description: Weather Emergency: A shelf-stable meal is delivered to Meals On Wheels clients. It is to be eaten in the unlikely event of cancellation. Weather meals are donated by the Sheboygan Service Club. subject: See on this page: Patient/patientBSJ1
part of:
  link: http://hl7.org/fhir/us/eltss/CarePlan/careplan1
  reference:
    v: CarePlan/careplan1
status:
  v: active
intent:
  v: plan
category:
  coding:
    system:
      v: http://hl7.org/fhir/us/core/CodeSystem/careplan-category
    code:
      v: assess-plan
description:
  v: Weather Emergency: A shelf-stable meal is delivered to Meals On Wheels clients. It is to be eaten in the unlikely event of cancellation. Weather meals are donated by the Sheboygan Service Club.
subject:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1

claim1
type: Claim
id:
  v: claim1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Claim-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Claim-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Claim ResourceClaim "claim1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Claim_eltss status: active type: Professional (Claim Type Codes#professional) use: claim patient: See on this page: Patient/patientBSJ1 created: 2020-05-01 provider: See on this page: Organization/funding1 priority: Normal (Process Priority Codes#normal) Insurances - Sequence Focal Coverage * 1 true See on this page: Coverage/coverage1 item sequence: 1 productOrService: T2003 (Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes#T2003) UnitPrices - Value Currency * 60 USD Nets - Value Currency * 600 USD
status:
  v: active
type:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/claim-type
    code:
      v: professional
use:
  v: claim
patient:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
created:
  v: 2020-05-01
provider:
  link: http://hl7.org/fhir/us/eltss/Organization/funding1
  reference:
    v: Organization/funding1
priority:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/processpriority
    code:
      v: normal
insurance:
  sequence:
    v: 1
  focal:
    v: true
  coverage:
    link: http://hl7.org/fhir/us/eltss/Coverage/coverage1
    reference:
      v: Coverage/coverage1
item:
  sequence:
    v: 1
  product or service:
    coding:
      system:
        v: http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets
      code:
        v: T2003
  unit price:
    value:
      v: 60
    currency:
      v: USD
  net:
    value:
      v: 600
    currency:
      v: USD

claim2
type: Claim
id:
  v: claim2
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Claim-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Claim-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Claim ResourceClaim "claim2" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Claim_eltss status: active type: Professional (Claim Type Codes#professional) use: claim patient: See on this page: Patient/patientBSJ1 created: 2020-05-01 provider: See on this page: Organization/funding1 priority: Normal (Process Priority Codes#normal) Insurances - Sequence Focal Coverage * 1 true See on this page: Coverage/coverage1 item sequence: 1 productOrService: G0108 (Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes#G0108) UnitPrices - Value Currency * 55 USD Nets - Value Currency * 660 USD
status:
  v: active
type:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/claim-type
    code:
      v: professional
use:
  v: claim
patient:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
created:
  v: 2020-05-01
provider:
  link: http://hl7.org/fhir/us/eltss/Organization/funding1
  reference:
    v: Organization/funding1
priority:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/processpriority
    code:
      v: normal
insurance:
  sequence:
    v: 1
  focal:
    v: true
  coverage:
    link: http://hl7.org/fhir/us/eltss/Coverage/coverage1
    reference:
      v: Coverage/coverage1
item:
  sequence:
    v: 1
  product or service:
    coding:
      system:
        v: http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets
      code:
        v: G0108
  unit price:
    value:
      v: 55
    currency:
      v: USD
  net:
    value:
      v: 660
    currency:
      v: USD

claim3
type: Claim
id:
  v: claim3
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Claim-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Claim-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Claim ResourceClaim "claim3" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Claim_eltss status: active type: Professional (Claim Type Codes#professional) use: claim patient: See on this page: Patient/patientBSJ1 created: 2020-05-01 provider: See on this page: Organization/funding1 priority: Normal (Process Priority Codes#normal) Insurances - Sequence Focal Coverage * 1 true See on this page: Coverage/coverage1 item sequence: 1 productOrService: Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility (Current Procedural Terminology (CPT®)#97110) UnitPrices - Value Currency * 65 USD Nets - Value Currency * 780 USD
status:
  v: active
type:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/claim-type
    code:
      v: professional
use:
  v: claim
patient:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
created:
  v: 2020-05-01
provider:
  link: http://hl7.org/fhir/us/eltss/Organization/funding1
  reference:
    v: Organization/funding1
priority:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/processpriority
    code:
      v: normal
insurance:
  sequence:
    v: 1
  focal:
    v: true
  coverage:
    link: http://hl7.org/fhir/us/eltss/Coverage/coverage1
    reference:
      v: Coverage/coverage1
item:
  sequence:
    v: 1
  product or service:
    coding:
      system:
        v: http://www.ama-assn.org/go/cpt
      code:
        v: 97110
  unit price:
    value:
      v: 65
    currency:
      v: USD
  net:
    value:
      v: 780
    currency:
      v: USD

