Such characteristics include, but are not limited to, type of residence (trailer, single family home, assisted living), living arrangement (e.g., alone, with parents), and housing status (e.g., evicted, homeless, home owner). Congregate living situations would be represented in this profile - such shared housing includes a broad range of settings, such as apartments, condominiums, student or faculty housing, national and state park staff housing, transitional housing, and domestic violence and abuse shelters.

It is based on the US Core Simple Observation Profile profile and further constrains it:

• sets Observation.category to "sdoh

  social determinants of health"

• sets Observation.code to "Characteristics of residence"
• further constrains Observation.subject to the US Public Health Patient
• binds Observation.value[x] to the Residence Accommodation Type value set

Represented USCDI+ Data Elements

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	USCoreSimpleObservationProfile(6.1.0)	US Public Health Characteristics of Home Environment Constraints: obs-6, obs-7
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
status	?!SΣ	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: sdoh
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:us-core	S	0..*	CodeableConcept	(USCDI) Classification of type of observation Binding: USCoreSimpleObservationCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	SΣ	1..1	CodeableConcept	(USCDI) Type of observation (code / type) Binding: LOINCCodes (preferred) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 75274-1
display		1..1	string	Representation defined by the system Fixed Value: Characteristics of residence
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(US Public Health Patient(2.0.0) | US Core Patient Profile(6.1.0))	(USCDI) Who and/or what the observation is about
effective[x]	SΣ	0..1		(USCDI) Clinically relevant time/time-period for observation
effectiveDateTime			dateTime S
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
performer	SΣ	0..*	Reference(US Core Practitioner Profile(6.1.0) | US Core Organization Profile(6.1.0) | US Core Patient Profile(6.1.0) | PractitionerRole | US Core CareTeam Profile(6.1.0) | US Core RelatedPerson Profile(6.1.0))	(USCDI) Who is responsible for the observation
value[x]	SΣC	1..1	CodeableConcept S	(USCDI+) Congregate Living, (USCDI+) Housing Instability, Homeless Binding: ResidenceAndAccommodationType (20240606) (extensible): Residence and Accommodation Type
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.category:us-core	Base	required	US Core Simple Observation Category	📍6.1.0	US Core v6.1
Observation.code	Base	preferred	LOINC Codes	📍4.0.1	FHIR Std.
Observation.value[x]	Base	extensible	Residence and Accommodation Type	📍20240606	VSAC v0.23

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	Observation.implicitRules, Observation.modifierExtension, Observation.status, Observation.category, Observation.category:us-core, Observation.code, Observation.subject, Observation.effective[x], Observation.performer, Observation.value[x]	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	Observation.modifierExtension	Must have either extensions or value[x], not both	extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present	dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation		0..*	USCoreSimpleObservationProfile(6.1.0)	US Public Health Characteristics of Home Environment
category		1..*	CodeableConcept	(USCDI) Classification of type of observation Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: sdoh
code		1..1	CodeableConcept	(USCDI) Type of observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 75274-1
display		1..1	string	Representation defined by the system Fixed Value: Characteristics of residence
subject		1..1	Reference(US Public Health Patient(2.0.0) | US Core Patient Profile(6.1.0))	(USCDI) Who and/or what the observation is about
value[x]		1..1	CodeableConcept	(USCDI+) Congregate Living, (USCDI+) Housing Instability, Homeless Binding: ResidenceAndAccommodationType (20240606) (extensible): Residence and Accommodation Type
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.value[x]	Base	extensible	Residence and Accommodation Type	📍20240606	VSAC v0.23

