Vital Records Death Reporting (VRDR) FHIR Implementation Guide
0.0.0-current - ci-build International flag

Vital Records Death Reporting (VRDR) FHIR Implementation Guide, published by IHE Quality, Research and Public Health Technical Committee. This guide is not an authorized publication; it is the continuous build for version 0.0.0-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/QRPH.VRDR/ and changes regularly. See the Directory of published versions

Resource Profile: DispositionLocation - Detailed Descriptions

Active as of 2024-03-11

Definitions for the vrdr-disposition-location resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Location
2. Location.name
ShortName of Disposition Location
4. Location.type
Control1..1
Pattern Value{
  "coding" : [{
    "system" : "http://profiles.ihe.net/QRPH/VRDR/CodeSystem/vrdr-location-type-cs",
    "code" : "disposition"
  }]
}
6. Location.address
Control1..?
8. Location.address.city
10. Location.address.city.extension
SlicingThis element introduces a set of slices on Location.address.city.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 12. Location.address.city.extension:cityCode
    Slice NamecityCode
    Definition

    Numeric code from in accordance with the NCHS Instruction Manual Part 8, Vital Records Geographic Classification, 2014 (https://www.cdc.gov/nchs/data/dvs/IMP8_2014.pdf) and https://ftp.cdc.gov/pub/health_Statistics/nchs/Manuals/Mortality/PLACE_CODES.txt.

    ShortCity Code
    Control0..1
    TypeExtension(City Code) (Extension Type: positiveInt)
    LabelCity Code
    14. Location.address.district
    16. Location.address.district.extension
    SlicingThis element introduces a set of slices on Location.address.district.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 18. Location.address.district.extension:districtCode
      Slice NamedistrictCode
      Definition

      Numeric code in accordance with the NCHS Instruction Manual Part 8, Vital Records Geographic Classification, 2014 (https://www.cdc.gov/nchs/data/dvs/IMP8_2014.pdf) and https://ftp.cdc.gov/pub/health_Statistics/nchs/Manuals/Mortality/PLACE_CODES.txt.

      ShortCounty code
      Control0..1
      TypeExtension(District Code) (Extension Type: positiveInt)
      LabelCounty code
      20. Location.address.state
      BindingFor example codes, see States, Territories and Provinces Value Set
      (example to http://profiles.ihe.net/QRPH/VRDR/ValueSet/vrdr-states-territories-provinces-vs)

      Guidance on how to interpret the contents of this table can be found here

      0. Location
      Definition

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

      ShortDetails and position information for a physical place
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. Location.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      4. Location.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      6. Location.status
      Definition

      The status property covers the general availability of the resource, not the current value which may be covered by the operationStatus, or by a schedule/slots if they are configured for the location.

      Shortactive | suspended | inactive
      Control0..1
      BindingThe codes SHALL be taken from LocationStatushttp://hl7.org/fhir/ValueSet/location-status|4.0.1
      (required to http://hl7.org/fhir/ValueSet/location-status|4.0.1)

      Indicates whether the location is still in use.

      Typecode
      Is Modifiertrue because This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. Location.name
      Definition

      Name of the location as used by humans. Does not need to be unique.

      ShortName of Disposition LocationName of the location as used by humans
      Comments

      If the name of a location changes, consider putting the old name in the alias column so that it can still be located through searches.

      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Location.type
      Definition

      Indicates the type of function performed at the location.

      ShortType of function performed
      Control10..1*
      BindingUnless not suitable, these codes SHALL be taken from ServiceDeliveryLocationRoleTypehttp://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType
      (extensible to http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType)

      Indicates the type of function performed at the location.

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Pattern Value{
        "coding" : [{
          "system" : "http://profiles.ihe.net/QRPH/VRDR/CodeSystem/vrdr-location-type-cs",
          "code" : "disposition"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Location.address
      Definition

      Physical location.

      ShortPhysical location
      Comments

      Additional addresses should be recorded using another instance of the Location resource, or via the Organization.

      Control10..1
      TypeAddress
      Is Modifierfalse
      Summaryfalse
      Requirements

      If locations can be visited, we need to keep track of their address.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. Location.address.use
      Definition

      The purpose of this address.

      Shorthome | work | temp | old | billing - purpose of this address
      Comments

      Applications can assume that an address is current unless it explicitly says that it is temporary or old.

