CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG - Local Development build (v3.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

• Content
• Detailed Descriptions
• Examples
• XML
• JSON

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 inherits from the QI Core 6.0.0 Encounter profile, which inherits from the US Core 6.1.0 Encounter profile.

This resource is required for the ACH Monthly Measure and must be referenced in all Individual MeasureReport resources for this measure.

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	S This element must be supported. C	1..*	QICoreEncounter(6.0.0)	(NHSN-MS) An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient during the NHSN ACH Monthly reporting period. This resource is required for the ACH Monthly Measure and must be referenced in all Individual MeasureReport resources for this measure. Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
Encounter.id	S This element must be supported. Σ This element is included in summaries.	1..1	id	(NHSN-MS) Logical id of this artifact
Encounter.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Encounter.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Encounter.identifier	S This element must be supported. Σ This element is included in summaries.	1..*	Identifier	(NHSN-MS) (USCDI) Identifier(s) by which this encounter is known
Encounter.identifier.use	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	0..1	code	(NHSN-MS) usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
Encounter.identifier.type	S This element must be supported. Σ This element is included in summaries.	0..1	CodeableConcept	(NHSN-MS) (USCDI) 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.
Encounter.identifier.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	(NHSN-MS) (USCDI) The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
Encounter.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	(NHSN-MS) (USCDI) The value that is unique Example General: 123456
Encounter.identifier.period	S This element must be supported. Σ This element is included in summaries.	0..1	Period	(NHSN-MS) Time period when id is/was valid for use
Encounter.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	(NHSN-MS) triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
Encounter.class	S This element must be supported. Σ This element is included in summaries.	1..1	Coding	(NHSN-MS) (USCDI) Classification of patient encounter Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter. Additional Bindings Purpose Documentation NHSN Inpatient Encounter Class Codes Extensible Includes codes from the NHSN Inpatient Encounter Class Codes ValueSet which is used as a component to determine if the Encounter is part of the Initial Population.
Encounter.classHistory	S This element must be supported.	0..*	BackboneElement	(NHSN-MS) List of past encounter classes
Encounter.classHistory.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.classHistory.class	S This element must be supported.	1..1	Coding	(NHSN-MS) inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
Encounter.classHistory.period	S This element must be supported.	1..1	Period	(NHSN-MS) The time that the episode was in the specified class
Encounter.type	S This element must be supported. Σ This element is included in summaries.	1..*	CodeableConcept	(NHSN-MS) (USCDI) Specific type of encounter Binding: USCoreEncounterType (6.1.0) (extensible): Valueset to describe the Encounter Type Additional Bindings Purpose Documentation ACH Monthly Encounter Initial Population Type ValueSet Extensible ACH Monthly Encounter Initial Population Type ValueSet which is used as a component to determine if the Encounter is part of the Initial Population.
Encounter.subject	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(Cross-Measure Patient Profile) {b}	(NHSN-MS) (QI-Core)(USCDI) The patient or group present at the encounter
Encounter.subject.reference	S This element must be supported. Σ This element is included in summaries. C	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.participant	S This element must be supported. Σ This element is included in summaries.	0..*	BackboneElement	(QI-Core)(USCDI) List of participants involved in the encounter
Encounter.participant.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.participant.type	S This element must be supported. Σ This element is included in summaries.	0..*	CodeableConcept	(USCDI) Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
Encounter.participant.period	S This element must be supported.	0..1	Period	(USCDI) Period of time during the encounter that the participant participated
Encounter.participant.individual	S This element must be supported. Σ This element is included in summaries.	0..1	Reference(QICore Practitioner | QICore PractitionerRole | QICore RelatedPerson)	(QI-Core)(USCDI) Persons involved in the encounter other than the patient
Encounter.period	S This element must be supported.	1..1	Period	(NHSN-MS) (USCDI) The start and end time of the encounter
Encounter.reasonCode	S This element must be supported. Σ This element is included in summaries.	0..*	CodeableConcept	(NHSN-MS) (USCDI) Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
Encounter.reasonReference	S This element must be supported. Σ This element is included in summaries.	0..*	Reference(QICore Condition Problems Health Concerns | QICore Condition Encounter Diagnosis | QICore Procedure | QICore Simple Observation | QICore ImmunizationRecommendation)	(QI-Core)(USCDI) Reason the encounter takes place (reference)
Encounter.diagnosis	S This element must be supported. Σ This element is included in summaries.	0..*	BackboneElement	(NHSN-MS) The list of diagnosis relevant to this encounter
Encounter.diagnosis.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.diagnosis.condition	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(Condition | Procedure) {b}	(NHSN-MS) The diagnosis or procedure relevant to the encounter
Encounter.diagnosis.condition.reference	S This element must be supported. Σ This element is included in summaries. C	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.diagnosis.use	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
Encounter.diagnosis.rank	S This element must be supported.	0..1	positiveInt	(NHSN-MS) Ranking of the diagnosis (for each role type)
Encounter.hospitalization	S This element must be supported.	0..1	BackboneElement	(NHSN-MS) (QI-Core)(USCDI) Details about the admission to a healthcare service
Encounter.hospitalization.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.hospitalization.origin	S This element must be supported.	0..1	Reference(QICore Location)	(NHSN-MS) The location/organization from which the patient came before admission
Encounter.hospitalization.admitSource	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) From where patient was admitted (physician referral, transfer) Binding: AdmitSource (extensible)
Encounter.hospitalization.reAdmission	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) 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: Hl7VSReAdmissionIndicator (3.0.0) (preferred)
Encounter.hospitalization.dietPreference	S This element must be supported.	0..*	CodeableConcept	(NHSN-MS) Diet preferences reported by the patient Binding: Diet (preferred)
Encounter.hospitalization.dischargeDisposition	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) (QI-Core)(USCDI) Category or kind of location after discharge Binding: DischargeDisposition (extensible)
Encounter.location	S This element must be supported.	1..*	BackboneElement	(NHSN-MS) List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
Encounter.location.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.location.location	S This element must be supported.	1..1	Reference(QICore Location) {b}	(NHSN-MS) (QI-Core)(USCDI) Location the encounter takes place
Encounter.location.location.reference	S This element must be supported. Σ This element is included in summaries. C	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.location.status	S This element must be supported.	0..1	code	(NHSN-MS) planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
Encounter.location.physicalType	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
Encounter.location.period	S This element must be supported.	1..1	Period	(NHSN-MS) (QI-Core) Time period during which the patient was present at the location
Encounter.serviceProvider	S This element must be supported.	0..1	Reference(QICore Organization)	(QI-Core)(USCDI) The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Encounter.identifier.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Encounter.identifier.​type	Base	extensible	IdentifierType	📦4.0.1	FHIR Std.
Encounter.status	Base	required	ACH Monthly Encounter Status ValueSet	📦3.0.0	This IG
Encounter.class	Base	extensible	ActEncounterCode	📍3.0.0	THO v7.1
Encounter.classHistory.​class	Base	extensible	ActEncounterCode	📍3.0.0	THO v7.1
Encounter.type	Base	extensible	US Core Encounter Type	📍6.1.0	US Core v6.1
Encounter.participant.​type	Base	extensible	Participant type	📦4.0.1	FHIR Std.
Encounter.reasonCode	Base	preferred	Encounter Reason Codes	📦4.0.1	FHIR Std.
Encounter.diagnosis.​use	Base	preferred	DiagnosisRole	📦4.0.1	FHIR Std.
Encounter.hospitalization.​admitSource	Base	extensible	Admit source	📦4.0.1	FHIR Std.
Encounter.hospitalization.​reAdmission	Base	preferred	hl7VS-re-admissionIndicator	📍3.0.0	THO v7.1
Encounter.hospitalization.​dietPreference	Base	preferred	Diet	📦4.0.1	FHIR Std.
Encounter.hospitalization.​dischargeDisposition	Base	extensible	Discharge disposition	📦4.0.1	FHIR Std.
Encounter.location.status	Base	required	EncounterLocationStatus	📍4.0.1	FHIR Std.
Encounter.location.physicalType	Base	extensible	Location type	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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.cdc.gov/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 QICoreEncounter

