This page is part of the CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG (v1.0.0: 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

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Resource Profile: ACH Monthly Event Encounter

This profile contains Required and Must Support data elements for reporting encounter information to the NHSN Acute Care Hospital (ACH) Monthly Digital Quality Measure. This profile is based on the HL7 FHIR? US Core Encounter Profile v3.1.1.

Usages:

• Examples for this Profile: Encounter/encounter-example-ach-monthly-pass1, Encounter/encounter-example-ach-monthly-pass2-emergency, Encounter/encounter-example-ach-monthly-pass2-inpatient, Encounter/encounter-example-ach-monthly-pass3-acute and Encounter/encounter-example-ach-monthly-pass3-short-stay

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter	C	0..*	USCoreEncounterProfile	An interaction during which services are provided to the patient Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
id	Σ	1..1	id	Logical id of this artifact
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	Identifier	Identifier(s) by which this encounter is known
use	?!SΣ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	SΣ	0..1	Period	Time period when id is/was valid for use
status	?!SΣ	1..1	code	triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
classHistory	S	0..*	BackboneElement	List of past encounter classes
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
subject	SΣ	1..1	Reference(US Core Patient Profile)	The patient or group present at the encounter
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
period	S	1..1	Period	The start and end time of the encounter
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
diagnosis	SΣ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	Σ	1..1	Reference(Condition | Procedure)	The diagnosis or procedure relevant to the encounter
use	S	0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank	S	0..1	positiveInt	Ranking of the diagnosis (for each role type)
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
origin	S	0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission	S	0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (preferred)
dietPreference	S	0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (preferred)
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (preferred)
location	S	1..*	BackboneElement	List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
status	S	0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType	S	0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
period		1..1	Period	Time period during which the patient was present at the location
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Encounter.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
Encounter.status	required	AcuteCareHospitalMonthlyEncounterStatus http://www.cy118119.com/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-status From this IG
Encounter.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type From the FHIR Standard
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason From the FHIR Standard
Encounter.diagnosis.use	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role From the FHIR Standard
Encounter.hospitalization.admitSource	preferred	AdmitSource http://hl7.org/fhir/ValueSet/encounter-admit-source From the FHIR Standard
Encounter.hospitalization.reAdmission	preferred	Hl7VSReAdmissionIndicator http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreference	preferred	Diet http://hl7.org/fhir/ValueSet/encounter-diet From the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	DischargeDisposition http://hl7.org/fhir/ValueSet/encounter-discharge-disposition From the FHIR Standard
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 From the FHIR Standard
Encounter.location.physicalType	extensible	LocationType http://hl7.org/fhir/ValueSet/location-physical-type From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
encounter-ach-monthly-initial-population	error	Encounter	Encounter: (class must be from ACH Monthly encounter class) or (type from 'Encounter Inpatient', 'Emergency Department Visit', or 'Observation Services') or (Encounter location type from 'Inpatient, Emergency, and Observation Locations') : class.memberOf('http://www.cy118119.com/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-class') or class.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.274') or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143')).exists() or location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists()
encounter-location-type-initial-population	warning	Encounter	Encounter: references at least one Location where type is from 'Inpatient, Emergency, and Observation Locations' : location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() or location.where(location.resolve().partOf.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists()
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from USCoreEncounterProfile