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	USCoreSimpleObservationProfile(6.1.0)	US Public Health Characteristics of Home Environment Constraints: obs-6, obs-7
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: sdoh
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:us-core	S	0..*	CodeableConcept	(USCDI) Classification of type of observation Binding: USCoreSimpleObservationCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	SΣ	1..1	CodeableConcept	(USCDI) Type of observation (code / type) Binding: LOINCCodes (preferred) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 75274-1
display		1..1	string	Representation defined by the system Fixed Value: Characteristics of residence
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(US Public Health Patient(2.0.0) | US Core Patient Profile(6.1.0))	(USCDI) Who and/or what the observation is about
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣ	0..1		(USCDI) Clinically relevant time/time-period for observation
effectiveDateTime			dateTime S
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(US Core Practitioner Profile(6.1.0) | US Core Organization Profile(6.1.0) | US Core Patient Profile(6.1.0) | PractitionerRole | US Core CareTeam Profile(6.1.0) | US Core RelatedPerson Profile(6.1.0))	(USCDI) Who is responsible for the observation
value[x]	SΣC	1..1	CodeableConcept S	(USCDI+) Congregate Living, (USCDI+) Housing Instability, Homeless Binding: ResidenceAndAccommodationType (20240606) (extensible): Residence and Accommodation Type
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation Constraints: obs-3
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
low	C	0..1	SimpleQuantity(4.0.1)	Low Range, if relevant
high	C	0..1	SimpleQuantity(4.0.1)	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(Observation | US Core DocumentReference Profile(6.1.0) | US Core QuestionnaireResponse Profile(6.1.0) | ImagingStudy | Media | MolecularSequence)	(USCDI) US Core Profiles or other resource the observation is made from
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.category:us-core	Base	required	US Core Simple Observation Category	📍6.1.0	US Core v6.1
Observation.code	Base	preferred	LOINC Codes	📍4.0.1	FHIR Std.
Observation.value[x]	Base	extensible	Residence and Accommodation Type	📍20240606	VSAC v0.23
Observation.dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.bodySite	Base	example	SNOMED CT Body Structures	📍4.0.1	FHIR Std.
Observation.method	Base	example	Observation Methods	📍4.0.1	FHIR Std.
Observation.referenceRange.​type	Base	preferred	Observation Reference Range Meaning Codes	📍4.0.1	FHIR Std.
Observation.referenceRange.​appliesTo	Base	example	Observation Reference Range Applies To Codes	📍4.0.1	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	Observation.meta, Observation.implicitRules, Observation.language, Observation.text, Observation.extension, Observation.modifierExtension, Observation.identifier, Observation.basedOn, Observation.partOf, Observation.status, Observation.category, Observation.category:us-core, Observation.code, Observation.subject, Observation.focus, Observation.encounter, Observation.effective[x], Observation.issued, Observation.performer, Observation.value[x], Observation.dataAbsentReason, Observation.interpretation, Observation.note, Observation.bodySite, Observation.method, Observation.specimen, Observation.device, Observation.referenceRange, Observation.referenceRange.extension, Observation.referenceRange.modifierExtension, Observation.referenceRange.low, Observation.referenceRange.high, Observation.referenceRange.type, Observation.referenceRange.appliesTo, Observation.referenceRange.age, Observation.referenceRange.text, Observation.hasMember, Observation.derivedFrom, Observation.component, Observation.component.extension, Observation.component.modifierExtension, Observation.component.code, Observation.component.value[x], Observation.component.dataAbsentReason, Observation.component.interpretation, Observation.component.referenceRange	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	Observation.extension, Observation.modifierExtension, Observation.referenceRange.extension, Observation.referenceRange.modifierExtension, Observation.component.extension, Observation.component.modifierExtension	Must have either extensions or value[x], not both	extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text	low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present	dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	USCoreSimpleObservationProfile(6.1.0)	US Public Health Characteristics of Home Environment Constraints: obs-6, obs-7
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
status	?!SΣ	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: sdoh
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:us-core	S	0..*	CodeableConcept	(USCDI) Classification of type of observation Binding: USCoreSimpleObservationCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	SΣ	1..1	CodeableConcept	(USCDI) Type of observation (code / type) Binding: LOINCCodes (preferred) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 75274-1
display		1..1	string	Representation defined by the system Fixed Value: Characteristics of residence
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(US Public Health Patient(2.0.0) | US Core Patient Profile(6.1.0))	(USCDI) Who and/or what the observation is about
effective[x]	SΣ	0..1		(USCDI) Clinically relevant time/time-period for observation
effectiveDateTime			dateTime S
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
performer	SΣ	0..*	Reference(US Core Practitioner Profile(6.1.0) | US Core Organization Profile(6.1.0) | US Core Patient Profile(6.1.0) | PractitionerRole | US Core CareTeam Profile(6.1.0) | US Core RelatedPerson Profile(6.1.0))	(USCDI) Who is responsible for the observation
value[x]	SΣC	1..1	CodeableConcept S	(USCDI+) Congregate Living, (USCDI+) Housing Instability, Homeless Binding: ResidenceAndAccommodationType (20240606) (extensible): Residence and Accommodation Type
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.category:us-core	Base	required	US Core Simple Observation Category	📍6.1.0	US Core v6.1
Observation.code	Base	preferred	LOINC Codes	📍4.0.1	FHIR Std.
Observation.value[x]	Base	extensible	Residence and Accommodation Type	📍20240606	VSAC v0.23