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter	S This element must be supported. C	1..*	QICoreEncounter(6.0.0)	(NHSN-MS) An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient during the NHSN ACH Monthly reporting period. This resource is required for the ACH Monthly Measure and must be referenced in all Individual MeasureReport resources for this measure. Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
Encounter.id	S This element must be supported.	1..1	id	(NHSN-MS) Logical id of this artifact
Encounter.meta
Encounter.meta.Slices for extension				Content/Rules for all slices
Encounter.meta.Slices for extension.extension:link-received-date-extension		0..1	dateTime	Received Date URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
Encounter.identifier		1..*	Identifier	(NHSN-MS)(USCDI) Identifier(s) by which this encounter is known
Encounter.identifier.use	S This element must be supported.	0..1	code	(NHSN-MS) usual | official | temp | secondary | old (If known)
Encounter.identifier.type	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) (USCDI) Description of identifier
Encounter.identifier.system		1..1	uri	(NHSN-MS)(USCDI) The namespace for the identifier value
Encounter.identifier.value		1..1	string	(NHSN-MS)(USCDI) The value that is unique
Encounter.identifier.period	S This element must be supported.	0..1	Period	(NHSN-MS) Time period when id is/was valid for use
Encounter.status		1..1	code	(NHSN-MS) triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
Encounter.class		1..1	Coding	(NHSN-MS)(USCDI) Classification of patient encounter Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter. Additional Bindings Purpose Documentation NHSN Inpatient Encounter Class Codes Extensible Includes codes from the NHSN Inpatient Encounter Class Codes ValueSet which is used as a component to determine if the Encounter is part of the Initial Population.
Encounter.classHistory	S This element must be supported.	0..*	BackboneElement	(NHSN-MS) List of past encounter classes
Encounter.classHistory.class	S This element must be supported.	1..1	Coding	(NHSN-MS) inpatient | outpatient | ambulatory | emergency +
Encounter.classHistory.period	S This element must be supported.	1..1	Period	(NHSN-MS) The time that the episode was in the specified class
Encounter.type		1..*	CodeableConcept	(NHSN-MS)(USCDI) Specific type of encounter Binding: USCoreEncounterType (6.1.0) (extensible): Valueset to describe the Encounter Type Additional Bindings Purpose Documentation ACH Monthly Encounter Initial Population Type ValueSet Extensible ACH Monthly Encounter Initial Population Type ValueSet which is used as a component to determine if the Encounter is part of the Initial Population.
Encounter.subject		1..1	Reference(Cross-Measure Patient Profile) {b}	(NHSN-MS)(QI-Core)(USCDI) The patient or group present at the encounter
Encounter.subject.reference	S This element must be supported.	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.period		1..1	Period	(NHSN-MS)(USCDI) The start and end time of the encounter
Encounter.reasonCode		0..*	CodeableConcept	(NHSN-MS)(USCDI) Coded reason the encounter takes place
Encounter.diagnosis	S This element must be supported.	0..*	BackboneElement	(NHSN-MS) The list of diagnosis relevant to this encounter
Encounter.diagnosis.condition	S This element must be supported.	1..1	Reference(Condition | Procedure) {b}	(NHSN-MS) The diagnosis or procedure relevant to the encounter
Encounter.diagnosis.condition.reference	S This element must be supported.	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.diagnosis.use	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
Encounter.diagnosis.rank	S This element must be supported.	0..1	positiveInt	(NHSN-MS) Ranking of the diagnosis (for each role type)
Encounter.hospitalization		0..1	BackboneElement	(NHSN-MS)(QI-Core)(USCDI) Details about the admission to a healthcare service
Encounter.hospitalization.origin	S This element must be supported.	0..1	Reference(QICore Location)	(NHSN-MS) The location/organization from which the patient came before admission
Encounter.hospitalization.admitSource	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) From where patient was admitted (physician referral, transfer) Binding: AdmitSource (extensible)
Encounter.hospitalization.reAdmission	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) 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: Hl7VSReAdmissionIndicator (3.0.0) (preferred)
Encounter.hospitalization.dietPreference	S This element must be supported.	0..*	CodeableConcept	(NHSN-MS) Diet preferences reported by the patient Binding: Diet (preferred)
Encounter.hospitalization.dischargeDisposition		0..1	CodeableConcept	(NHSN-MS)(QI-Core)(USCDI) Category or kind of location after discharge Binding: DischargeDisposition (extensible)
Encounter.location		1..*	BackboneElement	(NHSN-MS) List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
Encounter.location.location		1..1	Reference(QICore Location) {b}	(NHSN-MS)(QI-Core)(USCDI) Location the encounter takes place
Encounter.location.location.reference	S This element must be supported.	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.location.status	S This element must be supported.	0..1	code	(NHSN-MS) planned | active | reserved | completed
Encounter.location.physicalType	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
Encounter.location.period	S This element must be supported.	1..1	Period	(NHSN-MS) (QI-Core) Time period during which the patient was present at the location
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Encounter.status	Base	required	ACH Monthly Encounter Status ValueSet	📦3.0.0	This IG
Encounter.class	Base	extensible	ActEncounterCode	📍3.0.0	THO v7.1
Encounter.type	Base	extensible	US Core Encounter Type	📍6.1.0	US Core v6.1
Encounter.hospitalization.​admitSource	Base	extensible	Admit source	📦4.0.1	FHIR Std.
Encounter.hospitalization.​reAdmission	Base	preferred	hl7VS-re-admissionIndicator	📍3.0.0	THO v7.1
Encounter.hospitalization.​dietPreference	Base	preferred	Diet	📦4.0.1	FHIR Std.
Encounter.hospitalization.​dischargeDisposition	Base	extensible	Discharge disposition	📦4.0.1	FHIR Std.
Encounter.location.physicalType	Base	extensible	Location type	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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.cdc.gov/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	S This element must be supported. C	1..*	QICoreEncounter(6.0.0)	(NHSN-MS) An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient during the NHSN ACH Monthly reporting period. This resource is required for the ACH Monthly Measure and must be referenced in all Individual MeasureReport resources for this measure. Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
Encounter.id	S This element must be supported. Σ This element is included in summaries.	1..1	id	(NHSN-MS) Logical id of this artifact
Encounter.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Encounter.meta.id		0..1	string	Unique id for inter-element referencing
Encounter.meta.Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Encounter.meta.Slices for extension.extension:link-received-date-extension		0..1	dateTime	Received Date URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
Encounter.meta.versionId	Σ This element is included in summaries.	0..1	id	Version specific identifier
Encounter.meta.lastUpdated	Σ This element is included in summaries.	0..1	instant	When the resource version last changed