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter	C	0..*	USCoreEncounterProfile	An interaction during which services are provided to the patient Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
id		1..1	id	Logical id of this artifact
meta
Slices for extension				Content/Rules for all slices
extension:link-received-date-extension		0..1	dateTime	Received Date URL: http://www.cy118119.com/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
identifier		1..*	Identifier	Identifier(s) by which this encounter is known
use	S	0..1	code	usual | official | temp | secondary | old (If known)
type	S	0..1	CodeableConcept	Description of identifier
period	S	0..1	Period	Time period when id is/was valid for use
status		1..1	code	triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
classHistory	S	0..*	BackboneElement	List of past encounter classes
subject
reference	S	1..1	string	Literal reference, Relative, internal or absolute URL
period		1..1	Period	The start and end time of the encounter
diagnosis	S	0..*	BackboneElement	The list of diagnosis relevant to this encounter
use	S	0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
rank	S	0..1	positiveInt	Ranking of the diagnosis (for each role type)
hospitalization
origin	S	0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer)
reAdmission	S	0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (preferred)
dietPreference	S	0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (preferred)
dischargeDisposition		0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (preferred)
location		1..*	BackboneElement	List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
location
reference	S	1..1	string	Literal reference, Relative, internal or absolute URL
status	S	0..1	code	planned | active | reserved | completed
physicalType	S	0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
period		1..1	Period	Time period during which the patient was present at the location
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Encounter.status	required	AcuteCareHospitalMonthlyEncounterStatus http://www.cy118119.com/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-status From this IG
Encounter.hospitalization.reAdmission	preferred	Hl7VSReAdmissionIndicator http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreference	preferred	Diet http://hl7.org/fhir/ValueSet/encounter-diet From the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	DischargeDisposition http://hl7.org/fhir/ValueSet/encounter-discharge-disposition From the FHIR Standard
Encounter.location.physicalType	extensible	LocationType http://hl7.org/fhir/ValueSet/location-physical-type From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
encounter-ach-monthly-initial-population	error	Encounter	Encounter: (class must be from ACH Monthly encounter class) or (type from 'Encounter Inpatient', 'Emergency Department Visit', or 'Observation Services') or (Encounter location type from 'Inpatient, Emergency, and Observation Locations') : class.memberOf('http://www.cy118119.com/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-class') or class.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.274') or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143')).exists() or location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists()
encounter-location-type-initial-population	warning	Encounter	Encounter: references at least one Location where type is from 'Inpatient, Emergency, and Observation Locations' : location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() or location.where(location.resolve().partOf.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter	C	0..*	USCoreEncounterProfile	An interaction during which services are provided to the patient Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
id	Σ	1..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:link-received-date-extension		0..1	dateTime	Received Date URL: http://www.cy118119.com/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	Identifier	Identifier(s) by which this encounter is known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!SΣ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	SΣ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period		1..1	Period	The time that the episode was in the specified status
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
classHistory	S	0..*	BackboneElement	List of past encounter classes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
serviceType	Σ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority		0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (3.0.0) (example): Indicates the urgency of the encounter.
subject	SΣ	1..1	Reference(US Core Patient Profile)	The patient or group present at the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
episodeOfCare	Σ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
basedOn		0..*	Reference(ServiceRequest)	The ServiceRequest that initiated this encounter
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
appointment	Σ	0..*	Reference(Appointment)	The appointment that scheduled this encounter
period	S	1..1	Period	The start and end time of the encounter
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	Σ	0..*	Reference(Condition | Procedure | Observation | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	SΣ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	Σ	1..1	Reference(Condition | Procedure)	The diagnosis or procedure relevant to the encounter
use	S	0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank	S	0..1	positiveInt	Ranking of the diagnosis (for each role type)
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin	S	0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission	S	0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (preferred)
dietPreference	S	0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (preferred)
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination		0..1	Reference(Location | Organization)	Location/organization to which the patient is discharged
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (preferred)
location	S	1..*	BackboneElement	List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
status	S	0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType	S	0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
period		1..1	Period	Time period during which the patient was present at the location
serviceProvider		0..1	Reference(Organization)	The organization (facility) responsible for this encounter
partOf		0..1	Reference(Encounter)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels|4.0.1 From the FHIR Standard
Encounter.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags|4.0.1 From the FHIR Standard
Encounter.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Encounter.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
Encounter.status	required	AcuteCareHospitalMonthlyEncounterStatus http://www.cy118119.com/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-status From this IG
Encounter.statusHistory.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 From the FHIR Standard
Encounter.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceType	example	ServiceType http://hl7.org/fhir/ValueSet/service-type From the FHIR Standard
Encounter.priority	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority|3.0.0
Encounter.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types|4.0.1 From the FHIR Standard
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type From the FHIR Standard
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason From the FHIR Standard
Encounter.diagnosis.use	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role From the FHIR Standard
Encounter.hospitalization.admitSource	preferred	AdmitSource http://hl7.org/fhir/ValueSet/encounter-admit-source From the FHIR Standard
Encounter.hospitalization.reAdmission	preferred	Hl7VSReAdmissionIndicator http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreference	preferred	Diet http://hl7.org/fhir/ValueSet/encounter-diet From the FHIR Standard
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy http://hl7.org/fhir/ValueSet/encounter-special-courtesy From the FHIR Standard
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements http://hl7.org/fhir/ValueSet/encounter-special-arrangements From the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	DischargeDisposition http://hl7.org/fhir/ValueSet/encounter-discharge-disposition From the FHIR Standard
Encounter.location.location.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types|4.0.1 From the FHIR Standard
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 From the FHIR Standard
Encounter.location.physicalType	extensible	LocationType http://hl7.org/fhir/ValueSet/location-physical-type From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
encounter-ach-monthly-initial-population	error	Encounter	Encounter: (class must be from ACH Monthly encounter class) or (type from 'Encounter Inpatient', 'Emergency Department Visit', or 'Observation Services') or (Encounter location type from 'Inpatient, Emergency, and Observation Locations') : class.memberOf('http://www.cy118119.com/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-class') or class.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.274') or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143')).exists() or location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists()
encounter-location-type-initial-population	warning	Encounter	Encounter: references at least one Location where type is from 'Inpatient, Emergency, and Observation Locations' : location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() or location.where(location.resolve().partOf.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists()
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from USCoreEncounterProfile