contract1
type: Contract
id:
  v: contract1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Contract-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Contract-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Contract ResourceContract "contract1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Contract_eltss signer type: Patient (Details: Contract Signer Type Codes code PAT = ' Patient , stated as null ') party: See on this page: Patient/patientBSJ1 Signatures - Type When Who Data * Consent Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.7 = ' Consent Signature , stated as null ') Apr 2, 2020, 3:00:00 AM See on this page: Patient/patientBSJ1 (base64 data - 187 bytes) signer type: Guardian (Details: Contract Signer Type Codes code GUARD = ' Guardian , stated as null ') party: See on this page: RelatedPerson/guardian1 Signatures - Type When Who Data * Consent Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.7 = ' Consent Signature , stated as null ') Apr 2, 2020, 3:00:00 AM See on this page: RelatedPerson/guardian1 (base64 data - 187 bytes) signer type: Author (Details: Contract Signer Type Codes code AUT = ' Author , stated as null ') party: See on this page: Practitioner/planner1 Signatures - Type When Who Data * Author's Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.1 = ' Author's Signature , stated as null ') Apr 2, 2020, 3:00:00 AM See on this page: Practitioner/planner1 (base64 data - 187 bytes) signer type: Co-Author (Details: Contract Signer Type Codes code COAUTH = ' Co-Author , stated as null ') party: See on this page: Practitioner/caremgr1 Signatures - Type When Who Data * Author's Signature (Details: Signature Type Codes code 1.2.840.10065.1.12.1.1 = ' Author's Signature , stated as null ') Apr 2, 2020, 3:00:00 AM See on this page: Practitioner/caremgr1 (base64 data - 187 bytes) signer type: Healthcare Provider (Details: Contract Signer Type Codes code HPROV = ' Healthcare Provider , stated as null ') party: See on this page: Practitioner/provider3 Signatures - Type When Who Data * Consent Signature (Details: Signature Type Codes code 1.2…
signer:
  type:
    system:
      v: http://terminology.hl7.org/CodeSystem/contractsignertypecodes
    code:
      v: PAT
  party:
    link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
    reference:
      v: Patient/patientBSJ1
  signature:
    type:
      system:
        v: urn:iso-astm:E1762-95:2013
      code:
        v: 1.2.840.10065.1.12.1.7
    when:
      v: 2020-04-02T03:00:00Z
    who:
      link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
      reference:
        v: Patient/patientBSJ1
signer:
  type:
    system:
      v: http://terminology.hl7.org/CodeSystem/contractsignertypecodes
    code:
      v: GUARD
  party:
    link: http://hl7.org/fhir/us/eltss/RelatedPerson/guardian1
    reference:
      v: RelatedPerson/guardian1
  signature:
    type:
      system:
        v: urn:iso-astm:E1762-95:2013
      code:
        v: 1.2.840.10065.1.12.1.7
    when:
      v: 2020-04-02T03:00:00Z
    who:
      link: http://hl7.org/fhir/us/eltss/RelatedPerson/guardian1
      reference:
        v: RelatedPerson/guardian1