Encounter.meta.source	Σ This element is included in summaries.	0..1	uri	Identifies where the resource comes from
Encounter.meta.profile	Σ This element is included in summaries.	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
Encounter.meta.security	Σ This element is included in summaries.	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Encounter.meta.tag	Σ This element is included in summaries.	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".
Encounter.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Encounter.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Encounter.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
Encounter.contained		0..*	Resource	Contained, inline Resources
Encounter.extension		0..*	Extension	Additional content defined by implementations
Encounter.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Encounter.identifier	S This element must be supported. Σ This element is included in summaries.	1..*	Identifier	(NHSN-MS) (USCDI) Identifier(s) by which this encounter is known
Encounter.identifier.id		0..1	string	Unique id for inter-element referencing
Encounter.identifier.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Encounter.identifier.use	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	0..1	code	(NHSN-MS) usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
Encounter.identifier.type	S This element must be supported. Σ This element is included in summaries.	0..1	CodeableConcept	(NHSN-MS) (USCDI) 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.
Encounter.identifier.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	(NHSN-MS) (USCDI) The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
Encounter.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	(NHSN-MS) (USCDI) The value that is unique Example General: 123456
Encounter.identifier.period	S This element must be supported. Σ This element is included in summaries.	0..1	Period	(NHSN-MS) Time period when id is/was valid for use
Encounter.identifier.assigner	Σ This element is included in summaries.	0..1	Reference(Organization)	Organization that issued id (may be just text)
Encounter.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	(NHSN-MS) triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
Encounter.statusHistory		0..*	BackboneElement	List of past encounter statuses
Encounter.statusHistory.id		0..1	string	Unique id for inter-element referencing
Encounter.statusHistory.extension		0..*	Extension	Additional content defined by implementations
Encounter.statusHistory.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.statusHistory.status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
Encounter.statusHistory.period		1..1	Period	The time that the episode was in the specified status
Encounter.class	S This element must be supported. Σ This element is included in summaries.	1..1	Coding	(NHSN-MS) (USCDI) Classification of patient encounter Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter. Additional Bindings Purpose Documentation NHSN Inpatient Encounter Class Codes Extensible Includes codes from the NHSN Inpatient Encounter Class Codes ValueSet which is used as a component to determine if the Encounter is part of the Initial Population.
Encounter.classHistory	S This element must be supported.	0..*	BackboneElement	(NHSN-MS) List of past encounter classes
Encounter.classHistory.id		0..1	string	Unique id for inter-element referencing
Encounter.classHistory.extension		0..*	Extension	Additional content defined by implementations
Encounter.classHistory.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.classHistory.class	S This element must be supported.	1..1	Coding	(NHSN-MS) inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
Encounter.classHistory.period	S This element must be supported.	1..1	Period	(NHSN-MS) The time that the episode was in the specified class
Encounter.type	S This element must be supported. Σ This element is included in summaries.	1..*	CodeableConcept	(NHSN-MS) (USCDI) Specific type of encounter Binding: USCoreEncounterType (6.1.0) (extensible): Valueset to describe the Encounter Type Additional Bindings Purpose Documentation ACH Monthly Encounter Initial Population Type ValueSet Extensible ACH Monthly Encounter Initial Population Type ValueSet which is used as a component to determine if the Encounter is part of the Initial Population.
Encounter.serviceType	Σ This element is included in summaries.	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
Encounter.priority		0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (3.0.0) (example): Indicates the urgency of the encounter.
Encounter.subject	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(Cross-Measure Patient Profile) {b}	(NHSN-MS) (QI-Core)(USCDI) The patient or group present at the encounter
Encounter.subject.id		0..1	string	Unique id for inter-element referencing
Encounter.subject.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Encounter.subject.reference	S This element must be supported. Σ This element is included in summaries. C	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.subject.type	Σ This element is included in summaries.	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).
Encounter.subject.identifier	Σ This element is included in summaries.	0..1	Identifier	Logical reference, when literal reference is not known
Encounter.subject.display	Σ This element is included in summaries.	0..1	string	Text alternative for the resource
Encounter.episodeOfCare	Σ This element is included in summaries.	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
Encounter.basedOn		0..*	Reference(ServiceRequest)	The ServiceRequest that initiated this encounter
Encounter.participant	S This element must be supported. Σ This element is included in summaries.	0..*	BackboneElement	(QI-Core)(USCDI) List of participants involved in the encounter
Encounter.participant.id		0..1	string	Unique id for inter-element referencing
Encounter.participant.extension		0..*	Extension	Additional content defined by implementations
Encounter.participant.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.participant.type	S This element must be supported. Σ This element is included in summaries.	0..*	CodeableConcept	(USCDI) Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
Encounter.participant.period	S This element must be supported.	0..1	Period	(USCDI) Period of time during the encounter that the participant participated
Encounter.participant.individual	S This element must be supported. Σ This element is included in summaries.	0..1	Reference(QICore Practitioner | QICore PractitionerRole | QICore RelatedPerson)	(QI-Core)(USCDI) Persons involved in the encounter other than the patient
Encounter.appointment	Σ This element is included in summaries.	0..*	Reference(Appointment)	The appointment that scheduled this encounter
Encounter.period	S This element must be supported.	1..1	Period	(NHSN-MS) (USCDI) The start and end time of the encounter
Encounter.length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
Encounter.reasonCode	S This element must be supported. Σ This element is included in summaries.	0..*	CodeableConcept	(NHSN-MS) (USCDI) Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
Encounter.reasonReference	S This element must be supported. Σ This element is included in summaries.	0..*	Reference(QICore Condition Problems Health Concerns | QICore Condition Encounter Diagnosis | QICore Procedure | QICore Simple Observation | QICore ImmunizationRecommendation)	(QI-Core)(USCDI) Reason the encounter takes place (reference)
