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        CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG
        2.0.0 - Release 2 US

        This page is part of the NHSN Digital Quality Measures (dQM) Content Package Implementation Guide (v2.0.0: Release) based on FHIR (HL7? FHIR? Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

        Resource Profile: AcuteCareHospitalDailyEventLocation - Detailed Descriptions

        Page standards status: Trial-use Maturity Level: 2

        Definitions for the ach-daily-location resource profile.

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

        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.

        Short icon Changed:(NHSN-MS) Details and position information for a physical place where services are provided for the NHSN ACH Daily reporting period. This resource is required for the ACH Daily Measure and must be referenced in all Individual MeasureReport resources for this measure.Details and position information for a physical place
        Comments

        -

        Control icon Changed:10..*
        Is Modifier false
        Must Support icon Changed:true
        Summary false
        Invariants dom-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.

        Short icon Changed:(NHSN-MS) Logical id of this artifactLogical 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.

        Control 10..1
        Type idstring
        Is Modifier false
        Must Support icon Added:true
        Summary true
        4. 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.

        Short A 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.

        Control 0..1
        Type uri
        Is Modifier true 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 Value This primitive element may be present, or absent, or replaced by an extension
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        6. 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).

        Short Extensions 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.

        Control 0..*
        Type Extension
        Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summary false
        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 Names extensions, user content
        Invariants ele-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())
        8. 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.

        Short icon Changed:(NHSN-MS) active | suspended | inactiveactive | suspended | inactive
        Control 0..1
        Binding The 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.

        Type code
        Is Modifier true because This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Must Support true
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        10. Location.name
        Definition

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

        Short icon Changed:(NHSN-MS) Name of the location as used by humansName 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.

        Control 10..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Must Support true
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        12. Location.alias
        Definition

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

        Short icon Changed:(NHSN-MS) A list of alternate names that the location is known as, or was known as, in the pastA 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.

        Control 0..*
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Must Support true
        Summary false
        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.

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

        Indicates the type of function performed at the location.

        Short icon Changed:(NHSN-MS) Type of function performedType of function performed
        Control 10..*
        Binding Unless not suitable, these codes SHALL be taken from ServiceDeliveryLocationRoleType (3.0.0)http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType
        (extensible to http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType|3.0.0)
        Type CodeableConcept
        Is Modifier false
        Must Support icon Added:true
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. 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.

        Short icon Changed:(NHSN-MS)(QI-Core) Contact details of the locationContact details of the location
        Control 0..*
        Type ContactPoint
        Is Modifier false
        Must Support true
        Summary false
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. Location.address
        Definition

        Physical location.

        Short icon Changed:(NHSN-MS) Physical locationPhysical location
        Comments

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

        Control 0..1
        Type Address
        Is Modifier false
        Must Support true
        Summary false
        Requirements

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

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

        The purpose of this address.

        Short icon Changed:(NHSN-MS) home | work | temp | old | billing - purpose of this addresshome | 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.

        Control 0..1
        Binding The 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.

        Type code
        Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Must Support true
        Summary true
        Requirements

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

        Example General: home
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. 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.

        Short Street name, number, direction & P.O. Box etc.
        Control 0..*
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Must Support true
        Summary true
        Example General: 137 Nowhere Street
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. Location.address.city
        Definition

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

        Short Name of city, town etc.
        Control 0..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Must Support true
        Summary true
        Alternate Names Municpality
        Example General: Erewhon
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. 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).

        Short Sub-unit of country (abbreviations ok)
        Control 0..1
        Binding Unless not suitable, these codes SHALL be taken from For codes, see UspsTwoLetterAlphabeticCodes (6.1.0)
        (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state|6.1.0)

        Two letter USPS alphabetic codes.

        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Must Support true
        Summary true
        Alternate Names Province, Territory
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. Location.address.postalCode
        Definition

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

        Short US Zip CodesPostal code for area
        Control 0..1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Must Support true
        Summary true
        Alternate Names Zip
        Example General: 9132
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. Location.physicalType
        Definition

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

        Short Physical form of the location
        Control 0..1
        Binding For example codes, see LocationTypehttp://hl7.org/fhir/ValueSet/location-physical-type|4.0.1
        (example to http://hl7.org/fhir/ValueSet/location-physical-type)
        Type CodeableConcept
        Is Modifier false
        Summary true
        Requirements

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

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

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

        Short icon Changed:(QI-Core) Organization responsible for provisioning and upkeepOrganization 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.