signer:
  type:
    system:
      v: http://terminology.hl7.org/CodeSystem/contractsignertypecodes
    code:
      v: AUT
  party:
    link: http://hl7.org/fhir/us/eltss/Practitioner/planner1
    reference:
      v: Practitioner/planner1
  signature:
    type:
      system:
        v: urn:iso-astm:E1762-95:2013
      code:
        v: 1.2.840.10065.1.12.1.1
    when:
      v: 2020-04-02T03:00:00Z
    who:
      link: http://hl7.org/fhir/us/eltss/Practitioner/planner1
      reference:
        v: Practitioner/planner1
signer:
  type:
    system:
      v: http://terminology.hl7.org/CodeSystem/contractsignertypecodes
    code:
      v: COAUTH
  party:
    link: http://hl7.org/fhir/us/eltss/Practitioner/caremgr1
    reference:
      v: Practitioner/caremgr1
  signature:
    type:
      system:
        v: urn:iso-astm:E1762-95:2013
      code:
        v: 1.2.840.10065.1.12.1.1
    when:
      v: 2020-04-02T03:00:00Z
    who:
      link: http://hl7.org/fhir/us/eltss/Practitioner/caremgr1
      reference:
        v: Practitioner/caremgr1
signer:
  type:
    system:
      v: http://terminology.hl7.org/CodeSystem/contractsignertypecodes
    code:
      v: HPROV
  party:
    link: http://hl7.org/fhir/us/eltss/Practitioner/provider3
    reference:
      v: Practitioner/provider3
  signature:
    type:
      system:
        v: urn:iso-astm:E1762-95:2013
      code:
        v: 1.2.840.10065.1.12.1.7
    when:
      v: 2020-04-02T03:00:00Z
    who:
      link: http://hl7.org/fhir/us/eltss/Practitioner/provider3
      reference:
        v: Practitioner/provider3
signer:
  type:
    system:
      v: http://terminology.hl7.org/CodeSystem/contractsignertypecodes
    code:
      v: HPROV
  party:
    link: http://hl7.org/fhir/us/eltss/Practitioner/provider2b
    reference:
      v: Practitioner/provider2b
  signature:
    type:
      system:
        v: urn:iso-astm:E1762-95:2013
      code:
        v: 1.2.840.10065.1.12.1.7
    when:
      v: 2020-04-02T03:00:00Z
    who:
      link: http://hl7.org/fhir/us/eltss/Practitioner/provider2b
      reference:
        v: Practitioner/provider2b
signer:
  type:
    system:
      v: http://terminology.hl7.org/CodeSystem/contractsignertypecodes
    code:
      v: HPROV
  party:
    link: http://hl7.org/fhir/us/eltss/RelatedPerson/son1
    reference:
      v: RelatedPerson/son1
  signature:
    type:
      system:
        v: urn:iso-astm:E1762-95:2013
      code:
        v: 1.2.840.10065.1.12.1.7
    when:
      v: 2020-04-02T03:00:00Z
    who:
      link: http://hl7.org/fhir/us/eltss/RelatedPerson/son1
      reference:
        v: RelatedPerson/son1
signer:
  type:
    system:
      v: http://terminology.hl7.org/CodeSystem/contractsignertypecodes
    code:
      v: HPROV
  party:
    link: http://hl7.org/fhir/us/eltss/Practitioner/provider4
    reference:
      v: Practitioner/provider4
  signature:
    type:
      system:
        v: urn:iso-astm:E1762-95:2013
      code:
        v: 1.2.840.10065.1.12.1.7
    when:
      v: 2020-04-02T03:00:00Z
    who:
      link: http://hl7.org/fhir/us/eltss/Practitioner/provider4
      reference:
        v: Practitioner/provider4