Encounter.diagnosis	S This element must be supported. Σ This element is included in summaries.	0..*	BackboneElement	(NHSN-MS) The list of diagnosis relevant to this encounter
Encounter.diagnosis.id		0..1	string	Unique id for inter-element referencing
Encounter.diagnosis.extension		0..*	Extension	Additional content defined by implementations
Encounter.diagnosis.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.diagnosis.condition	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(Condition | Procedure) {b}	(NHSN-MS) The diagnosis or procedure relevant to the encounter
Encounter.diagnosis.condition.id		0..1	string	Unique id for inter-element referencing
Encounter.diagnosis.condition.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Encounter.diagnosis.condition.reference	S This element must be supported. Σ This element is included in summaries. C	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.diagnosis.condition.type	Σ This element is included in summaries.	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).
Encounter.diagnosis.condition.identifier	Σ This element is included in summaries.	0..1	Identifier	Logical reference, when literal reference is not known
Encounter.diagnosis.condition.display	Σ This element is included in summaries.	0..1	string	Text alternative for the resource
Encounter.diagnosis.use	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
Encounter.diagnosis.rank	S This element must be supported.	0..1	positiveInt	(NHSN-MS) Ranking of the diagnosis (for each role type)
Encounter.account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
Encounter.hospitalization	S This element must be supported.	0..1	BackboneElement	(NHSN-MS) (QI-Core)(USCDI) Details about the admission to a healthcare service
Encounter.hospitalization.id		0..1	string	Unique id for inter-element referencing
Encounter.hospitalization.extension		0..*	Extension	Additional content defined by implementations
Encounter.hospitalization.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.hospitalization.preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
Encounter.hospitalization.origin	S This element must be supported.	0..1	Reference(QICore Location)	(NHSN-MS) The location/organization from which the patient came before admission
Encounter.hospitalization.admitSource	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) From where patient was admitted (physician referral, transfer) Binding: AdmitSource (extensible)
Encounter.hospitalization.reAdmission	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) 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: Hl7VSReAdmissionIndicator (3.0.0) (preferred)
Encounter.hospitalization.dietPreference	S This element must be supported.	0..*	CodeableConcept	(NHSN-MS) Diet preferences reported by the patient Binding: Diet (preferred)
Encounter.hospitalization.specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
Encounter.hospitalization.specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
Encounter.hospitalization.destination		0..1	Reference(QICore Location)	Location/organization to which the patient is discharged
Encounter.hospitalization.dischargeDisposition	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) (QI-Core)(USCDI) Category or kind of location after discharge Binding: DischargeDisposition (extensible)
Encounter.location	S This element must be supported.	1..*	BackboneElement	(NHSN-MS) List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
Encounter.location.id		0..1	string	Unique id for inter-element referencing
Encounter.location.extension		0..*	Extension	Additional content defined by implementations
Encounter.location.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.location.location	S This element must be supported.	1..1	Reference(QICore Location) {b}	(NHSN-MS) (QI-Core)(USCDI) Location the encounter takes place
Encounter.location.location.id		0..1	string	Unique id for inter-element referencing
Encounter.location.location.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Encounter.location.location.reference	S This element must be supported. Σ This element is included in summaries. C	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.location.location.type	Σ This element is included in summaries.	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).
Encounter.location.location.identifier	Σ This element is included in summaries.	0..1	Identifier	Logical reference, when literal reference is not known
Encounter.location.location.display	Σ This element is included in summaries.	0..1	string	Text alternative for the resource
Encounter.location.status	S This element must be supported.	0..1	code	(NHSN-MS) planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
Encounter.location.physicalType	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
Encounter.location.period	S This element must be supported.	1..1	Period	(NHSN-MS) (QI-Core) Time period during which the patient was present at the location
Encounter.serviceProvider	S This element must be supported.	0..1	Reference(QICore Organization)	(QI-Core)(USCDI) The organization (facility) responsible for this encounter
Encounter.partOf		0..1	Reference(QICore Encounter)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Encounter.meta.security	Base	extensible	SecurityLabels	📍4.0.1	FHIR Std.
Encounter.meta.tag	Base	example	Common Tags	📍4.0.1	FHIR Std.
Encounter.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
Encounter.identifier.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Encounter.identifier.​type	Base	extensible	IdentifierType	📦4.0.1	FHIR Std.
Encounter.status	Base	required	ACH Monthly Encounter Status ValueSet	📦3.0.0	This IG
Encounter.statusHistory.​status	Base	required	EncounterStatus	📍4.0.1	FHIR Std.
Encounter.class	Base	extensible	ActEncounterCode	📍3.0.0	THO v7.1
Encounter.classHistory.​class	Base	extensible	ActEncounterCode	📍3.0.0	THO v7.1
Encounter.type	Base	extensible	US Core Encounter Type	📍6.1.0	US Core v6.1
Encounter.serviceType	Base	example	Service type	📦4.0.1	FHIR Std.
Encounter.priority	Base	example	ActPriority	📍3.0.0	THO v7.1
Encounter.subject.type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Encounter.participant.​type	Base	extensible	Participant type	📦4.0.1	FHIR Std.
Encounter.reasonCode	Base	preferred	Encounter Reason Codes	📦4.0.1	FHIR Std.
Encounter.diagnosis.​condition.type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Encounter.diagnosis.​use	Base	preferred	DiagnosisRole	📦4.0.1	FHIR Std.
Encounter.hospitalization.​admitSource	Base	extensible	Admit source	📦4.0.1	FHIR Std.
Encounter.hospitalization.​reAdmission	Base	preferred	hl7VS-re-admissionIndicator	📍3.0.0	THO v7.1
Encounter.hospitalization.​dietPreference	Base	preferred	Diet	📦4.0.1	FHIR Std.
Encounter.hospitalization.​specialCourtesy	Base	preferred	Special courtesy	📦4.0.1	FHIR Std.
Encounter.hospitalization.​specialArrangement	Base	preferred	Special arrangements	📦4.0.1	FHIR Std.
Encounter.hospitalization.​dischargeDisposition	Base	extensible	Discharge disposition	📦4.0.1	FHIR Std.
Encounter.location.location.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Encounter.location.status	Base	required	EncounterLocationStatus	📍4.0.1	FHIR Std.
Encounter.location.physicalType	Base	extensible	Location type	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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.cdc.gov/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 QICoreEncounter

