ELTSS 0.1.0 - STU1 Ballot 1

This page is part of the electronic Long-Term Services and Supports Implementation Guide (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

eLTSS Dataset to FHIR USCore Implementation Guide

eLTSS Dataset Element FHIR Resource US Core Profile
Person Name Patient US Core Patient Profile
Person Identifier Patient US Core Patient Profile
Person Identifier Type Patient US Core Patient Profile
Person Date of Birth Patient US Core Patient Profile
Person Phone Number Patient
Person Address Patient
Emergency Contact Name Patient
Emergency Contact Relationship Patient
Emergency Contact Phone Number Patient
Emergency Backup Plan CarePlan OR DocumentReference US Core CarePlan Profile OR US Core DocumentReference Profile
Goal Goal US Core Goal Profile
Step or Action CarePlan OR Service Request US Core CarePlan Profile
Strength Observation
Assessed Need Condition US Core Condition Profile
Person Setting Choice Indicator Questionnaire AND QuestionnaireResponse
Person Setting Choice Options Questionnaire AND QuestionnaireResponse
Plan Monitor Name Practitioner US Core Practitioner Profile
Plan Monitor Phone Number Practitioner US Core Practitioner Profile
Preference Observation
Service Options Given Indicator Questionnaire AND QuestionnaireResponse
Service Selection Indicator Questionnaire AND QuestionnaireResponse
Service Plan Agreement Indicator Questionnaire AND QuestionnaireResponse
Service Provider Options Given Indicator Questionnaire AND QuestionnaireResponse
Service Provider Selection Agreement Indicator Questionnaire AND QuestionnaireResponse
Plan Effective Date CarePlan US Core CarePlan Profile
Person Signature Contract
Person Printed Name Contract
Person Signature Date Contract
Guardian / Legal Representative Signature Contract
Guardian / Legal Representative Printed Name Contract
Guardian / Legal Representative Signature Date Contract
Support Planner Signature Contract
Support Planner Printed Name Contract
Support Planner Signature Date Contract
Service Provider Signature Contract
Service Provider Printed Name Contract
Service Provider Signature Date Contract
Identified Risk RiskAssessment
Risk Management Plan RiskAssessment OR DocumentReference US Core DocumentReference Profile
Service Name ServiceRequest
Self-Directed Service Indicator ServiceRequest
Service Start Date ServiceRequest
Service End Date ServiceRequest
Service Delivery Address Location US Core Location Profile
Service Comment ServiceRequest
Service Funding Source Coverage
Service Unit Quantity ServiceRequest
Unit of Service Type ServiceRequest
Service Unit Quantity Interval ServiceRequest
Service Rate per Unit Claim
Total Cost of Service Claim
Support Planner Name Practitioner | CareTeam | Organization | Patient | RelatedPerson US Core Practitioner Profile, US Core CareTeam Profile, US Core Organization Profile, US Core Patient Profile
Support Planner Phone Number Practitioner | CareTeam | Organization | Patient | RelatedPerson US Core Practitioner Profile, US Core CareTeam Profile, US Core Organization Profile, US Core Patient Profile
Service Provider Name Practitioner | CareTeam | Organization | Patient | RelatedPerson US Core Practitioner Profile, US Core CareTeam Profile, US Core Organization Profile, US Core Patient Profile
Service Provider Phone Number Practitioner | CareTeam | Organization | Patient | RelatedPerson US Core Practitioner Profile, US Core CareTeam Profile, US Core Organization Profile, US Core Patient Profile
Non-Paid Service Provider Relationship RelatedPerson