Example of personal care services provided at person's home (id = "HCBS")

<?xml version="1.0" encoding="UTF-8"?>

<Procedure xmlns="http://hl7.org/fhir">
  <id value="HCBS"/> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p> 
        <b>  Personal care services provided at person's home</b> 
      </p> 
      <p> 
        <b>  Based On</b>  : Peter's Long Term Services and Supports (LTSS) care plan</p> 
      <p> 
        <b>  Status</b>  : completed</p> 
      <p> 
        <b>  Beneficiary</b>  : Peter James</p> 
      <p> 
        <b>  Service Name/Code</b>  : Personal care services <span>  (Details : {HCPCS code 'T1019' = 'Personal care services, per 15 minutes'})</span> 
      </p> 
      <p> 
        <b>  Service Date</b>  : Apr 5, 2018</p> 
      <p> 
        <b>  Service Provider</b>  : Adam Careful</p> 
      <p> 
        <b>  Service Delivery Address</b>  : Peter's home</p> 
      <p> 
        <b>  Service Comment</b>  : Assisted with bathing and dressing, doing laundry, and meal preparation</p> 
    </div> 
  </text> 
  <basedOn> 
    <!--   <reference value="CarePlan/example-HCBS"/>     -->
    <display value="Peter's Long Term Service and Supports (LTSS) Care Plan"/> 
  </basedOn> 
  <status value="completed"/> 
  <code> 
    <coding> 
      <system value="https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/Alpha-Numeric-HCPCS.html"/> 
      <code value="T1019"/> 
      <display value="Personal care services, per 15 minutes, not for an inpatient or resident of a hospital,
       nursing facility, icf/mr or imd, part of the individualized plan of treatment."/> 
    </coding> 
    <text value="Personal care services"/> 
  </code> 
  <subject> 
    <reference value="Patient/example"/> 
    <display value="Peter James"/> 
  </subject> 
  <occurrenceDateTime value="2018-04-05"/> 
  <performer> 
    <actor> 
      <reference value="Practitioner/example"/> 
      <display value="Adam Careful"/> 
    </actor> 
  </performer> 
  <location> 
    <reference value="Location/ph"/> 
    <display value="Peter's Home"/> 
  </location> 
  <note> 
    <text value="Assisted with bathing and dressing, doing laundry, and meal preparation"/> 
  </note> 
</Procedure>