Example LTC Monthly Submission Pneumonia Bundle - CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG v2.0.0-cibuild

CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG - Local Development build (v2.0.0-cibuild) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Example Bundle: Example LTC Monthly Submission Pneumonia Bundle

Profile: NHSN Subject Bundle

Bundle bundle-example-ltc-monthly-subject-pneumonia of type collection

Entry 1 - fullUrl = http://nhsnlink.org/fhir/MeasureReport/measurereport-example-ltc-monthly-pneumonia

Resource MeasureReport:

Profile: DEQM Individual MeasureReport Profile
DEQM Measure Scoring Extension: Cohort
Extension Definition for MeasureReport.supplementalData for Version 5.0: Pneumonia LTC(official) Female, DoB: 1945-12-22 ( MRN: 1601191945010308 (use: usual, ))
Extension Definition for MeasureReport.supplementalData for Version 5.0: Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#10005104251 (use: usual, ); status = finished; class = inpatient acute (ActCode[9.0.0]#ACUTE); type = Hospital admission (procedure); period = 2025-02-01 16:02:00-0500 --> 2025-02-08 19:00:00-0500; reasonCode = Weakness
Extension Definition for MeasureReport.supplementalData for Version 5.0: Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#10005104251 (use: usual, ); status = in-progress; class = inpatient non-acute (ActCode[9.0.0]#NONAC); type = Subsequent nursing facility visit (procedure); period = 2025-02-08 16:02:00-0500 --> 2025-02-11 19:00:00-0500; reasonCode = Pneumonia, unspecified organism
Extension Definition for MeasureReport.supplementalData for Version 5.0: Coverage: identifier = Member Number: 335522612; status = active; type = subsidized health program; subscriberId = 123123123123; relationship = Child; period = 2020-08-01 --> (ongoing)
Extension Definition for MeasureReport.supplementalData for Version 5.0: Condition Pneumonia, unspecified organism
Extension Definition for MeasureReport.supplementalData for Version 5.0: MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888893 (use: usual, ); status = completed; category = Outpatient; medication[x] = ->Amoxicillin 1000 MG; effective[x] = 2024-01-31 04:54:00-0500
Extension Definition for MeasureReport.supplementalData for Version 5.0: MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888111 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Levofloxacin 500 MG; effective[x] = 2024-02-02 14:34:00-0500
Extension Definition for MeasureReport.supplementalData for Version 5.0: MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888892 (use: usual, ); status = active; intent = plan; category = Outpatient; medication[x] = ->Amoxicillin 1000 MG; authoredOn = 2024-01-31 04:46:00-0500
Extension Definition for MeasureReport.supplementalData for Version 5.0: MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888811 (use: usual, ); status = completed; intent = order; category = Inpatient; medication[x] = ->Levofloxacin 500 MG; authoredOn = 2024-02-02 13:43:00-0500
Extension Definition for MeasureReport.supplementalData for Version 5.0: Medication amoxicillin 1000 MG
Extension Definition for MeasureReport.supplementalData for Version 5.0: Medication levofloxacin 500 MG Oral Tablet
identifier: http://example.org/fhir/measurereport/id/123456789-pneumonia
status: Complete
type: Individual
measure: NHSN Acute Care Hospital Daily Initial Populationversion: null2.0.0-cibuild)
subject: Pneumonia LTC(official) Female, DoB: 1945-12-22 ( MRN: 1601191945010308 (use: usual, ))
date: 2024-01-06 21:04:29+0000
reporter: Organization Example NHSN Submitter
period: 2024-01-05 00:00:00+0000 --> 2024-01-06 00:00:00+0000
improvementNotation: Increased score indicates improvement
group
Populations
- Code Count
* Initial Population 1
evaluatedResource:
Pneumonia LTC(official) Female, DoB: 1945-12-22 ( MRN: 1601191945010308 (use: usual, ))
Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#10005104251 (use: usual, ); status = finished; class = inpatient acute (ActCode[9.0.0]#ACUTE); type = Hospital admission (procedure); period = 2025-02-01 16:02:00-0500 --> 2025-02-08 19:00:00-0500; reasonCode = Weakness
Encounter: identifier = urn:oid:2.16.840.1.113883.19.5.1.698.8#10005104251 (use: usual, ); status = in-progress; class = inpatient non-acute (ActCode[9.0.0]#NONAC); type = Subsequent nursing facility visit (procedure); period = 2025-02-08 16:02:00-0500 --> 2025-02-11 19:00:00-0500; reasonCode = Pneumonia, unspecified organism
Coverage: identifier = Member Number: 335522612; status = active; type = subsidized health program; subscriberId = 123123123123; relationship = Child; period = 2020-08-01 --> (ongoing)
Condition Pneumonia, unspecified organism
MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888893 (use: usual, ); status = completed; category = Outpatient; medication[x] = ->Amoxicillin 1000 MG; effective[x] = 2024-01-31 04:54:00-0500
MedicationAdministration: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#1018888111 (use: usual, ); status = completed; category = Inpatient; medication[x] = ->Levofloxacin 500 MG; effective[x] = 2024-02-02 14:34:00-0500
MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888892 (use: usual, ); status = active; intent = plan; category = Outpatient; medication[x] = ->Amoxicillin 1000 MG; authoredOn = 2024-01-31 04:46:00-0500
MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888811 (use: usual, ); status = completed; intent = order; category = Inpatient; medication[x] = ->Levofloxacin 500 MG; authoredOn = 2024-02-02 13:43:00-0500
Medication amoxicillin 1000 MG
Medication levofloxacin 500 MG Oral Tablet