        Control 0..1
        Type Reference(QICore Organization, Organization)
        Is Modifier false
        Must Support true
        Summary true
        Requirements

        Need to know who manages the location.

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

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

        Short icon Changed:(NHSN-MS) Another Location this one is physically a part ofAnother Location this one is physically a part of
        Control 0..1
        Type Reference(QICore Location, Location)bundled
        Is Modifier false
        Must Support true
        Summary false
        Requirements

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

        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. Location.partOf.reference
        Definition

        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

        Short icon Changed:(NHSN-MS) Literal reference, Relative, internal or absolute URLLiteral reference, Relative, internal or absolute URL
        Comments

        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

        Control 10..1
        This element is affected by the following invariants: ref-1
        Type string
        Is Modifier false
        Primitive Value This primitive element may be present, or absent, or replaced by an extension
        Must Support true
        Summary true
        Invariants ele-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 foundhere

        0. Location
        Short icon Added:(NHSN-MS) Details and position information for a physical place where services are provided for the NHSN ACH Daily reporting period. This resource is required for the ACH Daily Measure and must be referenced in all Individual MeasureReport resources for this measure.
        Control icon Added:1..?
        Must Support icon Added:true
        2. Location.id
        Short icon Added:(NHSN-MS) Logical id of this artifact
        Control 1..?
        Must Support icon Added:true
        4. Location.meta
        6. Location.meta.extension:link-received-date-extension
        Slice Name link-received-date-extension
        Control 0..1
        Type Extension(Received Date) (Extension Type: dateTime)
        icon Added: 8. Location.status
        Short (NHSN-MS) active | suspended | inactive
        icon Added: 10. Location.name
        Short (NHSN-MS) Name of the location as used by humans
        12. Location.alias
        Short icon Added:(NHSN-MS) A list of alternate names that the location is known as, or was known as, in the past
        Must Support true
        14. Location.type
        Short icon Added:(NHSN-MS) Type of function performed
        Control 1..?
        Binding Unless not suitable, these codes SHALL be taken from ServiceDeliveryLocationRoleType (3.0.0)
        (extensible to http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType|3.0.0)
        Must Support icon Added:true
        icon Added: 16. Location.telecom
        Short (NHSN-MS)(QI-Core) Contact details of the location
        icon Added: 18. Location.address
        Short (NHSN-MS) Physical location
        20. Location.address.use
        Short (NHSN-MS) home | work | temp | old | billing - purpose of this address
        Must Support true
        22. Location.physicalType
        Binding icon Changed:For example codes, see LocationType
        (example to http://hl7.org/fhir/ValueSet/location-physical-type)
        Must Support icon Removed:true
        24. Location.partOf
        Short icon Added:(NHSN-MS) Another Location this one is physically a part of
        Type icon Added:Reference(QICore Location)bundled
        Must Support true
        26. Location.partOf.reference
        Short icon Added:(NHSN-MS) Literal reference, Relative, internal or absolute URL
        Control 1..?
        Must Support true
        icon Removed:--. Location.address.use
        Must Support true

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

        0. Location
        Definition

        icon Changed:

        -

        Short icon Changed:(NHSN-MS) Details and position information for a physical place where services are provided for the NHSN ACH Daily reporting period. This resource is required for the ACH Daily Measure and must be referenced in all Individual MeasureReport resources for this measure.
        Comments

        icon Added:

        -

        Control icon Changed:1..*
        Is Modifier false
        Must Support icon Changed:true
        Summary false
        Invariants dom-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.

        Short icon Changed:(NHSN-MS) Logical 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.

        Control 1..1
        Type id
        Is Modifier false
        Must Support icon Added:true
        Summary true
        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.