coverage1
type: Coverage
id:
  v: coverage1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
text:
  status:
    v: generated
  div: Generated Narrative: Coverage ResourceCoverage "coverage1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! status: active beneficiary: See on this page: Patient/patientBSJ1 payor: See on this page: Organization/funding1
status:
  v: active
beneficiary:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
payor:
  link: http://hl7.org/fhir/us/eltss/Organization/funding1
  reference:
    v: Organization/funding1

episode1
type: EpisodeOfCare
id:
  v: episode1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/EpisodeOfCare-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/EpisodeOfCare-eltss
text:
  status:
    v: generated
  div: Generated Narrative: EpisodeOfCare ResourceEpisodeOfCare "episode1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: EpisodeOfCare_eltss status: active patient: See on this page: Patient/patientBSJ1 careManager: See on this page: Practitioner/caremgr1
status:
  v: active
patient:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
care manager:
  link: http://hl7.org/fhir/us/eltss/Practitioner/caremgr1
  reference:
    v: Practitioner/caremgr1

funding1
type: Organization
id:
  v: funding1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
    link: http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
text:
  status:
    v: generated
  div: Generated Narrative: Organization ResourceOrganization "funding1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: US Core Organization Profile identifier: United States National Provider Identifier/1144221847, <a href="http://terminology.hl7.org/5.5.0/NamingSystem-CLIA.html" title=""The Centers for Medicare & Medicaid Services (CMS) regulates all laboratory testing (except research) performed on humans in the U.S. through the Clinical Laboratory Improvement Amendments (CLIA). In total, CLIA covers approximately 330,000 laboratory entities. The Division of Clinical Laboratory Improvement & Quality, within the Quality, Safety & Oversight Group, under the Center for Clinical Standards and Quality (CCSQ) has the responsibility for implementing the CLIA Program. The objective of the CLIA program is to ensure quality laboratory testing. Although all clinical laboratories must be properly certified to receive Medicare or Medicaid payments, CLIA has no direct Medicare or Medicaid program responsibilities." CMS CLIA certified laboratories will be assigned a10-digit alphanumeric CLIA identification number, with the "D" in the third position identifying the provider/supplier as a laboratory certified under CLIA." CLIA is maintained by CMS. It is in the public domain and free to use without restriction. See http://cms.gov/regulations-and-guidance/legislation/clia.">Clinical Laboratory Improvement Amendments/12D4567890 active: true name: Texas Department of Community Health address: 7430 Louis Pasteur Dr, San Antonio, TX 78229
identifier:
  system:
    v: http://hl7.org/fhir/sid/us-npi
  value:
    v: 1144221847
identifier:
  system:
    v: urn:oid:2.16.840.1.113883.4.7
  value:
    v: 12D4567890
active:
  v: true
name:
  v: Texas Department of Community Health
address:
  text:
    v: 7430 Louis Pasteur Dr, San Antonio, TX 78229

guardian1
type: RelatedPerson
id:
  v: guardian1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/RelatedPerson-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/RelatedPerson-eltss
text:
  status:
    v: generated
  div: Generated Narrative: RelatedPerson ResourceRelatedPerson "guardian1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: eLTSS RelatedPerson Profile active: true patient: See on this page: Patient/patientBSJ1 relationship: guardian (RoleCode#GUARD) name: Charles Johnson
active:
  v: true
patient:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
relationship:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/v3-RoleCode
    code:
      v: GUARD
name:
  text:
    v: Charles Johnson
  family:
    v: Charles
  given:
    v: Johnson

location1
type: Location
id:
  v: location1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Location-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Location-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Location ResourceLocation "location1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Location_eltss name: In Home address: 111 Maple Ct, San Antonio, TX 78212
name:
  v: In Home
address:
  text:
    v: 111 Maple Ct, San Antonio, TX 78212

need1
type: Condition
id:
  v: need1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Condition-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Condition-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Condition ResourceCondition "need1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Condition_eltss clinicalStatus: Active (Condition Clinical Status Codes#active) verificationStatus: Confirmed (ConditionVerificationStatus#confirmed) category: Health Concern (US Core Condition Category Extension Codes#health-concern), Assessed Need (eLTSS Condition Category Codes#assessed-need), SDOH (US Core Category#sdoh) code: Needs transportation (SNOMED CT#713458007 "Lack of access to transportation (finding)") subject: See on this page: Patient/patientBSJ1
clinical status:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/condition-clinical
    code:
      v: active
verification status:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/condition-ver-status
    code:
      v: confirmed
category:
  coding:
    system:
      v: http://hl7.org/fhir/us/core/CodeSystem/condition-category
    code:
      v: health-concern
    display:
      v: Health Concern
category:
  coding:
    system:
      v: http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code
    code:
      v: assessed-need
category:
  coding:
    system:
      v: http://hl7.org/fhir/us/core/CodeSystem/us-core-category
    code:
      v: sdoh
code:
  coding: http://snomed.info/id/713458007
    system:
      v: http://snomed.info/sct
    code:
      v: 713458007
    display:
      v: Lack of access to transportation (finding)
  text:
    v: Needs transportation
subject:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1

need2
type: Condition
id:
  v: need2
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Condition-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Condition-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Condition ResourceCondition "need2" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Condition_eltss clinicalStatus: Active (Condition Clinical Status Codes#active) verificationStatus: Confirmed (ConditionVerificationStatus#confirmed) category: Health Concern (US Core Condition Category Extension Codes#health-concern), Assessed Need (eLTSS Condition Category Codes#assessed-need) code: Needs health / nutrition education for diabetes (SNOMED CT#734920002 "Diabetes mellitus education service") subject: See on this page: Patient/patientBSJ1
clinical status:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/condition-clinical
    code:
      v: active
verification status:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/condition-ver-status
    code:
      v: confirmed
category:
  coding:
    system:
      v: http://hl7.org/fhir/us/core/CodeSystem/condition-category
    code:
      v: health-concern
    display:
      v: Health Concern
category:
  coding:
    system:
      v: http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code
    code:
      v: assessed-need
code:
  coding: http://snomed.info/id/734920002
    system:
      v: http://snomed.info/sct
    code:
      v: 734920002
    display:
      v: Diabetes mellitus education service
  text:
    v: Needs health / nutrition education for diabetes
subject:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1