Summary

Mandatory: 7 elements
Must-Support: 15 elements

Extensions

This structure refers to these extensions:

• http://www.cy118119.com/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension

Maturity: 1

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter	C	0..*	USCoreEncounterProfile	An interaction during which services are provided to the patient Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
id	Σ	1..1	id	Logical id of this artifact
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	Identifier	Identifier(s) by which this encounter is known
use	?!SΣ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	SΣ	0..1	Period	Time period when id is/was valid for use
status	?!SΣ	1..1	code	triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
classHistory	S	0..*	BackboneElement	List of past encounter classes
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
subject	SΣ	1..1	Reference(US Core Patient Profile)	The patient or group present at the encounter
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
period	S	1..1	Period	The start and end time of the encounter
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
diagnosis	SΣ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	Σ	1..1	Reference(Condition | Procedure)	The diagnosis or procedure relevant to the encounter
use	S	0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank	S	0..1	positiveInt	Ranking of the diagnosis (for each role type)
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
origin	S	0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission	S	0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (preferred)
dietPreference	S	0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (preferred)
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (preferred)
location	S	1..*	BackboneElement	List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
status	S	0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType	S	0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
period		1..1	Period	Time period during which the patient was present at the location
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Encounter.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
Encounter.status	required	AcuteCareHospitalMonthlyEncounterStatus http://www.cy118119.com/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-status From this IG
Encounter.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type From the FHIR Standard
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason From the FHIR Standard
Encounter.diagnosis.use	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role From the FHIR Standard
Encounter.hospitalization.admitSource	preferred	AdmitSource http://hl7.org/fhir/ValueSet/encounter-admit-source From the FHIR Standard
Encounter.hospitalization.reAdmission	preferred	Hl7VSReAdmissionIndicator http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreference	preferred	Diet http://hl7.org/fhir/ValueSet/encounter-diet From the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	DischargeDisposition http://hl7.org/fhir/ValueSet/encounter-discharge-disposition From the FHIR Standard
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 From the FHIR Standard
Encounter.location.physicalType	extensible	LocationType http://hl7.org/fhir/ValueSet/location-physical-type From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
encounter-ach-monthly-initial-population	error	Encounter	Encounter: (class must be from ACH Monthly encounter class) or (type from 'Encounter Inpatient', 'Emergency Department Visit', or 'Observation Services') or (Encounter location type from 'Inpatient, Emergency, and Observation Locations') : class.memberOf('http://www.cy118119.com/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-class') or class.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.274') or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143')).exists() or location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists()
encounter-location-type-initial-population	warning	Encounter	Encounter: references at least one Location where type is from 'Inpatient, Emergency, and Observation Locations' : location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() or location.where(location.resolve().partOf.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists()
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from USCoreEncounterProfile