Summary

Mandatory: 7 elements(1 nested mandatory element)
Must-Support: 21 elements

Structures

This structure refers to these other structures:

• Cross-Measure Patient Profile (http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/cross-measure-patient)
• QICore Location (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location)

Extensions

This structure refers to these extensions:

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

Maturity: 2

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter	S This element must be supported. C	1..*	QICoreEncounter(6.0.0)	(NHSN-MS) An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient during the NHSN ACH Monthly reporting period. This resource is required for the ACH Monthly Measure and must be referenced in all Individual MeasureReport resources for this measure. Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
Encounter.id	S This element must be supported. Σ This element is included in summaries.	1..1	id	(NHSN-MS) Logical id of this artifact
Encounter.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Encounter.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Encounter.identifier	S This element must be supported. Σ This element is included in summaries.	1..*	Identifier	(NHSN-MS) (USCDI) Identifier(s) by which this encounter is known
Encounter.identifier.use	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	0..1	code	(NHSN-MS) usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
Encounter.identifier.type	S This element must be supported. Σ This element is included in summaries.	0..1	CodeableConcept	(NHSN-MS) (USCDI) 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.
Encounter.identifier.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	(NHSN-MS) (USCDI) The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
Encounter.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	(NHSN-MS) (USCDI) The value that is unique Example General: 123456
Encounter.identifier.period	S This element must be supported. Σ This element is included in summaries.	0..1	Period	(NHSN-MS) Time period when id is/was valid for use
Encounter.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	(NHSN-MS) triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
Encounter.class	S This element must be supported. Σ This element is included in summaries.	1..1	Coding	(NHSN-MS) (USCDI) Classification of patient encounter Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter. Additional Bindings Purpose Documentation NHSN Inpatient Encounter Class Codes Extensible Includes codes from the NHSN Inpatient Encounter Class Codes ValueSet which is used as a component to determine if the Encounter is part of the Initial Population.
Encounter.classHistory	S This element must be supported.	0..*	BackboneElement	(NHSN-MS) List of past encounter classes
Encounter.classHistory.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.classHistory.class	S This element must be supported.	1..1	Coding	(NHSN-MS) inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
Encounter.classHistory.period	S This element must be supported.	1..1	Period	(NHSN-MS) The time that the episode was in the specified class
Encounter.type	S This element must be supported. Σ This element is included in summaries.	1..*	CodeableConcept	(NHSN-MS) (USCDI) Specific type of encounter Binding: USCoreEncounterType (6.1.0) (extensible): Valueset to describe the Encounter Type Additional Bindings Purpose Documentation ACH Monthly Encounter Initial Population Type ValueSet Extensible ACH Monthly Encounter Initial Population Type ValueSet which is used as a component to determine if the Encounter is part of the Initial Population.
Encounter.subject	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(Cross-Measure Patient Profile) {b}	(NHSN-MS) (QI-Core)(USCDI) The patient or group present at the encounter
Encounter.subject.reference	S This element must be supported. Σ This element is included in summaries. C	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.participant	S This element must be supported. Σ This element is included in summaries.	0..*	BackboneElement	(QI-Core)(USCDI) List of participants involved in the encounter
Encounter.participant.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.participant.type	S This element must be supported. Σ This element is included in summaries.	0..*	CodeableConcept	(USCDI) Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
Encounter.participant.period	S This element must be supported.	0..1	Period	(USCDI) Period of time during the encounter that the participant participated
Encounter.participant.individual	S This element must be supported. Σ This element is included in summaries.	0..1	Reference(QICore Practitioner | QICore PractitionerRole | QICore RelatedPerson)	(QI-Core)(USCDI) Persons involved in the encounter other than the patient
Encounter.period	S This element must be supported.	1..1	Period	(NHSN-MS) (USCDI) The start and end time of the encounter
Encounter.reasonCode	S This element must be supported. Σ This element is included in summaries.	0..*	CodeableConcept	(NHSN-MS) (USCDI) Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
Encounter.reasonReference	S This element must be supported. Σ This element is included in summaries.	0..*	Reference(QICore Condition Problems Health Concerns | QICore Condition Encounter Diagnosis | QICore Procedure | QICore Simple Observation | QICore ImmunizationRecommendation)	(QI-Core)(USCDI) Reason the encounter takes place (reference)
Encounter.diagnosis	S This element must be supported. Σ This element is included in summaries.	0..*	BackboneElement	(NHSN-MS) The list of diagnosis relevant to this encounter
Encounter.diagnosis.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.diagnosis.condition	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(Condition | Procedure) {b}	(NHSN-MS) The diagnosis or procedure relevant to the encounter
Encounter.diagnosis.condition.reference	S This element must be supported. Σ This element is included in summaries. C	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.diagnosis.use	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
Encounter.diagnosis.rank	S This element must be supported.	0..1	positiveInt	(NHSN-MS) Ranking of the diagnosis (for each role type)
Encounter.hospitalization	S This element must be supported.	0..1	BackboneElement	(NHSN-MS) (QI-Core)(USCDI) Details about the admission to a healthcare service
Encounter.hospitalization.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.hospitalization.origin	S This element must be supported.	0..1	Reference(QICore Location)	(NHSN-MS) The location/organization from which the patient came before admission
Encounter.hospitalization.admitSource	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) From where patient was admitted (physician referral, transfer) Binding: AdmitSource (extensible)
Encounter.hospitalization.reAdmission	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) 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: Hl7VSReAdmissionIndicator (3.0.0) (preferred)
Encounter.hospitalization.dietPreference	S This element must be supported.	0..*	CodeableConcept	(NHSN-MS) Diet preferences reported by the patient Binding: Diet (preferred)
Encounter.hospitalization.dischargeDisposition	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) (QI-Core)(USCDI) Category or kind of location after discharge Binding: DischargeDisposition (extensible)
Encounter.location	S This element must be supported.	1..*	BackboneElement	(NHSN-MS) List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
Encounter.location.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.location.location	S This element must be supported.	1..1	Reference(QICore Location) {b}	(NHSN-MS) (QI-Core)(USCDI) Location the encounter takes place
Encounter.location.location.reference	S This element must be supported. Σ This element is included in summaries. C	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.location.status	S This element must be supported.	0..1	code	(NHSN-MS) planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
Encounter.location.physicalType	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
Encounter.location.period	S This element must be supported.	1..1	Period	(NHSN-MS) (QI-Core) Time period during which the patient was present at the location
Encounter.serviceProvider	S This element must be supported.	0..1	Reference(QICore Organization)	(QI-Core)(USCDI) The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Encounter.identifier.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Encounter.identifier.​type	Base	extensible	IdentifierType	📦4.0.1	FHIR Std.
Encounter.status	Base	required	ACH Monthly Encounter Status ValueSet	📦3.0.0	This IG
Encounter.class	Base	extensible	ActEncounterCode	📍3.0.0	THO v7.1
Encounter.classHistory.​class	Base	extensible	ActEncounterCode	📍3.0.0	THO v7.1
Encounter.type	Base	extensible	US Core Encounter Type	📍6.1.0	US Core v6.1
Encounter.participant.​type	Base	extensible	Participant type	📦4.0.1	FHIR Std.
Encounter.reasonCode	Base	preferred	Encounter Reason Codes	📦4.0.1	FHIR Std.
Encounter.diagnosis.​use	Base	preferred	DiagnosisRole	📦4.0.1	FHIR Std.
Encounter.hospitalization.​admitSource	Base	extensible	Admit source	📦4.0.1	FHIR Std.
Encounter.hospitalization.​reAdmission	Base	preferred	hl7VS-re-admissionIndicator	📍3.0.0	THO v7.1
Encounter.hospitalization.​dietPreference	Base	preferred	Diet	📦4.0.1	FHIR Std.
Encounter.hospitalization.​dischargeDisposition	Base	extensible	Discharge disposition	📦4.0.1	FHIR Std.
Encounter.location.status	Base	required	EncounterLocationStatus	📍4.0.1	FHIR Std.
Encounter.location.physicalType	Base	extensible	Location type	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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.cdc.gov/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 QICoreEncounter

