dQM CMS Content Implementation Guide
2026.1.0 - CI Build
dQM CMS Content Implementation Guide
2026.1.0 - CI Build
dQM CMS Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2026.1.0 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-2026/ and changes regularly. See the Directory of published versions
| Page standards status: Informative | Maturity Level: 1 |
{
"resourceType" : "Library",
"id" : "AdvancedIllnessandFrailty",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"narrative-table\">\n <tbody>\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Metadata</th>\n\n\n</tr>\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Title</th>\n\n\n\n<td class=\"content-container\">Advanced Illness and Frailty</td>\n\n\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Version</th>\n\n\n\n<td class=\"content-container\">2026.1.0</td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Topic</th>\n\n\n\n<td class=\"content-container\">FHIR\n</td>\n\n\n</tr>\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Topic</th>\n\n\n\n<td class=\"content-container\">CQL\n</td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Description</th>\n\n\n\n<td class=\"content-container\"><div><p>AdvancedIllnessandFrailty logic.</p>\n</div></td>\n\n\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Type</th>\n\n\n\n<td class=\"content-container\">\n logic-library from <a href=\"http://terminology.hl7.org/7.3.0/CodeSystem-library-type.html\">http://terminology.hl7.org/CodeSystem/library-type</a> \n\n\n</td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"parameters\"> </a>Parameters</th>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Parameter</th>\n\n\n\n<td class=\"content-container\">None</td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Library Content</th>\n\n\n</tr>\n \n \n <tr>\n <th scope=\"row\" class=\"row-header\">CQL Content</th>\n <td>\n <a name=\"cql-content\"> </a>\n <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\nNOTE: For use by March 2026 US Realm Connectathon participants for internal use only. Not for use or distribution in commercial products.\n*/\nlibrary AdvancedIllnessandFrailty version '2.1.000'\n\nusing USQualityCore version '0.5.0'\nusing USCore version '6.1.0-derived'\nusing FHIR version '4.0.1'\n\ninclude hl7.fhir.uv.cql.FHIRHelpers version '4.0.1' called FHIRHelpers\ninclude hl7.fhir.uv.cql.FHIRCommon version '2.0.0' called FHIRCommon\ninclude hl7.fhir.us.cql.CumulativeMedicationDuration version '2.0.0-ballot' called CMD\n\ninclude Status version '2.1.000' called Status\n\ncodesystem "LOINC": 'http://loinc.org'\ncodesystem "SNOMEDCT": 'http://snomed.info/sct'\n\nvalueset "Advanced Illness": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082'\nvalueset "Dementia Medications": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510'\nvalueset "Frailty Device": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300'\nvalueset "Frailty Diagnosis": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074'\nvalueset "Frailty Encounter": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088'\nvalueset "Frailty Symptom": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075'\n \ncode "Housing status": '71802-3' from "LOINC" display 'Housing status'\ncode "Lives in nursing home (finding)": '160734000' from "SNOMEDCT" display 'Lives in nursing home (finding)'\ncode "Medical equipment used": '98181-1' from "LOINC" display 'Medical equipment used'\n\nparameter "Measurement Period" Interval<DateTime>\n\ncontext Patient\n\ndefine "Is Age 66 or Older with Advanced Illness and Frailty":\n AgeInYearsAt(date from end of "Measurement Period") >= 66\n and "Has Criteria Indicating Frailty"\n and ( "Has Advanced Illness in Year Before or During Measurement Period"\n or "Has Dementia Medications in Year Before or During Measurement Period"\n )\n\ndefine "Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty":\n ( AgeInYearsAt(date from end of "Measurement Period") in Interval[66, 80]\n and "Has Criteria Indicating Frailty"\n and ( "Has Advanced Illness in Year Before or During Measurement Period"\n or "Has Dementia Medications in Year Before or During Measurement Period"\n )\n )\n or ( AgeInYearsAt(date from end of "Measurement Period")>= 81\n and "Has Criteria Indicating Frailty"\n )\n\ndefine "Has Criteria Indicating Frailty":\n exists ( (([USQualityCore.DeviceRequest: "Frailty Device"]).isDeviceOrderPersonalUseDevices()) FrailtyDeviceOrder\n where FrailtyDeviceOrder.authoredOn.toInterval() during day of "Measurement Period"\n )\n or exists ( (([ObservationScreeningAssessment: "Medical equipment used"]).isAssessmentPerformed()) EquipmentUsed\n where EquipmentUsed.value as CodeableConcept in "Frailty Device" \n and EquipmentUsed.effective.toInterval() ends during day of "Measurement Period"\n )\n // TODO: Consider whether to keep this as the union of problems and encounter diagnoses\n or exists ( (([FHIR.Condition: "Frailty Diagnosis"]).verified()) FrailtyDiagnosis\n where FrailtyDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"\n )\n or exists ( (([USQualityCore.Encounter: "Frailty Encounter"]).isEncounterPerformed()) FrailtyEncounter\n where FrailtyEncounter.period overlaps day of "Measurement Period"\n )\n or exists ( (([USQualityCore.SimpleObservation: "Frailty Symptom"]).isSymptom()) FrailtySymptom\n where FrailtySymptom.effective.toInterval() overlaps day of "Measurement Period"\n )\n\ndefine "Has Advanced Illness in Year Before or During Measurement Period":\n// TODO: Consider whether to keep this as the union of problems and encounter diagnoses\nexists ((([Condition: "Advanced Illness"]).verified()) AdvancedIllnessDiagnosis\nwhere AdvancedIllnessDiagnosis.prevalenceInterval() starts during day of Interval[start of "Measurement Period" - 1 year, end of "Measurement Period"])\n\ndefine "Has Dementia Medications in Year Before or During Measurement Period":\n exists (( ([FHIR.MedicationRequest: "Dementia Medications"]).isMedicationActive()) DementiaMedication\n where DementiaMedication.medicationRequestPeriod() overlaps day of Interval[start of "Measurement Period" - 1 year, \n end of "Measurement Period"]\n )\n\ndefine "Is Age 66 or Older Living Long Term in a Nursing Home":\n AgeInYearsAt(date from end of "Measurement Period") >= 66\n and ( ( Last( (([ObservationScreeningAssessment: "Housing status"]).isAssessmentPerformed()) HousingStatus \n where HousingStatus.effective.toInterval() ends on or before \n day of end of "Measurement Period"\n sort by \n end of effective.toInterval() asc\n )) LastHousingStatus\n where LastHousingStatus.value ~ "Lives in nursing home (finding)"\n ) is not null\n </code></pre>\n </td>\n </tr>\n \n \n\n<tr>\n <th colspan=\"2\" scope=\"row\" class=\"row-header\">Generated using version 0.5.6-cibuild of the sample-content-ig Liquid templates</th>\n</tr>\n\n </tbody>\n </table>\n</div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger" : 1
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "cds"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "informative"
}
],
"url" : "https://madie.cms.gov/Library/AdvancedIllnessandFrailty",
"version" : "2026.1.0",
"name" : "AdvancedIllnessandFrailty",
"title" : "Advanced Illness and Frailty",
"status" : "active",
"experimental" : false,
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/library-type",
"code" : "logic-library"
}
]
},
"date" : "2026-07-30T20:17:17+00:00",
"description" : "AdvancedIllnessandFrailty logic.",
"topic" : [
{
"text" : "FHIR"
},
{
"text" : "CQL"
}
],
"content" : [
{
"contentType" : "text/cql",
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}
]
}