need3
type: Condition
id:
  v: need3
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Condition-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Condition-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Condition ResourceCondition "need3" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Condition_eltss clinicalStatus: Active (Condition Clinical Status Codes#active) verificationStatus: Confirmed (ConditionVerificationStatus#confirmed) category: Health Concern (US Core Condition Category Extension Codes#health-concern), Assessed Need (eLTSS Condition Category Codes#assessed-need), Cognitive Status (US Core Category#cognitive-status) code: Depression (on treatment) (SNOMED CT#35489007 "Depressive disorder (disorder)") subject: See on this page: Patient/patientBSJ1
clinical status:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/condition-clinical
    code:
      v: active
verification status:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/condition-ver-status
    code:
      v: confirmed
category:
  coding:
    system:
      v: http://hl7.org/fhir/us/core/CodeSystem/condition-category
    code:
      v: health-concern
    display:
      v: Health Concern
category:
  coding:
    system:
      v: http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code
    code:
      v: assessed-need
category:
  coding:
    system:
      v: http://hl7.org/fhir/us/core/CodeSystem/us-core-category
    code:
      v: cognitive-status
code:
  coding: http://snomed.info/id/35489007
    system:
      v: http://snomed.info/sct
    code:
      v: 35489007
    display:
      v: Depressive disorder (disorder)
  text:
    v: Depression (on treatment)
subject:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1

need4
type: Condition
id:
  v: need4
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Condition-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Condition-eltss
text:
  status:
    v: extensions
  div: Generated Narrative: Condition ResourceCondition "need4" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Condition_eltss Condition Due To: See on this page: Condition/need3 clinicalStatus: Active (Condition Clinical Status Codes#active) verificationStatus: Confirmed (ConditionVerificationStatus#confirmed) category: Health Concern (US Core Condition Category Extension Codes#health-concern), Assessed Need (eLTSS Condition Category Codes#assessed-need), SDOH (US Core Category#sdoh) code: Needs physical exercises (SNOMED CT#183301007 "Physical exercises (regime/therapy)") subject: See on this page: Patient/patientBSJ1
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/condition-dueTo
  value: Reference
    link: http://hl7.org/fhir/us/eltss/Condition/need3
    reference:
      v: Condition/need3
clinical status:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/condition-clinical
    code:
      v: active
verification status:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/condition-ver-status
    code:
      v: confirmed
category:
  coding:
    system:
      v: http://hl7.org/fhir/us/core/CodeSystem/condition-category
    code:
      v: health-concern
    display:
      v: Health Concern
category:
  coding:
    system:
      v: http://hl7.org/fhir/us/eltss/CodeSystem/eltss-condition-category-code
    code:
      v: assessed-need
category:
  coding:
    system:
      v: http://hl7.org/fhir/us/core/CodeSystem/us-core-category
    code:
      v: sdoh
code:
  coding: http://snomed.info/id/183301007
    system:
      v: http://snomed.info/sct
    code:
      v: 183301007
    display:
      v: Physical exercises (regime/therapy)
  text:
    v: Needs physical exercises
subject:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1

pref1
type: Observation
id:
  v: pref1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Observation-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Observation-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Observation ResourceObservation "pref1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Observation_eltss status: final category: Social History (Observation Category Codes#social-history) code: Care experience preference (LOINC#95541-9) subject: See on this page: Patient/patientBSJ1 effective: 2013-04-02 10:30:10+0100 issued: Apr 3, 2013, 2:30:10 PM performer: See on this page: Practitioner/caremgr1: Care Manager value: Accessing the ICWP Waiver for her current service needs, and would like to remain on ICWP and continue with her current services.
status:
  v: final
category:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/observation-category
    code:
      v: social-history
    display:
      v: Social History
code:
  coding: https://loinc.org/rdf/95541-9
    system:
      v: http://loinc.org
    code:
      v: 95541-9
    display:
      v: Care experience preference
subject:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
effective:
  v: 2013-04-02T10:30:10+01:00
issued:
  v: 2013-04-03T15:30:10+01:00
performer:
  link: http://hl7.org/fhir/us/eltss/Practitioner/caremgr1
  reference:
    v: Practitioner/caremgr1
  display:
    v: Care Manager
value:
  v: Accessing the ICWP Waiver for her current service needs, and would like to remain on ICWP and continue with her current services.