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter	S This element must be supported. C	1..*	QICoreEncounter(6.0.0)	(NHSN-MS) An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient during the NHSN ACH Monthly reporting period. This resource is required for the ACH Monthly Measure and must be referenced in all Individual MeasureReport resources for this measure. Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
Encounter.id	S This element must be supported.	1..1	id	(NHSN-MS) Logical id of this artifact
Encounter.meta
Encounter.meta.Slices for extension				Content/Rules for all slices
Encounter.meta.Slices for extension.extension:link-received-date-extension		0..1	dateTime	Received Date URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
Encounter.identifier		1..*	Identifier	(NHSN-MS)(USCDI) Identifier(s) by which this encounter is known
Encounter.identifier.use	S This element must be supported.	0..1	code	(NHSN-MS) usual | official | temp | secondary | old (If known)
Encounter.identifier.type	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) (USCDI) Description of identifier
Encounter.identifier.system		1..1	uri	(NHSN-MS)(USCDI) The namespace for the identifier value
Encounter.identifier.value		1..1	string	(NHSN-MS)(USCDI) The value that is unique
Encounter.identifier.period	S This element must be supported.	0..1	Period	(NHSN-MS) Time period when id is/was valid for use
Encounter.status		1..1	code	(NHSN-MS) triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
Encounter.class		1..1	Coding	(NHSN-MS)(USCDI) Classification of patient encounter Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter. Additional Bindings Purpose Documentation NHSN Inpatient Encounter Class Codes Extensible Includes codes from the NHSN Inpatient Encounter Class Codes ValueSet which is used as a component to determine if the Encounter is part of the Initial Population.
Encounter.classHistory	S This element must be supported.	0..*	BackboneElement	(NHSN-MS) List of past encounter classes
Encounter.classHistory.class	S This element must be supported.	1..1	Coding	(NHSN-MS) inpatient | outpatient | ambulatory | emergency +
Encounter.classHistory.period	S This element must be supported.	1..1	Period	(NHSN-MS) The time that the episode was in the specified class
Encounter.type		1..*	CodeableConcept	(NHSN-MS)(USCDI) Specific type of encounter Binding: USCoreEncounterType (6.1.0) (extensible): Valueset to describe the Encounter Type Additional Bindings Purpose Documentation ACH Monthly Encounter Initial Population Type ValueSet Extensible ACH Monthly Encounter Initial Population Type ValueSet which is used as a component to determine if the Encounter is part of the Initial Population.
Encounter.subject		1..1	Reference(Cross-Measure Patient Profile) {b}	(NHSN-MS)(QI-Core)(USCDI) The patient or group present at the encounter
Encounter.subject.reference	S This element must be supported.	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.period		1..1	Period	(NHSN-MS)(USCDI) The start and end time of the encounter
Encounter.reasonCode		0..*	CodeableConcept	(NHSN-MS)(USCDI) Coded reason the encounter takes place
Encounter.diagnosis	S This element must be supported.	0..*	BackboneElement	(NHSN-MS) The list of diagnosis relevant to this encounter
Encounter.diagnosis.condition	S This element must be supported.	1..1	Reference(Condition | Procedure) {b}	(NHSN-MS) The diagnosis or procedure relevant to the encounter
Encounter.diagnosis.condition.reference	S This element must be supported.	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.diagnosis.use	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
Encounter.diagnosis.rank	S This element must be supported.	0..1	positiveInt	(NHSN-MS) Ranking of the diagnosis (for each role type)
Encounter.hospitalization		0..1	BackboneElement	(NHSN-MS)(QI-Core)(USCDI) Details about the admission to a healthcare service
Encounter.hospitalization.origin	S This element must be supported.	0..1	Reference(QICore Location)	(NHSN-MS) The location/organization from which the patient came before admission
Encounter.hospitalization.admitSource	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) From where patient was admitted (physician referral, transfer) Binding: AdmitSource (extensible)
Encounter.hospitalization.reAdmission	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) 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: Hl7VSReAdmissionIndicator (3.0.0) (preferred)
Encounter.hospitalization.dietPreference	S This element must be supported.	0..*	CodeableConcept	(NHSN-MS) Diet preferences reported by the patient Binding: Diet (preferred)
Encounter.hospitalization.dischargeDisposition		0..1	CodeableConcept	(NHSN-MS)(QI-Core)(USCDI) Category or kind of location after discharge Binding: DischargeDisposition (extensible)
Encounter.location		1..*	BackboneElement	(NHSN-MS) List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
Encounter.location.location		1..1	Reference(QICore Location) {b}	(NHSN-MS)(QI-Core)(USCDI) Location the encounter takes place
Encounter.location.location.reference	S This element must be supported.	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.location.status	S This element must be supported.	0..1	code	(NHSN-MS) planned | active | reserved | completed
Encounter.location.physicalType	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
Encounter.location.period	S This element must be supported.	1..1	Period	(NHSN-MS) (QI-Core) Time period during which the patient was present at the location
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Encounter.status	Base	required	ACH Monthly Encounter Status ValueSet	📦3.0.0	This IG
Encounter.class	Base	extensible	ActEncounterCode	📍3.0.0	THO v7.1
Encounter.type	Base	extensible	US Core Encounter Type	📍6.1.0	US Core v6.1
Encounter.hospitalization.​admitSource	Base	extensible	Admit source	📦4.0.1	FHIR Std.
Encounter.hospitalization.​reAdmission	Base	preferred	hl7VS-re-admissionIndicator	📍3.0.0	THO v7.1
Encounter.hospitalization.​dietPreference	Base	preferred	Diet	📦4.0.1	FHIR Std.
Encounter.hospitalization.​dischargeDisposition	Base	extensible	Discharge disposition	📦4.0.1	FHIR Std.
Encounter.location.physicalType	Base	extensible	Location type	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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.cdc.gov/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	S This element must be supported. C	1..*	QICoreEncounter(6.0.0)	(NHSN-MS) An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient during the NHSN ACH Monthly reporting period. This resource is required for the ACH Monthly Measure and must be referenced in all Individual MeasureReport resources for this measure. Constraints: encounter-ach-monthly-initial-population, encounter-location-type-initial-population
Encounter.id	S This element must be supported. Σ This element is included in summaries.	1..1	id	(NHSN-MS) Logical id of this artifact
Encounter.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Encounter.meta.id		0..1	string	Unique id for inter-element referencing
Encounter.meta.Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Encounter.meta.Slices for extension.extension:link-received-date-extension		0..1	dateTime	Received Date URL: http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
Encounter.meta.versionId	Σ This element is included in summaries.	0..1	id	Version specific identifier
Encounter.meta.lastUpdated	Σ This element is included in summaries.	0..1	instant	When the resource version last changed
Encounter.meta.source	Σ This element is included in summaries.	0..1	uri	Identifies where the resource comes from
Encounter.meta.profile	Σ This element is included in summaries.	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