        Short Metadata about the resource
        Control 0..1
        Type Meta
        Is Modifier false
        Summary true
        Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        6. Location.meta.id
        Definition

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

        Short Unique id for inter-element referencing
        Control 0..1
        Type string
        Is Modifier false
        XML Format In the XML format, this property is represented as an attribute.
        Summary false
        8. Location.meta.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.

        Short Additional 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.

        Control 0..*
        Type Extension
        Is Modifier false
        Summary false
        Alternate Names extensions, user content
        Invariants ele-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())
        Slicing This element introduces a set of slices on Location.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 10. Location.meta.extension:link-received-date-extension
          Slice Name link-received-date-extension
          Definition

          This extension stores the date and time a Resource was received by the processing system (e.g., NHSNLink).

          Short Received Date
          Control 0..1
          Type Extension(Received Date) (Extension Type: dateTime)
          Is Modifier false
          Summary false
          Invariants ele-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())
          12. Location.meta.versionId
          Definition

          The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

          Short Version specific identifier
          Comments

          The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

          Control 0..1
          Type id
          Is Modifier false
          Primitive Value This primitive element may be present, or absent, or replaced by an extension
          Summary true
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          14. Location.meta.lastUpdated
          Definition

          When the resource last changed - e.g. when the version changed.

          Short When the resource version last changed
          Comments

          This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

          Control 0..1
          Type instant
          Is Modifier false
          Primitive Value This primitive element may be present, or absent, or replaced by an extension
          Summary true
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          16. Location.meta.source
          Definition

          A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

          Short Identifies where the resource comes from
          Comments

          In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

          This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

          Control 0..1
          Type uri
          Is Modifier false
          Primitive Value This primitive element may be present, or absent, or replaced by an extension
          Summary true
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          18. Location.meta.profile
          Definition

          A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

          Short Profiles this resource claims to conform to
          Comments

          It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

          Control 0..*
          Type canonical(StructureDefinition)
          Is Modifier false
          Primitive Value This primitive element may be present, or absent, or replaced by an extension
          Summary true
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          20. Location.meta.security
          Definition

          Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

          Short Security Labels applied to this resource
          Comments

          The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

          Control 0..*
          Binding Unless not suitable, these codes SHALL be taken from All Security Labels
          (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.0.1)

          Security Labels from the Healthcare Privacy and Security Classification System.

          Type Coding
          Is Modifier false
          Summary true
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          22. Location.meta.tag
          Definition

          Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

          Short Tags applied to this resource
          Comments

          The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

          Control 0..*
          Binding For example codes, see CommonTags
          (example to http://hl7.org/fhir/ValueSet/common-tags|4.0.1)

          Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

          Type Coding
          Is Modifier false
          Summary true
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          24. 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.

          Short A 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.

          Control 0..1
          Type uri
          Is Modifier true 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 Value This primitive element may be present, or absent, or replaced by an extension
          Summary true
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          26. Location.language
          Definition

          The base language in which the resource is written.

          Short Language 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).

          Control 0..1
          Binding The codes SHOULD be taken from CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages)

          A human language.

          Additional Bindings Purpose
          AllLanguages Max Binding
          Type code
          Is Modifier false
          Primitive Value This primitive element may be present, or absent, or replaced by an extension
          Summary false
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          28. 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.

          Short Text 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.

          Control 0..1
          Type Narrative
          Is Modifier false
          Summary false
          Alternate Names narrative, html, xhtml, display
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          30. 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.

          Short Contained, 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.

          Control 0..*
          Type Resource
          Is Modifier false
          Summary false
          Alternate Names inline resources, anonymous resources, contained resources
          32. 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.

          Short Additional 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.

          Control 0..*
          Type Extension
          Is Modifier false
          Summary false
          Alternate Names extensions, user content
          Invariants ele-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())
          34. 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).

          Short Extensions 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.

          Control 0..*
          Type Extension
          Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Summary false
          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 Names extensions, user content
          Invariants ele-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())
          36. Location.identifier
          Definition

          Unique code or number identifying the location to its users.

          Short Unique code or number identifying the location to its users
          Note This is a business identifier, not a resource identifier (see discussion)
          Control 0..*
          Type Identifier
          Is Modifier false
          Summary true
          Requirements

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

          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. 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.