provider2a
type: Organization
id:
  v: provider2a
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
    link: http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
text:
  status:
    v: generated
  div: Generated Narrative: Organization ResourceOrganization "provider2a" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: US Core Organization Profile identifier: United States National Provider Identifier/1144221847, <a href="http://terminology.hl7.org/5.5.0/NamingSystem-CLIA.html" title=""The Centers for Medicare & Medicaid Services (CMS) regulates all laboratory testing (except research) performed on humans in the U.S. through the Clinical Laboratory Improvement Amendments (CLIA). In total, CLIA covers approximately 330,000 laboratory entities. The Division of Clinical Laboratory Improvement & Quality, within the Quality, Safety & Oversight Group, under the Center for Clinical Standards and Quality (CCSQ) has the responsibility for implementing the CLIA Program. The objective of the CLIA program is to ensure quality laboratory testing. Although all clinical laboratories must be properly certified to receive Medicare or Medicaid payments, CLIA has no direct Medicare or Medicaid program responsibilities." CMS CLIA certified laboratories will be assigned a10-digit alphanumeric CLIA identification number, with the "D" in the third position identifying the provider/supplier as a laboratory certified under CLIA." CLIA is maintained by CMS. It is in the public domain and free to use without restriction. See http://cms.gov/regulations-and-guidance/legislation/clia.">Clinical Laboratory Improvement Amendments/12D4567890 active: true name: The Transporter, Inc. telecom: ph: (210) 555 1313 address: 111 Business Street, San Antonio, TX 78212
identifier:
  system:
    v: http://hl7.org/fhir/sid/us-npi
  value:
    v: 1144221847
identifier:
  system:
    v: urn:oid:2.16.840.1.113883.4.7
  value:
    v: 12D4567890
active:
  v: true
name:
  v: The Transporter, Inc.
telecom:
  system:
    v: phone
  value:
    v: (210) 555 1313
address:
  text:
    v: 111 Business Street, San Antonio, TX 78212

provider2b
type: Practitioner
id:
  v: provider2b
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Practitioner ResourcePractitioner "provider2b" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Practitioner_eltss identifier: http://www.acme.org/practitioners/11223344 name: Bill Driver telecom: ph: (210) 111 2222
identifier:
  system:
    v: http://www.acme.org/practitioners
  value:
    v: 11223344
name:
  text:
    v: Bill Driver
  family:
    v: Driver
  given:
    v: Bill
telecom:
  system:
    v: phone
  value:
    v: (210) 111 2222

provider3
type: Practitioner
id:
  v: provider3
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Practitioner ResourcePractitioner "provider3" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Practitioner_eltss identifier: http://www.acme.org/practitioners/987654 name: Lisa Educator telecom: ph: (210) 555 1213
identifier:
  system:
    v: http://www.acme.org/practitioners
  value:
    v: 987654
name:
  text:
    v: Lisa Educator
  family:
    v: Educator
  given:
    v: Lisa
telecom:
  system:
    v: phone
  value:
    v: (210) 555 1213

provider4
type: Practitioner
id:
  v: provider4
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Practitioner ResourcePractitioner "provider4" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Practitioner_eltss identifier: http://www.acme.org/practitioners/987657 name: Norma Trainer telecom: ph: (210) 555 1214
identifier:
  system:
    v: http://www.acme.org/practitioners
  value:
    v: 987657
name:
  text:
    v: Norma Trainer
  family:
    v: Trainer
  given:
    v: Norma
telecom:
  system:
    v: phone
  value:
    v: (210) 555 1214

PractitionerRole-1
type: PractitionerRole
id:
  v: PractitionerRole-1
meta:
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/PractitionerRole-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/PractitionerRole-eltss
text:
  status:
    v: generated
  div: Generated Narrative: PractitionerRole ResourcePractitionerRole "PractitionerRole-1" Profile: eLTSS PractitionerRole Profile practitioner: See on this page: Practitioner/caremgr1: Sam Monitor organization: See on this page: Organization/funding1: Texas Department of Community Health code: Community Health Worker (provider-taxonomy#172V00000X) specialty: Case Manager/Care Coordinator (provider-taxonomy#171M00000X) location: See on this page: Location/communitysite: Health Level Seven International telecom: ph: (210) 555 1222
practitioner:
  link: http://hl7.org/fhir/us/eltss/Practitioner/caremgr1
  reference:
    v: Practitioner/caremgr1
  display:
    v: Sam Monitor
organization:
  link: http://hl7.org/fhir/us/eltss/Organization/funding1
  reference:
    v: Organization/funding1
  display:
    v: Texas Department of Community Health
code:
  coding:
    system:
      v: http://nucc.org/provider-taxonomy
    code:
      v: 172V00000X
    display:
      v: Community Health Worker
specialty:
  coding:
    system:
      v: http://nucc.org/provider-taxonomy
    code:
      v: 171M00000X
    display:
      v: Case Manager/Care Coordinator
location:
  link: http://hl7.org/fhir/us/eltss/Location/communitysite
  reference:
    v: Location/communitysite
  display:
    v: Health Level Seven International
telecom:
  system:
    v: phone
  value:
    v: (210) 555 1222