Encounter.meta.security	Σ This element is included in summaries.	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Encounter.meta.tag	Σ This element is included in summaries.	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".
Encounter.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Encounter.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Encounter.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
Encounter.contained		0..*	Resource	Contained, inline Resources
Encounter.extension		0..*	Extension	Additional content defined by implementations
Encounter.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Encounter.identifier	S This element must be supported. Σ This element is included in summaries.	1..*	Identifier	(NHSN-MS) (USCDI) Identifier(s) by which this encounter is known
Encounter.identifier.id		0..1	string	Unique id for inter-element referencing
Encounter.identifier.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Encounter.identifier.use	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	0..1	code	(NHSN-MS) usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
Encounter.identifier.type	S This element must be supported. Σ This element is included in summaries.	0..1	CodeableConcept	(NHSN-MS) (USCDI) 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.
Encounter.identifier.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	(NHSN-MS) (USCDI) The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
Encounter.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	(NHSN-MS) (USCDI) The value that is unique Example General: 123456
Encounter.identifier.period	S This element must be supported. Σ This element is included in summaries.	0..1	Period	(NHSN-MS) Time period when id is/was valid for use
Encounter.identifier.assigner	Σ This element is included in summaries.	0..1	Reference(Organization)	Organization that issued id (may be just text)
Encounter.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	(NHSN-MS) triaged | in-progress | finished | onleave | entered-in-error Binding: ACH Monthly Encounter Status ValueSet (required)
Encounter.statusHistory		0..*	BackboneElement	List of past encounter statuses
Encounter.statusHistory.id		0..1	string	Unique id for inter-element referencing
Encounter.statusHistory.extension		0..*	Extension	Additional content defined by implementations
Encounter.statusHistory.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.statusHistory.status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
Encounter.statusHistory.period		1..1	Period	The time that the episode was in the specified status
Encounter.class	S This element must be supported. Σ This element is included in summaries.	1..1	Coding	(NHSN-MS) (USCDI) Classification of patient encounter Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter. Additional Bindings Purpose Documentation NHSN Inpatient Encounter Class Codes Extensible Includes codes from the NHSN Inpatient Encounter Class Codes ValueSet which is used as a component to determine if the Encounter is part of the Initial Population.
Encounter.classHistory	S This element must be supported.	0..*	BackboneElement	(NHSN-MS) List of past encounter classes
Encounter.classHistory.id		0..1	string	Unique id for inter-element referencing
Encounter.classHistory.extension		0..*	Extension	Additional content defined by implementations
Encounter.classHistory.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.classHistory.class	S This element must be supported.	1..1	Coding	(NHSN-MS) inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
Encounter.classHistory.period	S This element must be supported.	1..1	Period	(NHSN-MS) The time that the episode was in the specified class
Encounter.type	S This element must be supported. Σ This element is included in summaries.	1..*	CodeableConcept	(NHSN-MS) (USCDI) Specific type of encounter Binding: USCoreEncounterType (6.1.0) (extensible): Valueset to describe the Encounter Type Additional Bindings Purpose Documentation ACH Monthly Encounter Initial Population Type ValueSet Extensible ACH Monthly Encounter Initial Population Type ValueSet which is used as a component to determine if the Encounter is part of the Initial Population.
Encounter.serviceType	Σ This element is included in summaries.	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
Encounter.priority		0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (3.0.0) (example): Indicates the urgency of the encounter.
Encounter.subject	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(Cross-Measure Patient Profile) {b}	(NHSN-MS) (QI-Core)(USCDI) The patient or group present at the encounter
Encounter.subject.id		0..1	string	Unique id for inter-element referencing
Encounter.subject.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Encounter.subject.reference	S This element must be supported. Σ This element is included in summaries. C	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.subject.type	Σ This element is included in summaries.	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).
Encounter.subject.identifier	Σ This element is included in summaries.	0..1	Identifier	Logical reference, when literal reference is not known
Encounter.subject.display	Σ This element is included in summaries.	0..1	string	Text alternative for the resource
Encounter.episodeOfCare	Σ This element is included in summaries.	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
Encounter.basedOn		0..*	Reference(ServiceRequest)	The ServiceRequest that initiated this encounter
Encounter.participant	S This element must be supported. Σ This element is included in summaries.	0..*	BackboneElement	(QI-Core)(USCDI) List of participants involved in the encounter
Encounter.participant.id		0..1	string	Unique id for inter-element referencing
Encounter.participant.extension		0..*	Extension	Additional content defined by implementations
Encounter.participant.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.participant.type	S This element must be supported. Σ This element is included in summaries.	0..*	CodeableConcept	(USCDI) Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
Encounter.participant.period	S This element must be supported.	0..1	Period	(USCDI) Period of time during the encounter that the participant participated
Encounter.participant.individual	S This element must be supported. Σ This element is included in summaries.	0..1	Reference(QICore Practitioner | QICore PractitionerRole | QICore RelatedPerson)	(QI-Core)(USCDI) Persons involved in the encounter other than the patient
Encounter.appointment	Σ This element is included in summaries.	0..*	Reference(Appointment)	The appointment that scheduled this encounter
Encounter.period	S This element must be supported.	1..1	Period	(NHSN-MS) (USCDI) The start and end time of the encounter
Encounter.length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
Encounter.reasonCode	S This element must be supported. Σ This element is included in summaries.	0..*	CodeableConcept	(NHSN-MS) (USCDI) Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
Encounter.reasonReference	S This element must be supported. Σ This element is included in summaries.	0..*	Reference(QICore Condition Problems Health Concerns | QICore Condition Encounter Diagnosis | QICore Procedure | QICore Simple Observation | QICore ImmunizationRecommendation)	(QI-Core)(USCDI) Reason the encounter takes place (reference)
Encounter.diagnosis	S This element must be supported. Σ This element is included in summaries.	0..*	BackboneElement	(NHSN-MS) The list of diagnosis relevant to this encounter
Encounter.diagnosis.id		0..1	string	Unique id for inter-element referencing
Encounter.diagnosis.extension		0..*	Extension	Additional content defined by implementations