          Short icon Changed:(NHSN-MS) active | suspended | inactive
          Control 0..1
          Binding The 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.

          Type code
          Is Modifier true because This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid
          Primitive Value This primitive element may be present, or absent, or replaced by an extension
          Must Support true
          Summary true
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. 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.

          Short The operational status of the location (typically only for a bed/room)
          Control 0..1
          Binding The codes SHOULD be taken from Hl7VSBedStatus (3.0.0)
          (preferred to http://terminology.hl7.org/ValueSet/v2-0116|3.0.0)

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

          Type Coding
          Is Modifier false
          Summary true
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. Location.name
          Definition

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

          Short icon Changed:(NHSN-MS) Name 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.

          Control 1..1
          Type string
          Is Modifier false
          Primitive Value This primitive element may be present, or absent, or replaced by an extension
          Must Support true
          Summary true
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. Location.alias
          Definition

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

          Short icon Changed:(NHSN-MS) A 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.

          Control 0..*
          Type string
          Is Modifier false
          Primitive Value This primitive element may be present, or absent, or replaced by an extension
          Must Support true
          Summary false
          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.

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

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

          Short Additional details about the location that could be displayed as further information to identify the location beyond its name
          Control 0..1
          Type string
          Is Modifier false
          Primitive Value This primitive element may be present, or absent, or replaced by an extension
          Summary true
          Requirements

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

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

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

          Short instance | 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.

          Control 0..1
          Binding The 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.

          Type code
          Is Modifier false
          Primitive Value This primitive element may be present, or absent, or replaced by an extension
          Summary true
          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.

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

          Indicates the type of function performed at the location.

          Short icon Changed:(NHSN-MS) Type of function performed
          Control 1..*
          Binding Unless not suitable, these codes SHALL be taken from ServiceDeliveryLocationRoleType (3.0.0)
          (extensible to http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType|3.0.0)
          Type CodeableConcept
          Is Modifier false
          Must Support icon Added:true
          Summary true
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. 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.

          Short icon Changed:(NHSN-MS)(QI-Core) Contact details of the location
          Control 0..*
          Type ContactPoint
          Is Modifier false
          Must Support true
          Summary false
          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. Location.address
          Definition

          Physical location.

          Short icon Changed:(NHSN-MS) Physical location
          Comments

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

          Control 0..1
          Type Address
          Is Modifier false
          Must Support true
          Summary false
          Requirements

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

          Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. 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.

          Short Unique id for inter-element referencing
          Control 0..1
          Type string
          Is Modifier false
          XML Format In the XML format, this property is represented as an attribute.
          Summary false
          58. 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.

          Short Additional 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.

          Control 0..*
          Type Extension
          Is Modifier false
          Summary false
          Alternate Names extensions, user content
          Invariants ele-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())
          Slicing This element introduces a set of slices on Location.address.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 60. Location.address.use
            Definition

            The purpose of this address.

            Short icon Changed:(NHSN-MS) home | 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.

            Control 0..1
            Binding The codes SHALL be taken from AddressUse
            (required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

            The use of an address.

            Type code
            Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
            Primitive Value This primitive element may be present, or absent, or replaced by an extension
            Must Support true
            Summary true
            Requirements

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

            Example General: home
            Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. 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.

            Short postal | 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).

            Control 0..1
            Binding The 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).

            Type code
            Is Modifier false
            Primitive Value This primitive element may be present, or absent, or replaced by an extension
            Summary true
            Example General: both
            Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            64. 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.

            Short Text 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.

            Control 0..1
            Type string
            Is Modifier false
            Primitive Value This primitive element may be present, or absent, or replaced by an extension
            Summary true
            Requirements

            A renderable, unencoded form.

            Example General: 137 Nowhere Street, Erewhon 9132
            Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            66. 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.