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter	C	0..*	USCoreEncounterProfile	An interaction during which services are provided to the patient Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
id		1..1	id	Logical id of this artifact
meta
Slices for extension				Content/Rules for all slices
extension:link-received-date-extension		0..1	dateTime	Received Date URL: http://www.cy118119.com/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
identifier		1..*	Identifier	Identifier(s) by which this encounter is known
use	S	0..1	code	usual | official | temp | secondary | old (If known)
type	S	0..1	CodeableConcept	Description of identifier
period	S	0..1	Period	Time period when id is/was valid for use
status		1..1	code	triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
classHistory	S	0..*	BackboneElement	List of past encounter classes
subject
reference	S	1..1	string	Literal reference, Relative, internal or absolute URL
period		1..1	Period	The start and end time of the encounter
diagnosis	S	0..*	BackboneElement	The list of diagnosis relevant to this encounter
use	S	0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
rank	S	0..1	positiveInt	Ranking of the diagnosis (for each role type)
hospitalization
origin	S	0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer)
reAdmission	S	0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (preferred)
dietPreference	S	0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (preferred)
dischargeDisposition		0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (preferred)
location		1..*	BackboneElement	List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
location
reference	S	1..1	string	Literal reference, Relative, internal or absolute URL
status	S	0..1	code	planned | active | reserved | completed
physicalType	S	0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
period		1..1	Period	Time period during which the patient was present at the location
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Encounter.status	required	AcuteCareHospitalMonthlyEncounterStatus http://www.cy118119.com/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-status From this IG
Encounter.hospitalization.reAdmission	preferred	Hl7VSReAdmissionIndicator http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreference	preferred	Diet http://hl7.org/fhir/ValueSet/encounter-diet From the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	DischargeDisposition http://hl7.org/fhir/ValueSet/encounter-discharge-disposition From the FHIR Standard
Encounter.location.physicalType	extensible	LocationType http://hl7.org/fhir/ValueSet/location-physical-type From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
encounter-ach-monthly-initial-population	error	Encounter	Encounter: (class must be from ACH Monthly encounter class) or (type from 'Encounter Inpatient', 'Emergency Department Visit', or 'Observation Services') or (Encounter location type from 'Inpatient, Emergency, and Observation Locations') : class.memberOf('http://www.cy118119.com/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-class') or class.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.274') or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143')).exists() or location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists()
encounter-location-type-initial-population	warning	Encounter	Encounter: references at least one Location where type is from 'Inpatient, Emergency, and Observation Locations' : location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() or location.where(location.resolve().partOf.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter	C	0..*	USCoreEncounterProfile	An interaction during which services are provided to the patient Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
id	Σ	1..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:link-received-date-extension		0..1	dateTime	Received Date URL: http://www.cy118119.com/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	Identifier	Identifier(s) by which this encounter is known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!SΣ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	SΣ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period		1..1	Period	The time that the episode was in the specified status
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
classHistory	S	0..*	BackboneElement	List of past encounter classes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
serviceType	Σ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority		0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (3.0.0) (example): Indicates the urgency of the encounter.
subject	SΣ	1..1	Reference(US Core Patient Profile)	The patient or group present at the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
episodeOfCare	Σ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
basedOn		0..*	Reference(ServiceRequest)	The ServiceRequest that initiated this encounter
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
appointment	Σ	0..*	Reference(Appointment)	The appointment that scheduled this encounter
period	S	1..1	Period	The start and end time of the encounter
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	Σ	0..*	Reference(Condition | Procedure | Observation | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	SΣ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	Σ	1..1	Reference(Condition | Procedure)	The diagnosis or procedure relevant to the encounter
use	S	0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank	S	0..1	positiveInt	Ranking of the diagnosis (for each role type)
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin	S	0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission	S	0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (preferred)
dietPreference	S	0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (preferred)
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination		0..1	Reference(Location | Organization)	Location/organization to which the patient is discharged
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (preferred)
location	S	1..*	BackboneElement	List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
status	S	0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType	S	0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
period		1..1	Period	Time period during which the patient was present at the location
serviceProvider		0..1	Reference(Organization)	The organization (facility) responsible for this encounter
partOf		0..1	Reference(Encounter)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels|4.0.1 From the FHIR Standard
Encounter.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags|4.0.1 From the FHIR Standard
Encounter.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Encounter.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
Encounter.status	required	AcuteCareHospitalMonthlyEncounterStatus http://www.cy118119.com/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-status From this IG
Encounter.statusHistory.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 From the FHIR Standard
Encounter.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceType	example	ServiceType http://hl7.org/fhir/ValueSet/service-type From the FHIR Standard
Encounter.priority	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority|3.0.0
Encounter.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types|4.0.1 From the FHIR Standard
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type From the FHIR Standard
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason From the FHIR Standard
Encounter.diagnosis.use	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role From the FHIR Standard
Encounter.hospitalization.admitSource	preferred	AdmitSource http://hl7.org/fhir/ValueSet/encounter-admit-source From the FHIR Standard
Encounter.hospitalization.reAdmission	preferred	Hl7VSReAdmissionIndicator http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreference	preferred	Diet http://hl7.org/fhir/ValueSet/encounter-diet From the FHIR Standard
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy http://hl7.org/fhir/ValueSet/encounter-special-courtesy From the FHIR Standard
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements http://hl7.org/fhir/ValueSet/encounter-special-arrangements From the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	DischargeDisposition http://hl7.org/fhir/ValueSet/encounter-discharge-disposition From the FHIR Standard
Encounter.location.location.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types|4.0.1 From the FHIR Standard
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 From the FHIR Standard
Encounter.location.physicalType	extensible	LocationType http://hl7.org/fhir/ValueSet/location-physical-type From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
encounter-ach-monthly-initial-population	error	Encounter	Encounter: (class must be from ACH Monthly encounter class) or (type from 'Encounter Inpatient', 'Emergency Department Visit', or 'Observation Services') or (Encounter location type from 'Inpatient, Emergency, and Observation Locations') : class.memberOf('http://www.cy118119.com/nhsn/fhirportal/dqm/ig/ValueSet/ach-monthly-encounter-class') or class.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.274') or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292')).exists() or type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143')).exists() or location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists()
encounter-location-type-initial-population	warning	Encounter	Encounter: references at least one Location where type is from 'Inpatient, Emergency, and Observation Locations' : location.where(location.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists() or location.where(location.resolve().partOf.resolve().type.where(coding.memberOf('http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.265')).exists()).exists()
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from USCoreEncounterProfile

Summary

Mandatory: 7 elements
Must-Support: 15 elements

Extensions

This structure refers to these extensions:

• http://www.cy118119.com/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension

Maturity: 1