      Control0..1
      BindingThe codes SHALL be taken from AddressUsehttp://hl7.org/fhir/ValueSet/address-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

      The use of an address.

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Allows an appropriate address to be chosen from a list of many.

      Example<br/><b>General</b>:home
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. Location.address.state
      Definition

      Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

      ShortSub-unit of country (abbreviations ok)
      Control0..1
      BindingFor example codes, see For codes, see States, Territories and Provinces Value Set
      (example to http://profiles.ihe.net/QRPH/VRDR/ValueSet/vrdr-states-territories-provinces-vs)
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Alternate NamesProvince, Territory
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Guidance on how to interpret the contents of this table can be found here

      0. Location
      Definition

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

      ShortDetails and position information for a physical place
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. Location.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. Location.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. Location.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. Location.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Location.text
      Definition

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Location.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

      ShortContained, inline Resources
      Comments

      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

      Control0..*
      TypeResource
      Is Modifierfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. Location.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      16. Location.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      18. Location.identifier
      Definition

      Unique code or number identifying the location to its users.

      ShortUnique code or number identifying the location to its users
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Summarytrue
      Requirements

      Organization label locations in registries, need to keep track of those.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. Location.status
      Definition

      The status property covers the general availability of the resource, not the current value which may be covered by the operationStatus, or by a schedule/slots if they are configured for the location.

      Shortactive | suspended | inactive
      Control0..1
      BindingThe codes SHALL be taken from LocationStatus
      (required to http://hl7.org/fhir/ValueSet/location-status|4.0.1)

      Indicates whether the location is still in use.

      Typecode
      Is Modifiertrue because This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Location.operationalStatus
      Definition

      The operational status covers operation values most relevant to beds (but can also apply to rooms/units/chairs/etc. such as an isolation unit/dialysis chair). This typically covers concepts such as contamination, housekeeping, and other activities like maintenance.

      ShortThe operational status of the location (typically only for a bed/room)
      Control0..1
      BindingThe codes SHOULD be taken from hl7VS-bedStatus
      (preferred to http://terminology.hl7.org/ValueSet/v2-0116)

      The operational status if the location (where typically a bed/room).

      TypeCoding
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. Location.name
      Definition

      Name of the location as used by humans. Does not need to be unique.

      ShortName of Disposition Location
      Comments

      If the name of a location changes, consider putting the old name in the alias column so that it can still be located through searches.

      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. Location.alias
      Definition

      A list of alternate names that the location is known as, or was known as, in the past.

      ShortA list of alternate names that the location is known as, or was known as, in the past
      Comments

      There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the location.

      Control0..*
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Requirements

      Over time locations and organizations go through many changes and can be known by different names.

      For searching knowing previous names that the location was known by can be very useful.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. Location.description
      Definition

      Description of the Location, which helps in finding or referencing the place.

      ShortAdditional details about the location that could be displayed as further information to identify the location beyond its name
      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Humans need additional information to verify a correct location has been identified.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. Location.mode
      Definition

      Indicates whether a resource instance represents a specific location or a class of locations.

      Shortinstance | kind
      Comments

      This is labeled as a modifier because whether or not the location is a class of locations changes how it can be used and understood.

      Control0..1
      BindingThe codes SHALL be taken from LocationMode
      (required to http://hl7.org/fhir/ValueSet/location-mode|4.0.1)

      Indicates whether a resource instance represents a specific location or a class of locations.

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      When using a Location resource for scheduling or orders, we need to be able to refer to a class of Locations instead of a specific Location.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. Location.type
      Definition

      Indicates the type of function performed at the location.

      ShortType of function performed
      Control1..1
      BindingUnless not suitable, these codes SHALL be taken from ServiceDeliveryLocationRoleType
      (extensible to http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType)

      Indicates the type of function performed at the location.

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Pattern Value{
        "coding" : [{
          "system" : "http://profiles.ihe.net/QRPH/VRDR/CodeSystem/vrdr-location-type-cs",
          "code" : "disposition"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. Location.telecom
      Definition

      The contact details of communication devices available at the location. This can include phone numbers, fax numbers, mobile numbers, email addresses and web sites.

      ShortContact details of the location
      Control0..*
      TypeContactPoint
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. Location.address
      Definition

      Physical location.

      ShortPhysical location
      Comments

      Additional addresses should be recorded using another instance of the Location resource, or via the Organization.