            Short Street name, number, direction & P.O. Box etc.
            Control 0..*
            Type string
            Is Modifier false
            Primitive Value This primitive element may be present, or absent, or replaced by an extension
            Must Support true
            Summary true
            Example General: 137 Nowhere Street
            Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            68. Location.address.city
            Definition

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

            Short Name of city, town etc.
            Control 0..1
            Type string
            Is Modifier false
            Primitive Value This primitive element may be present, or absent, or replaced by an extension
            Must Support true
            Summary true
            Alternate Names Municpality
            Example General: Erewhon
            Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            70. Location.address.district
            Definition

            The name of the administrative area (county).

            Short District 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.

            Control 0..1
            Type string
            Is Modifier false
            Primitive Value This primitive element may be present, or absent, or replaced by an extension
            Summary true
            Alternate Names County
            Example General: Madison
            Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            72. 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).

            Short Sub-unit of country (abbreviations ok)
            Control 0..1
            Binding Unless not suitable, these codes SHALL be taken from UspsTwoLetterAlphabeticCodes (6.1.0)
            (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state|6.1.0)

            Two letter USPS alphabetic codes.

            Type string
            Is Modifier false
            Primitive Value This primitive element may be present, or absent, or replaced by an extension
            Must Support true
            Summary true
            Alternate Names Province, Territory
            Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            74. Location.address.postalCode
            Definition

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

            Short US Zip Codes
            Control 0..1
            Type string
            Is Modifier false
            Primitive Value This primitive element may be present, or absent, or replaced by an extension
            Must Support true
            Summary true
            Alternate Names Zip
            Example General: 9132
            Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            76. Location.address.country
            Definition

            Country - a nation as commonly understood or generally accepted.

            Short Country (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.

            Control 0..1
            Type string
            Is Modifier false
            Primitive Value This primitive element may be present, or absent, or replaced by an extension
            Summary true
            Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            78. Location.address.period
            Definition

            Time period when address was/is in use.

            Short Time period when address was/is in use
            Control 0..1
            Type Period
            Is Modifier false
            Summary true
            Requirements

            Allows addresses to be placed in historical context.

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

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

            Short Physical form of the location
            Control 0..1
            Binding For example codes, see LocationType
            (example to http://hl7.org/fhir/ValueSet/location-physical-type)
            Type CodeableConcept
            Is Modifier false
            Must Support icon Removed:true
            Summary true
            Requirements

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

            Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            82. 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).

            Short The absolute geographic location
            Control 0..1
            Type BackboneElement
            Is Modifier false
            Summary false
            Requirements

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

            Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            84. 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.

            Short Unique id for inter-element referencing
            Control 0..1
            Type string
            Is Modifier false
            XML Format In the XML format, this property is represented as an attribute.
            Summary false
            86. 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.

            Short Additional 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.

            Control 0..*
            Type Extension
            Is Modifier false
            Summary false
            Alternate Names extensions, user content
            Invariants ele-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.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).

            Short Extensions 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.

            Control 0..*
            Type Extension
            Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summary true
            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 Names extensions, user content, modifiers
            Invariants ele-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())
            90. 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).

            Short Longitude with WGS84 datum
            Control 1..1
            Type decimal
            Is Modifier false
            Primitive Value This primitive element may be present, or absent, or replaced by an extension
            Summary false
            Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            92. 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).

            Short Latitude with WGS84 datum
            Control 1..1
            Type decimal
            Is Modifier false
            Primitive Value This primitive element may be present, or absent, or replaced by an extension
            Summary false
            Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            94. 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).

            Short Altitude with WGS84 datum
            Control 0..1
            Type decimal
            Is Modifier false
            Primitive Value This primitive element may be present, or absent, or replaced by an extension
            Summary false
            Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            96. Location.managingOrganization
            Definition

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

            Short icon Changed:(QI-Core) Organization 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.

            Control 0..1
            Type Reference(QICore Organization)
            Is Modifier false
            Must Support true
            Summary true
            Requirements

            Need to know who manages the location.

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

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

            Short icon Changed:(NHSN-MS) Another Location this one is physically a part of
            Control 0..1
            Type Reference(QICore Location)bundled
            Is Modifier false
            Must Support true
            Summary false
            Requirements

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

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

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

            Short Unique id for inter-element referencing
            Control 0..1
            Type string
            Is Modifier false
            XML Format In the XML format, this property is represented as an attribute.
            Summary false
            102. Location.partOf.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.