communitysite
type: Location
id:
  v: communitysite
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Location-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Location-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Location ResourceLocation "communitysite" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Location_eltss name: In Home address: 7430 Louis Pasteur Dr, San Antonio, TX 78229
name:
  v: In Home
address:
  text:
    v: 7430 Louis Pasteur Dr, San Antonio, TX 78229

questionnaire1
type: Questionnaire
id:
  v: questionnaire1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/Questionnaire-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/Questionnaire-eltss
text:
  status:
    v: generated
  div: Generated Narrative: Questionnaire ResourceQuestionnaire "questionnaire1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: Questionnaire_eltss url: http://hl7.org/fhir/us/eltss/Questionnaire/questionnaire1 identifier: <a href="http://terminology.hl7.org/5.5.0/NamingSystem-uri.html" title="As defined by RFC 3986 (http://www.ietf.org/rfc/rfc3986.txt)(with many schemes defined in many RFCs). For OIDs and UUIDs, use the URN form (urn:oid:(note: lowercase) and urn:uuid:). See http://www.ietf.org/rfc/rfc3001.txt and http://www.ietf.org/rfc/rfc4122.txt This oid is used as an identifier II.root to indicate the the extension is an absolute URI (technically, an IRI). Typically, this is used for OIDs and GUIDs. Note that when this OID is used with OIDs and GUIDs, the II.extension should start with urn:oid or urn:uuid: Note that this OID is created to aid with interconversion between CDA and FHIR - FHIR uses urn:ietf:rfc:3986 as equivalent to this OID. URIs as identifiers appear more commonly in FHIR. This OID may also be used in CD.codeSystem.">Uniform Resource Identifier (URI)/urn:oid:2.999 name: Questionnaire1 status: active item linkId: q1 text: Did you choose the setting in which you reside? type: boolean item linkId: q2 text: What alternative home and community-based settings were considered? type: string item linkId: q3 text: Were you given a choice of services outlined in the plan? type: boolean item linkId: q4 text: Did you participate in the selection of services outlined in the plan? type: boolean item linkId: q5 text: Do you agree to the services outlined in the plan? type: boolean item linkId: q6 text: Were you offered a choice of providers for each service? type: boolean item linkId: q7 text: Do you feel you made an informed choice in selecting the provider for each service? type: boolean
url:
  v: http://hl7.org/fhir/us/eltss/Questionnaire/questionnaire1
identifier:
  system:
    v: urn:ietf:rfc:3986
  value:
    v: urn:oid:2.999
name:
  v: Questionnaire1
status:
  v: active
item:
  link id:
    v: q1
  text:
    v: Did you choose the setting in which you reside?
  type:
    v: boolean
item:
  link id:
    v: q2
  text:
    v: What alternative home and community-based settings were considered?
  type:
    v: string
item:
  link id:
    v: q3
  text:
    v: Were you given a choice of services outlined in the plan?
  type:
    v: boolean
item:
  link id:
    v: q4
  text:
    v: Did you participate in the selection of services outlined in the plan?
  type:
    v: boolean
item:
  link id:
    v: q5
  text:
    v: Do you agree to the services outlined in the plan?
  type:
    v: boolean
item:
  link id:
    v: q6
  text:
    v: Were you offered a choice of providers for each service?
  type:
    v: boolean
item:
  link id:
    v: q7
  text:
    v: Do you feel you made an informed choice in selecting the provider for each service?
  type:
    v: boolean

questionnaireresponse1
type: QuestionnaireResponse
id:
  v: questionnaireresponse1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/QuestionnaireResponse-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/QuestionnaireResponse-eltss
text:
  status:
    v: generated
  div: Generated Narrative: QuestionnaireResponse ResourceQuestionnaireResponse "questionnaireresponse1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: eLTSS QuestionnaireResponse Profile questionnaire: Questionnaire1 status: completed subject: See on this page: Patient/patientBSJ1 authored: 2020-09-03 10:16:03-0400 item linkId: q1 Answers - Value[x] * true item linkId: q2 Answers - Value[x] * Assisted living facility item linkId: q3 Answers - Value[x] * true item linkId: q4 Answers - Value[x] * true item linkId: q5 Answers - Value[x] * true item linkId: q6 Answers - Value[x] * true item linkId: q7 Answers - Value[x] * true
questionnaire:
  v: http://hl7.org/fhir/us/eltss/Questionnaire/questionnaire1
  link: http://hl7.org/fhir/us/eltss/Questionnaire/questionnaire1
status:
  v: completed
subject:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
authored:
  v: 2020-09-03T10:16:03.512-04:00
item:
  link id:
    v: q1
  answer:
    value:
      v: true
item:
  link id:
    v: q2
  answer:
    value:
      v: Assisted living facility
item:
  link id:
    v: q3
  answer:
    value:
      v: true
item:
  link id:
    v: q4
  answer:
    value:
      v: true
item:
  link id:
    v: q5
  answer:
    value:
      v: true
item:
  link id:
    v: q6
  answer:
    value:
      v: true
item:
  link id:
    v: q7
  answer:
    value:
      v: true