      Control1..1
      TypeAddress
      Is Modifierfalse
      Summaryfalse
      Requirements

      If locations can be visited, we need to keep track of their address.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. Location.address.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      40. Location.address.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Location.address.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 42. Location.address.use
        Definition

        The purpose of this address.

        Shorthome | work | temp | old | billing - purpose of this address
        Comments

        Applications can assume that an address is current unless it explicitly says that it is temporary or old.

        Control0..1
        BindingThe codes SHALL be taken from AddressUse
        (required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

        The use of an address.

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Allows an appropriate address to be chosen from a list of many.

        Example<br/><b>General</b>:home
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. Location.address.type
        Definition

        Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

        Shortpostal | physical | both
        Comments

        The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

        Control0..1
        BindingThe codes SHALL be taken from AddressType
        (required to http://hl7.org/fhir/ValueSet/address-type|4.0.1)

        The type of an address (physical / postal).

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Example<br/><b>General</b>:both
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. Location.address.text
        Definition

        Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

        ShortText representation of the address
        Comments

        Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        A renderable, unencoded form.

        Example<br/><b>General</b>:137 Nowhere Street, Erewhon 9132
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. Location.address.line
        Definition

        This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

        ShortStreet name, number, direction & P.O. Box etc.
        Control0..*
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Example<br/><b>General</b>:137 Nowhere Street
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. Location.address.city
        Definition

        The name of the city, town, suburb, village or other community or delivery center.

        ShortName of city, town etc.
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Alternate NamesMunicpality
        Example<br/><b>General</b>:Erewhon
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. Location.address.city.id
        Definition

        unique id for the element within a resource (for internal references)

        Shortxml:id (or equivalent in JSON)
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        54. Location.address.city.extension
        Definition

        An Extension

        ShortExtension
        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Location.address.city.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 56. Location.address.city.extension:cityCode
          Slice NamecityCode
          Definition

          Numeric code from in accordance with the NCHS Instruction Manual Part 8, Vital Records Geographic Classification, 2014 (https://www.cdc.gov/nchs/data/dvs/IMP8_2014.pdf) and https://ftp.cdc.gov/pub/health_Statistics/nchs/Manuals/Mortality/PLACE_CODES.txt.

          ShortCity Code
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(City Code) (Extension Type: positiveInt)
          Is Modifierfalse
          LabelCity Code
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          58. Location.address.city.value
          Definition

          The actual value

          ShortPrimitive value for string
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Max Length1048576
          60. Location.address.district
          Definition

          The name of the administrative area (county).

          ShortDistrict name (aka county)
          Comments

          District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Alternate NamesCounty
          Example<br/><b>General</b>:Madison
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          62. Location.address.district.id
          Definition

          unique id for the element within a resource (for internal references)

          Shortxml:id (or equivalent in JSON)
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          64. Location.address.district.extension
          Definition

          An Extension

          ShortExtension
          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Location.address.district.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 66. Location.address.district.extension:districtCode
            Slice NamedistrictCode
            Definition

            Numeric code in accordance with the NCHS Instruction Manual Part 8, Vital Records Geographic Classification, 2014 (https://www.cdc.gov/nchs/data/dvs/IMP8_2014.pdf) and https://ftp.cdc.gov/pub/health_Statistics/nchs/Manuals/Mortality/PLACE_CODES.txt.

            ShortCounty code
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(District Code) (Extension Type: positiveInt)
            Is Modifierfalse
            LabelCounty code
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            68. Location.address.district.value
            Definition

            The actual value

            ShortPrimitive value for string
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            Max Length1048576
            70. Location.address.state
            Definition

            Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

            ShortSub-unit of country (abbreviations ok)
            Control0..1
            BindingFor example codes, see States, Territories and Provinces Value Set
            (example to http://profiles.ihe.net/QRPH/VRDR/ValueSet/vrdr-states-territories-provinces-vs)
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Alternate NamesProvince, Territory
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            72. Location.address.postalCode
            Definition

            A postal code designating a region defined by the postal service.

            ShortPostal code for area
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Alternate NamesZip
            Example<br/><b>General</b>:9132
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            74. Location.address.country
            Definition

            Country - a nation as commonly understood or generally accepted.

            ShortCountry (e.g. can be ISO 3166 2 or 3 letter code)
            Comments

            ISO 3166 3 letter codes can be used in place of a human readable country name.