            Short Additional 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.

            Control 0..*
            Type Extension
            Is Modifier false
            Summary false
            Alternate Names extensions, user content
            Invariants ele-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())
            Slicing This element introduces a set of slices on Location.partOf.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 104. Location.partOf.reference
              Definition

              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

              Short icon Changed:(NHSN-MS) Literal reference, Relative, internal or absolute URL
              Comments

              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

              Control 1..1
              This element is affected by the following invariants: ref-1
              Type string
              Is Modifier false
              Primitive Value This primitive element may be present, or absent, or replaced by an extension
              Must Support true
              Summary true
              Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              106. Location.partOf.type
              Definition

              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

              Short Type the reference refers to (e.g. "Patient")
              Comments

              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

              Control 0..1
              Binding Unless not suitable, these codes SHALL be taken from ResourceType
              (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

              Aa resource (or, for logical models, the URI of the logical model).

              Type uri
              Is Modifier false
              Primitive Value This primitive element may be present, or absent, or replaced by an extension
              Summary true
              Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              108. Location.partOf.identifier
              Definition

              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

              Short Logical reference, when literal reference is not known
              Comments

              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

              Note This is a business identifier, not a resource identifier (see discussion)
              Control 0..1
              Type Identifier
              Is Modifier false
              Summary true
              Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              110. Location.partOf.display
              Definition

              Plain text narrative that identifies the resource in addition to the resource reference.

              Short Text alternative for the resource
              Comments

              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

              Control 0..1
              Type string
              Is Modifier false
              Primitive Value This primitive element may be present, or absent, or replaced by an extension
              Summary true
              Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              112. Location.hoursOfOperation
              Definition

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

              Short What 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.

              Control 0..*
              Type BackboneElement
              Is Modifier false
              Summary false
              Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              114. 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.

              Short Unique id for inter-element referencing
              Control 0..1
              Type string
              Is Modifier false
              XML Format In the XML format, this property is represented as an attribute.
              Summary false
              116. 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.

              Short Additional 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.

              Control 0..*
              Type Extension
              Is Modifier false
              Summary false
              Alternate Names extensions, user content
              Invariants ele-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())
              118. 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).

              Short Extensions 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.

              Control 0..*
              Type Extension
              Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summary true
              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 Names extensions, user content, modifiers
              Invariants ele-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())
              120. Location.hoursOfOperation.daysOfWeek
              Definition

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

              Short mon | tue | wed | thu | fri | sat | sun
              Control 0..*
              Binding The codes SHALL be taken from DaysOfWeek
              (required to http://hl7.org/fhir/ValueSet/days-of-week|4.0.1)

              The days of the week.

              Type code
              Is Modifier false
              Primitive Value This primitive element may be present, or absent, or replaced by an extension
              Summary false
              Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              122. Location.hoursOfOperation.allDay
              Definition

              The Location is open all day.

              Short The Location is open all day
              Control 0..1
              Type boolean
              Is Modifier false
              Primitive Value This primitive element may be present, or absent, or replaced by an extension
              Summary false
              Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              124. Location.hoursOfOperation.openingTime
              Definition

              Time that the Location opens.

              Short Time that the Location opens
              Control 0..1
              Type time
              Is Modifier false
              Primitive Value This primitive element may be present, or absent, or replaced by an extension
              Summary false
              Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              126. Location.hoursOfOperation.closingTime
              Definition

              Time that the Location closes.

              Short Time that the Location closes
              Control 0..1
              Type time
              Is Modifier false
              Primitive Value This primitive element may be present, or absent, or replaced by an extension
              Summary false
              Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              128. 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.

              Short Description of availability exceptions
              Control 0..1
              Type string
              Is Modifier false
              Primitive Value This primitive element may be present, or absent, or replaced by an extension
              Summary false
              Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              130. Location.endpoint
              Definition

              Technical endpoints providing access to services operated for the location.

              Short Technical endpoints providing access to services operated for the location
              Control 0..*
              Type Reference(Endpoint)
              Is Modifier false
              Summary false
              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.

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

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