Entry 2 - fullUrl = http://nhsnlink.org/fhir/Patient/patient-example-ltc-monthly-pneumonia

Resource Patient:

Profile: Cross-Measure Patient Profile
Pneumonia LTC(official) Female, DoB: 1945-12-22 ( MRN: 1601191945010308 (use: usual, ))
Active: true
Contact Detail
ph: 999-999-9999(Home)
123 Sesame Street Lansing Lansing MI 48864 US
US Core Ethnicity Extension:
ombCategory: Race & Ethnicity - CDC: 2186-5 (Not Hispanic or Latino)
text: Non Hispanic or Latino
US Core Birth Sex Extension F
US Core Race Extension:
ombCategory: Race & Ethnicity - CDC: 2106-3 (White)
text: White

Entry 3 - fullUrl = http://nhsnlink.org/fhir/Encounter/encounter-example-ltc-monthly-pneumonia-1

Resource Encounter:

Profile: LTC Monthly Event Encounter
identifier: urn:oid:2.16.840.1.113883.19.5.1.698.8/10005104251 (use: usual, )
status: completed
class: inpatient acute
type: Hospital Admission
subject: Pneumonia LTC
Diagnoses
- Condition
* No display for Encounter.diagnosis.condition (reference: ->Pneumonia)
Locations
- Location Period
* Inpatient Ward 2024-02-01 16:02:00-0500 --> 2024-02-08 16:02:00-0500

Entry 4 - fullUrl = http://nhsnlink.org/fhir/Encounter/encounter-example-ltc-monthly-pneumonia-2

Resource Encounter:

Profile: LTC Monthly Event Encounter
identifier: urn:oid:2.16.840.1.113883.19.5.1.698.8/10005104251 (use: usual, )
status: In Progress
class: inpatient non-acute
type: Nursing Facility Visit
subject: Pneumonia LTC
Diagnoses
- Condition
* No display for Encounter.diagnosis.condition (reference: ->Pneumonia)
Locations
- Location Period
* Inpatient Ward 2024-02-08 16:02:00-0500 --> 2024-02-11 16:02:00-0500

Entry 5 - fullUrl = http://nhsnlink.org/fhir/Coverage/coverage-example-ltc-monthly-pneumonia-medicare

Resource Coverage:

Profile: LTC Monthly Event Coverage
identifier: Member Number/335522612
status: Active
type: subsidized health program
subscriberId: 123123123123
beneficiary: Pneumonia LTC(official) Female, DoB: 1945-12-22 ( MRN: 1601191945010308 (use: usual, ))
relationship: Child
period: 2020-08-01 --> (ongoing)

Entry 6 - fullUrl = http://nhsnlink.org/fhir/Condition/condition-example-diagnosis-ltc-monthly-pneumonia

Resource Condition:

Profile: QICore Condition Encounter Diagnosisversion: null6.0.0)
clinicalStatus: Active
verificationStatus: Confirmed
category: Encounter Diagnosis
code: Pneumonia, unspecified organism
subject: Pneumonia LTC