risk1
type: RiskAssessment
id:
  v: risk1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/RiskAssessment-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/RiskAssessment-eltss
text:
  status:
    v: extensions
  div: Generated Narrative: RiskAssessment ResourceRiskAssessment "risk1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: RiskAssessment_eltss RiskPlan: : This points to a management plan for any risks. This is not the backup plan, which is an alternative plan for the CarePlan. The risk management plan is meant to help avoid needing the backup plan. status: final subject: See on this page: Patient/patientBSJ1 prediction outcome: At risk for falls (finding) (SNOMED CT#129839007) prediction outcome: At risk of stroke (SNOMED CT#866240007) mitigation: Betsy is at risk for falls and of having a stroke. Her risk is increased due to her depression medication. She has grab bars installed in the shower and is working on her balance with a trainer.
extension:
  url:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/eltss-RiskPlan
  value: Reference
    display:
      v: This points to a management plan for any risks. This is not the backup plan, which is an alternative plan for the CarePlan. The risk management plan is meant to help avoid needing the backup plan.
status:
  v: final
subject:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
prediction:
  outcome:
    coding: http://snomed.info/id/129839007
      system:
        v: http://snomed.info/sct
      code:
        v: 129839007
    text:
      v: At risk for falls (finding)
prediction:
  outcome:
    coding: http://snomed.info/id/866240007
      system:
        v: http://snomed.info/sct
      code:
        v: 866240007
    text:
      v: At risk of stroke
mitigation:
  v: Betsy is at risk for falls and of having a stroke. Her risk is increased due to her depression medication. She has grab bars installed in the shower and is working on her balance with a trainer.

service1
type: ServiceRequest
id:
  v: service1
meta:
  version id:
    v: 1
  last updated:
    v: 2020-09-03T10:16:03.512-04:00
  source:
    v: #KZ0jzPjXDrhCiMif
  profile:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/ServiceRequest-eltss
    link: http://hl7.org/fhir/us/eltss/StructureDefinition/ServiceRequest-eltss
text:
  status:
    v: extensions
  div: Generated Narrative: ServiceRequest ResourceServiceRequest "service1" Version"1" Updated"2020-09-03 10:16:03-0400" Information Source: #KZ0jzPjXDrhCiMif! Profile: ServiceRequest_eltss Eltss_directedBy: self () status: active intent: plan code: Bath tub wall rail, each (Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes#E0241) quantity: 1 install (Details: NCI Thesaurus codeC81906 = 'Deploy') subject: See on this page: Patient/patientBSJ1 occurrence: 2020-05-01 --> 2020-12-31 performer: See on this page: RelatedPerson/son1 locationReference: See on this page: Location/location1 supportingInfo: See on this page: RiskAssessment/risk1
extension:
  url:
    v: http://hl7.org/fhir/us/eltss/StructureDefinition/eltss-directedBy
  value: CodeableConcept
    text:
      v: self
status:
  v: active
intent:
  v: plan
code:
  coding:
    system:
      v: http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets
    code:
      v: E0241
  text:
    v: Bath tub wall rail, each
quantity: Quantity
  value:
    v: 1
  unit:
    v: install
  system:
    v: http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl
  code:
    v: C81906
subject:
  link: http://hl7.org/fhir/us/eltss/Patient/patientBSJ1
  reference:
    v: Patient/patientBSJ1
occurrence: Period
  start:
    v: 2020-05-01
  end:
    v: 2020-12-31
performer:
  link: http://hl7.org/fhir/us/eltss/RelatedPerson/son1
  reference:
    v: RelatedPerson/son1
location reference:
  link: http://hl7.org/fhir/us/eltss/Location/location1
  reference:
    v: Location/location1
supporting info:
  link: http://hl7.org/fhir/us/eltss/RiskAssessment/risk1
  reference:
    v: RiskAssessment/risk1