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	Observation.implicitRules, Observation.modifierExtension, Observation.status, Observation.category, Observation.category:us-core, Observation.code, Observation.subject, Observation.effective[x], Observation.performer, Observation.value[x]	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	Observation.modifierExtension	Must have either extensions or value[x], not both	extension.exists() != value.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present	dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Differential View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation		0..*	USCoreSimpleObservationProfile(6.1.0)	US Public Health Characteristics of Home Environment
category		1..*	CodeableConcept	(USCDI) Classification of type of observation Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: sdoh
code		1..1	CodeableConcept	(USCDI) Type of observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 75274-1
display		1..1	string	Representation defined by the system Fixed Value: Characteristics of residence
subject		1..1	Reference(US Public Health Patient(2.0.0) | US Core Patient Profile(6.1.0))	(USCDI) Who and/or what the observation is about
value[x]		1..1	CodeableConcept	(USCDI+) Congregate Living, (USCDI+) Housing Instability, Homeless Binding: ResidenceAndAccommodationType (20240606) (extensible): Residence and Accommodation Type
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.value[x]	Base	extensible	Residence and Accommodation Type	📍20240606	VSAC v0.23

Snapshot ViewView

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	USCoreSimpleObservationProfile(6.1.0)	US Public Health Characteristics of Home Environment Constraints: obs-6, obs-7
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/us-core-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: sdoh
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:us-core	S	0..*	CodeableConcept	(USCDI) Classification of type of observation Binding: USCoreSimpleObservationCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	SΣ	1..1	CodeableConcept	(USCDI) Type of observation (code / type) Binding: LOINCCodes (preferred) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 75274-1
display		1..1	string	Representation defined by the system Fixed Value: Characteristics of residence
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(US Public Health Patient(2.0.0) | US Core Patient Profile(6.1.0))	(USCDI) Who and/or what the observation is about
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣ	0..1		(USCDI) Clinically relevant time/time-period for observation
effectiveDateTime			dateTime S
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(US Core Practitioner Profile(6.1.0) | US Core Organization Profile(6.1.0) | US Core Patient Profile(6.1.0) | PractitionerRole | US Core CareTeam Profile(6.1.0) | US Core RelatedPerson Profile(6.1.0))	(USCDI) Who is responsible for the observation
value[x]	SΣC	1..1	CodeableConcept S	(USCDI+) Congregate Living, (USCDI+) Housing Instability, Homeless Binding: ResidenceAndAccommodationType (20240606) (extensible): Residence and Accommodation Type
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation Constraints: obs-3
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
low	C	0..1	SimpleQuantity(4.0.1)	Low Range, if relevant
high	C	0..1	SimpleQuantity(4.0.1)	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(Observation | US Core DocumentReference Profile(6.1.0) | US Core QuestionnaireResponse Profile(6.1.0) | ImagingStudy | Media | MolecularSequence)	(USCDI) US Core Profiles or other resource the observation is made from
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.category:us-core	Base	required	US Core Simple Observation Category	📍6.1.0	US Core v6.1
Observation.code	Base	preferred	LOINC Codes	📍4.0.1	FHIR Std.
Observation.value[x]	Base	extensible	Residence and Accommodation Type	📍20240606	VSAC v0.23
Observation.dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.bodySite	Base	example	SNOMED CT Body Structures	📍4.0.1	FHIR Std.
Observation.method	Base	example	Observation Methods	📍4.0.1	FHIR Std.
Observation.referenceRange.​type	Base	preferred	Observation Reference Range Meaning Codes	📍4.0.1	FHIR Std.
Observation.referenceRange.​appliesTo	Base	example	Observation Reference Range Applies To Codes	📍4.0.1	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	Observation.meta, Observation.implicitRules, Observation.language, Observation.text, Observation.extension, Observation.modifierExtension, Observation.identifier, Observation.basedOn, Observation.partOf, Observation.status, Observation.category, Observation.category:us-core, Observation.code, Observation.subject, Observation.focus, Observation.encounter, Observation.effective[x], Observation.issued, Observation.performer, Observation.value[x], Observation.dataAbsentReason, Observation.interpretation, Observation.note, Observation.bodySite, Observation.method, Observation.specimen, Observation.device, Observation.referenceRange, Observation.referenceRange.extension, Observation.referenceRange.modifierExtension, Observation.referenceRange.low, Observation.referenceRange.high, Observation.referenceRange.type, Observation.referenceRange.appliesTo, Observation.referenceRange.age, Observation.referenceRange.text, Observation.hasMember, Observation.derivedFrom, Observation.component, Observation.component.extension, Observation.component.modifierExtension, Observation.component.code, Observation.component.value[x], Observation.component.dataAbsentReason, Observation.component.interpretation, Observation.component.referenceRange	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	Observation.extension, Observation.modifierExtension, Observation.referenceRange.extension, Observation.referenceRange.modifierExtension, Observation.component.extension, Observation.component.modifierExtension	Must have either extensions or value[x], not both	extension.exists() != value.exists()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text	low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present	dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

• US Public Health Patient (http://hl7.org/fhir/us/ph-library/StructureDefinition/us-ph-patient|2.0.0)
• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|6.1.0)

Maturity: 3