Entry 7 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ltc-monthly-pneumonia-amoxicillin

Resource MedicationAdministration:

Profile: LTC Monthly Event Medication Administration
identifier: urn:oid:2.16.840.1.113883.19.5.1.798/101888893 (use: usual, )
status: completed
category: Outpatient
subject: Pneumonia LTC
request: MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888892 (use: usual, ); status = active; intent = plan; category = Outpatient; medication[x] = ->Amoxicillin 1000 MG; authoredOn = 2024-01-31 04:46:00-0500
Dosages
- Text Route Dose
* 1000 MG Oral once before dental procedure Oral 1 g (Details: UCUM codeg = 'g')

Entry 8 - fullUrl = http://nhsnlink.org/fhir/MedicationAdministration/medadmin-example-ltc-monthly-pneumonia-levofloxacin

Resource MedicationAdministration:

Profile: LTC Monthly Event Medication Administration
identifier: urn:oid:2.16.840.1.113883.19.5.1.798/1018888111 (use: usual, )
status: completed
category: Inpatient
subject: Pneumonia LTC
request: MedicationRequest: identifier = urn:oid:2.16.840.1.113883.19.5.1.798#101888811 (use: usual, ); status = completed; intent = order; category = Inpatient; medication[x] = ->Levofloxacin 500 MG; authoredOn = 2024-02-02 13:43:00-0500
Dosages
- Text Route Dose
* 500 MG Oral Tablet once daily Oral route 500 MG (Details: UCUM codeMG = 'MG')

Entry 9 - fullUrl = http://nhsnlink.org/fhir/MedicationRequest/medicationrequest-example-ltc-monthly-pneumonia-amoxicillin

Resource MedicationRequest:

Profile: LTC Monthly Event Medication Request
identifier: urn:oid:2.16.840.1.113883.19.5.1.798/101888892 (use: usual, )
status: Active
intent: Plan
category: Outpatient
subject: Pneumonia LTC
encounter: Hospital Admission
authoredOn: 2024-01-31 04:46:00-0500
requester: Pneumonia LTC(official) Female, DoB: 1945-12-22 ( MRN: 1601191945010308 (use: usual, ))
dosageInstruction
text: 2gram PO 30-60 minutes before dental procedure
timing: Once per 30 minutes
route: Oral
DoseAndRates
- Type Dose[x]
* calculated 2 g (Details: UCUM codeg = 'g')

Entry 10 - fullUrl = http://nhsnlink.org/fhir/MedicationRequest/medicationrequest-example-ltc-monthly-pneumonia-levofloxacin

Resource MedicationRequest:

Profile: LTC Monthly Event Medication Request
identifier: urn:oid:2.16.840.1.113883.19.5.1.798/101888811 (use: usual, )
status: Completed
intent: Order
category: Inpatient
subject: Pneumonia LTC
encounter: Hospital Admission
authoredOn: 2024-02-02 13:43:00-0500
requester: Pneumonia LTC(official) Female, DoB: 1945-12-22 ( MRN: 1601191945010308 (use: usual, ))
dosageInstruction
text: 500mg by mouth once a day for 7 days
timing: Once per 1 day
route: Oral route
DoseAndRates
- Type Dose[x]
* calculated 500 MG

Entry 11 - fullUrl = http://nhsnlink.org/fhir/Medication/medication-example-amoxicillin-1000

Resource Medication:

Profile: LTC Monthly Event Medication
code: Amoxicillin 1000mg oral tablet
status: Active

Entry 12 - fullUrl = http://nhsnlink.org/fhir/Medication/medication-example-levofloxacin-500

Resource Medication:

Profile: LTC Monthly Event Medication
code: Levofloxacin 500mg Oral Tablet
status: Active

Entry 13 - fullUrl = http://nhsnlink.org/fhir/Location/location-example-ltc-monthly-nursing-facility

Resource Location:

Profile: QICore Locationversion: null6.0.0)
identifier: http://www.example.com/location/3001
status: Active
name: LTC Monthly - Long Term Care Facility General Nursing Unit
description:
LTC Monthly General Nursing Unit

type: Long Term Care Facility General Nursing Unit