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            76. Location.address.period
            Definition

            Time period when address was/is in use.

            ShortTime period when address was/is in use
            Control0..1
            TypePeriod
            Is Modifierfalse
            Summarytrue
            Requirements

            Allows addresses to be placed in historical context.

            Example<br/><b>General</b>:{ "start" : "2010-03-23", "end" : "2010-07-01" }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            78. Location.physicalType
            Definition

            Physical form of the location, e.g. building, room, vehicle, road.

            ShortPhysical form of the location
            Control0..1
            BindingFor example codes, see LocationType
            (example to http://hl7.org/fhir/ValueSet/location-physical-type)

            Physical form of the location.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            For purposes of showing relevant locations in queries, we need to categorize locations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            80. Location.position
            Definition

            The absolute geographic location of the Location, expressed using the WGS84 datum (This is the same co-ordinate system used in KML).

            ShortThe absolute geographic location
            Control0..1
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Requirements

            For mobile applications and automated route-finding knowing the exact location of the Location is required.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            82. Location.position.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            84. Location.position.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            86. Location.position.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            88. Location.position.longitude
            Definition

            Longitude. The value domain and the interpretation are the same as for the text of the longitude element in KML (see notes below).

            ShortLongitude with WGS84 datum
            Control1..1
            Typedecimal
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            90. Location.position.latitude
            Definition

            Latitude. The value domain and the interpretation are the same as for the text of the latitude element in KML (see notes below).

            ShortLatitude with WGS84 datum
            Control1..1
            Typedecimal
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            92. Location.position.altitude
            Definition

            Altitude. The value domain and the interpretation are the same as for the text of the altitude element in KML (see notes below).

            ShortAltitude with WGS84 datum
            Control0..1
            Typedecimal
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            94. Location.managingOrganization
            Definition

            The organization responsible for the provisioning and upkeep of the location.

            ShortOrganization responsible for provisioning and upkeep
            Comments

            This can also be used as the part of the organization hierarchy where this location provides services. These services can be defined through the HealthcareService resource.

            Control0..1
            TypeReference(Organization)
            Is Modifierfalse
            Summarytrue
            Requirements

            Need to know who manages the location.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            96. Location.partOf
            Definition

            Another Location of which this Location is physically a part of.

            ShortAnother Location this one is physically a part of
            Control0..1
            TypeReference(Location)
            Is Modifierfalse
            Summaryfalse
            Requirements

            For purposes of location, display and identification, knowing which locations are located within other locations is important.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            98. Location.hoursOfOperation
            Definition

            What days/times during a week is this location usually open.

            ShortWhat days/times during a week is this location usually open
            Comments

            This type of information is commonly found published in directories and on websites informing customers when the facility is available.

            Specific services within the location may have their own hours which could be shorter (or longer) than the locations hours.

            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            100. Location.hoursOfOperation.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            102. Location.hoursOfOperation.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            104. Location.hoursOfOperation.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            106. Location.hoursOfOperation.daysOfWeek
            Definition

            Indicates which days of the week are available between the start and end Times.

            Shortmon | tue | wed | thu | fri | sat | sun
            Control0..*
            BindingThe codes SHALL be taken from DaysOfWeek
            (required to http://hl7.org/fhir/ValueSet/days-of-week|4.0.1)

            The days of the week.

            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            108. Location.hoursOfOperation.allDay
            Definition

            The Location is open all day.

            ShortThe Location is open all day
            Control0..1
            Typeboolean
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            110. Location.hoursOfOperation.openingTime
            Definition

            Time that the Location opens.

            ShortTime that the Location opens
            Control0..1
            Typetime
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            112. Location.hoursOfOperation.closingTime
            Definition

            Time that the Location closes.

            ShortTime that the Location closes
            Control0..1
            Typetime
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            114. Location.availabilityExceptions
            Definition

            A description of when the locations opening ours are different to normal, e.g. public holiday availability. Succinctly describing all possible exceptions to normal site availability as detailed in the opening hours Times.

            ShortDescription of availability exceptions
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            116. Location.endpoint
            Definition

            Technical endpoints providing access to services operated for the location.

            ShortTechnical endpoints providing access to services operated for the location
            Control0..*
            TypeReference(Endpoint)
            Is Modifierfalse
            Summaryfalse
            Requirements

            Organizations may have different systems at different locations that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))