Draft dQM CMS Content Implementation Guide
2025.1.0 - CI Build

Draft dQM CMS Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2025.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/dqm-content-cms-2025/ and changes regularly. See the Directory of published versions

Library: PalliativeCare

Official URL: https://madie.cms.gov/Library/PalliativeCare Version: 2.1.000
Active as of 2025-08-20 Responsible: National Committee for Quality Assurance Computable Name: PalliativeCare

This library contains a definition used to exclude patients receiving palliative care for any part of the measurement period.

Metadata
Title PalliativeCare
Version 2.1.000
Topic FHIR
Topic CQL
Steward (Publisher) National Committee for Quality Assurance
Description

This library contains a definition used to exclude patients receiving palliative care for any part of the measurement period.
Type logic-library from http://terminology.hl7.org/CodeSystem/library-type
Dependency Description: Model USQualityCore
Resource: https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild
Canonical URL: https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild
Dependency Description: Library FHIRHelpers
Resource: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
Dependency Description: Library FHIRCommon
Resource: http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0
Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0
Dependency Description: Library Status
Resource: Statusversion: null2.1.000)
Canonical URL: https://madie.cms.gov/Library/Status|2.1.000
Dependency Description: Code System LOINC
Resource: Logical Observation Identifiers, Names and Codes (LOINC)
Canonical URL: http://loinc.org
Dependency Description: Value Set Palliative Care Encounter
Resource: Palliative Care Encounter
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090
Dependency Description: Value Set Palliative Care Intervention
Resource: Palliative Care Intervention
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
Dependency Description: Value Set Palliative Care Diagnosis
Resource: Palliative Care Diagnosis
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
Data Requirement Type: Observation
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment
Code Filter(s):
Path: code
Code(s): LOINC: 71007-9 (Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal))
Data Requirement Type: Condition
Profile(s): Condition
Code Filter(s):
Path: code
ValueSet: Palliative Care Diagnosis
Data Requirement Type: Encounter
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter
Code Filter(s):
Path: type
ValueSet: Palliative Care Encounter
Data Requirement Type: Procedure
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedure
Code Filter(s):
Path: code
ValueSet: Palliative Care Intervention
Parameters
Name Use Card. Type Documentation
Measurement Period In 0..1 Period
Patient Out 0..1 Resource
Has Palliative Care in the Measurement Period Out 0..1 boolean
Library Content
CQL Content 
/*
NOTE: For use by March 2026 US Realm Connectathon participants for internal use only. Not for use or distribution in commercial products.
*/
library PalliativeCare version '2.1.000'

using USQualityCore version '0.1.0-cibuild'
using USCore version '6.1.0-derived'
using FHIR version '4.0.1'

include hl7.fhir.uv.cql.FHIRHelpers version '4.0.1' called FHIRHelpers
include hl7.fhir.uv.cql.FHIRCommon version '2.0.0' called FHIRCommon

include Status version '2.1.000' called Status

codesystem "LOINC": 'http://loinc.org'

valueset "Palliative Care Encounter": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090'
valueset "Palliative Care Intervention": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135'
valueset "Palliative Care Diagnosis": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167'

code "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)": '71007-9' from "LOINC" display 'Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)'

parameter "Measurement Period" Interval<DateTime>

context Patient

define "Has Palliative Care in the Measurement Period":
  // TODO: Shouldn't need to specify a code path here (see https://jira.hl7.org/browse/FHIR-53941)
  exists ((([USQualityCore.ObservationScreeningAssessment: code ~ "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"]).isAssessmentPerformed()) PalliativeAssessment
      where PalliativeAssessment.effective.toInterval() overlaps day of "Measurement Period"
  )
    // TODO: Consider whether to keep this as the union of the problems and encounter diagnosis list? Anything enforced by the profiles that is expected but isn't stated here?
    or exists ((([FHIR.Condition: "Palliative Care Diagnosis"]).verified()) PalliativeDiagnosis
        where PalliativeDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"
    )
    or exists ((([USQualityCore.Encounter: "Palliative Care Encounter"]).isEncounterPerformed()) PalliativeEncounter
        where PalliativeEncounter.period overlaps day of "Measurement Period"
    )
    or exists ((([USQualityCore.Procedure: "Palliative Care Intervention"]).isInterventionPerformed()) PalliativeIntervention
        where PalliativeIntervention.performed.toInterval() overlaps day of "Measurement Period"
    )
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