Encounter.diagnosis.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.diagnosis.condition	S This element must be supported. Σ This element is included in summaries.	1..1	Reference(Condition | Procedure) {b}	(NHSN-MS) The diagnosis or procedure relevant to the encounter
Encounter.diagnosis.condition.id		0..1	string	Unique id for inter-element referencing
Encounter.diagnosis.condition.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Encounter.diagnosis.condition.reference	S This element must be supported. Σ This element is included in summaries. C	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.diagnosis.condition.type	Σ This element is included in summaries.	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).
Encounter.diagnosis.condition.identifier	Σ This element is included in summaries.	0..1	Identifier	Logical reference, when literal reference is not known
Encounter.diagnosis.condition.display	Σ This element is included in summaries.	0..1	string	Text alternative for the resource
Encounter.diagnosis.use	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
Encounter.diagnosis.rank	S This element must be supported.	0..1	positiveInt	(NHSN-MS) Ranking of the diagnosis (for each role type)
Encounter.account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
Encounter.hospitalization	S This element must be supported.	0..1	BackboneElement	(NHSN-MS) (QI-Core)(USCDI) Details about the admission to a healthcare service
Encounter.hospitalization.id		0..1	string	Unique id for inter-element referencing
Encounter.hospitalization.extension		0..*	Extension	Additional content defined by implementations
Encounter.hospitalization.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.hospitalization.preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
Encounter.hospitalization.origin	S This element must be supported.	0..1	Reference(QICore Location)	(NHSN-MS) The location/organization from which the patient came before admission
Encounter.hospitalization.admitSource	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) From where patient was admitted (physician referral, transfer) Binding: AdmitSource (extensible)
Encounter.hospitalization.reAdmission	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) 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: Hl7VSReAdmissionIndicator (3.0.0) (preferred)
Encounter.hospitalization.dietPreference	S This element must be supported.	0..*	CodeableConcept	(NHSN-MS) Diet preferences reported by the patient Binding: Diet (preferred)
Encounter.hospitalization.specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
Encounter.hospitalization.specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
Encounter.hospitalization.destination		0..1	Reference(QICore Location)	Location/organization to which the patient is discharged
Encounter.hospitalization.dischargeDisposition	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) (QI-Core)(USCDI) Category or kind of location after discharge Binding: DischargeDisposition (extensible)
Encounter.location	S This element must be supported.	1..*	BackboneElement	(NHSN-MS) List of locations where the patient has been. Used in part to discern whether the patient is Inpatient, Emergency and or Observation status.
Encounter.location.id		0..1	string	Unique id for inter-element referencing
Encounter.location.extension		0..*	Extension	Additional content defined by implementations
Encounter.location.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Encounter.location.location	S This element must be supported.	1..1	Reference(QICore Location) {b}	(NHSN-MS) (QI-Core)(USCDI) Location the encounter takes place
Encounter.location.location.id		0..1	string	Unique id for inter-element referencing
Encounter.location.location.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Encounter.location.location.reference	S This element must be supported. Σ This element is included in summaries. C	1..1	string	(NHSN-MS) Literal reference, Relative, internal or absolute URL
Encounter.location.location.type	Σ This element is included in summaries.	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).
Encounter.location.location.identifier	Σ This element is included in summaries.	0..1	Identifier	Logical reference, when literal reference is not known
Encounter.location.location.display	Σ This element is included in summaries.	0..1	string	Text alternative for the resource
Encounter.location.status	S This element must be supported.	0..1	code	(NHSN-MS) planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
Encounter.location.physicalType	S This element must be supported.	0..1	CodeableConcept	(NHSN-MS) The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (extensible)
Encounter.location.period	S This element must be supported.	1..1	Period	(NHSN-MS) (QI-Core) Time period during which the patient was present at the location
Encounter.serviceProvider	S This element must be supported.	0..1	Reference(QICore Organization)	(QI-Core)(USCDI) The organization (facility) responsible for this encounter
Encounter.partOf		0..1	Reference(QICore Encounter)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Encounter.meta.security	Base	extensible	SecurityLabels	📍4.0.1	FHIR Std.
Encounter.meta.tag	Base	example	Common Tags	📍4.0.1	FHIR Std.
Encounter.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
Encounter.identifier.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Encounter.identifier.​type	Base	extensible	IdentifierType	📦4.0.1	FHIR Std.
Encounter.status	Base	required	ACH Monthly Encounter Status ValueSet	📦3.0.0	This IG
Encounter.statusHistory.​status	Base	required	EncounterStatus	📍4.0.1	FHIR Std.
Encounter.class	Base	extensible	ActEncounterCode	📍3.0.0	THO v7.1
Encounter.classHistory.​class	Base	extensible	ActEncounterCode	📍3.0.0	THO v7.1
Encounter.type	Base	extensible	US Core Encounter Type	📍6.1.0	US Core v6.1
Encounter.serviceType	Base	example	Service type	📦4.0.1	FHIR Std.
Encounter.priority	Base	example	ActPriority	📍3.0.0	THO v7.1
Encounter.subject.type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Encounter.participant.​type	Base	extensible	Participant type	📦4.0.1	FHIR Std.
Encounter.reasonCode	Base	preferred	Encounter Reason Codes	📦4.0.1	FHIR Std.
Encounter.diagnosis.​condition.type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Encounter.diagnosis.​use	Base	preferred	DiagnosisRole	📦4.0.1	FHIR Std.
Encounter.hospitalization.​admitSource	Base	extensible	Admit source	📦4.0.1	FHIR Std.
Encounter.hospitalization.​reAdmission	Base	preferred	hl7VS-re-admissionIndicator	📍3.0.0	THO v7.1
Encounter.hospitalization.​dietPreference	Base	preferred	Diet	📦4.0.1	FHIR Std.
Encounter.hospitalization.​specialCourtesy	Base	preferred	Special courtesy	📦4.0.1	FHIR Std.
Encounter.hospitalization.​specialArrangement	Base	preferred	Special arrangements	📦4.0.1	FHIR Std.
Encounter.hospitalization.​dischargeDisposition	Base	extensible	Discharge disposition	📦4.0.1	FHIR Std.
Encounter.location.location.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Encounter.location.status	Base	required	EncounterLocationStatus	📍4.0.1	FHIR Std.
Encounter.location.physicalType	Base	extensible	Location type	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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.cdc.gov/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 QICoreEncounter

Summary

Mandatory: 7 elements(1 nested mandatory element)
Must-Support: 21 elements

Structures

This structure refers to these other structures:

• Cross-Measure Patient Profile (http://www.cdc.gov/nhsn/fhirportal/dqm/ig/StructureDefinition/cross-measure-patient)
• QICore Location (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location)

Extensions

This structure refers to these extensions:

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

Maturity: 2