Electronic Long-Term Services and Supports (eLTSS) Release 1 - US Realm
2.0.0 - STU2 United States of America flag

This page is part of the electronic Long-Term Services and Supports Implementation Guide (v2.0.0: STU2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: Contract_eltss - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 2

Definitions for the Contract-eltss resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Contract
Definition

A legally enforceable, formally recorded unilateral or bilateral directive (i.e., a policy or agreement).

Must Supportfalse
2. Contract.extension
SlicingThis element introduces a set of slices on Contract.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • type @ url
  • 4. Contract.extension:resource-pertainsToGoal
    Slice Nameresource-pertainsToGoal
    ShortThe resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources.
    Control0..*
    TypeExtension(ServiceRequest Pertains To Goal) (Extension Type: Reference(Goal))
    Must Supporttrue
    6. Contract.instantiatesCanonical
    TypeReference(Contract_eltss)
    8. Contract.domain
    TypeReference(Location_eltss)
    10. Contract.site
    TypeReference(Location_eltss)
    12. Contract.author
    TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, US Core Organization Profile)
    14. Contract.contentDefinition
    16. Contract.contentDefinition.publisher
    TypeReference(Practitioner_eltss, eLTSS PractitionerRole Profile, US Core Organization Profile)
    18. Contract.term
    Definition

    One or more Contract Provisions which may be related and conveyed as a group and may contain nested groups.

    20. Contract.term.offer
    Definition

    The matter of concern in the context of this agreement provision.

    22. Contract.term.offer.party
    Definition

    Recipient of the Offer

    24. Contract.term.offer.party.reference
    TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, Group, US Core Organization Profile)
    26. Contract.term.asset
    28. Contract.term.asset.valuedItem
    30. Contract.term.asset.valuedItem.responsible
    TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, eLTSS RelatedPerson Profile, US Core Organization Profile)
    32. Contract.term.asset.valuedItem.recipient
    TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, eLTSS RelatedPerson Profile, US Core Organization Profile)
    34. Contract.term.action
    36. Contract.term.action.subject
    Definition

    Entity of the action to be performed.

    38. Contract.term.action.subject.reference
    TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, Group, US Core Organization Profile)
    40. Contract.term.action.context
    TypeReference(EpisodeOfCare_eltss, US Core Encounter Profile)
    42. Contract.term.action.requester
    TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, Group, US Core Organization Profile)
    44. Contract.term.action.performer
    TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, US Core Organization Profile)
    46. Contract.term.action.reasonReference
    TypeReference(Condition_eltss, Observation_eltss, Questionnaire_eltss, US Core DocumentReference Profile, DiagnosticReport, QuestionnaireResponse)
    48. Contract.signer
    Definition

    Person, Guardian / Legal Representative, Support Planner, or Service Provider Signature

    ShortPerson, Guardian / Legal Representative, Support Planner, or Service Provider Signature
    Comments

    FHIR includes a preferred coding for contract signatory roles, which map well to the eLTSS signatories. The primary one for the patient/beneficiary is "PAT" (patient), although implementers may use others as well. However, implementers must realize that type may be used to differentiate between the patient, service provider, planner, etc. so there need to be distinct role types utilized.

    Must Supporttrue
    50. Contract.signer.type
    Comments

    Would probably use "CONSENTER" which represents "consent signature" in this use case.

    Must Supporttrue
    52. Contract.signer.party
    Definition

    Person, Guardian / Legal Representative, Support Planner, or Service Provider Printed Name

    ShortPerson, Guardian / Legal Representative, Support Planner, or Service Provider Printed Name
    Comments

    Must match signature.who.

    TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, eLTSS RelatedPerson Profile, US Core Organization Profile)
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    54. Contract.signer.signature
    Definition

    Legally binding Contract DSIG signature contents encoded in Base64.

    Must Supporttrue
    56. Contract.signer.signature.type
    Comments

    Would probably use "1.2.840.10065.1.12.1.7" which represents "consent signature" in this use case.

    Must Supporttrue
    58. Contract.signer.signature.when
    Definition

    Person, Guardian / Legal Representative, Support Planner, or Service Provider Signature Date

    ShortPerson, Guardian / Legal Representative, Support Planner, or Service Provider Signature Date
    Must Supporttrue
    60. Contract.signer.signature.who
    Definition

    Person, Guardian / Legal Representative, Support Planner, or Service Provider Signature

    ShortPerson, Guardian/Legal Representative, Support Planner, or Service Provider Printed Name
    Comments

    Must match signer.party.

    TypeReference(eLTSS PractitionerRole Profile, eLTSS RelatedPerson Profile, US Core Organization Profile, Practitioner_eltss, Patient_eltss)
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    62. Contract.signer.signature.data
    Must Supporttrue
    64. Contract.rule
    Definition

    List of Computable Policy Rule Language Representation(s) of this Contract.

    66. Contract.rule.content[x]
    ShortComputable Contract Rule(s)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]

    Guidance on how to interpret the contents of this table can be found here

    0. Contract
    Definition

    A legally enforceable, formally recorded unilateral or bilateral directive (i.e., a policy or agreement).


    Legally enforceable, formally recorded unilateral or bilateral directive i.e., a policy or agreement.

    ShortLegal Agreement
    Control0..*
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    dom-6: A resource should have narrative for robust management (text.`div`.exists())
    2. Contract.implicitRules
    Definition

    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

    ShortA set of rules under which this content was created
    Comments

    Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

    Control0..1
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    4. Contract.extension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortExtensionAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on Contract.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ url
    • 6. Contract.extension:resource-pertainsToGoal
      Slice Nameresource-pertainsToGoal
      Definition

      Indicates that the resource is related to either the measurement, achievement or progress towards the referenced goal. For example, a Procedure to exercise pertainsToGoal of losing weight.

      ShortThe resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources.
      Comments

      This extension is limited to subject-specific activity-related resources (events & intents). I.e. This can't be put on Goal or Patient. This association isn't for the purpose of goal management, but for things such as noting that a particular observation result, prescription or other activity is pertinent to the achievement (or possibly non-achievement) of the referenced goal.

      Control0..*
      TypeExtension(ServiceRequest Pertains To Goal) (Extension Type: Reference(Goal))
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      8. Contract.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      10. Contract.status
      Definition

      The status of the resource instance.

      Shortamended | appended | cancelled | disputed | entered-in-error | executable | executed | negotiable | offered | policy | rejected | renewed | revoked | resolved | terminated
      Comments

      This element is labeled as a modifier because the status contains codes that mark the contract as not currently valid or active.

      Control0..1
      BindingThe codes SHALL be taken from ContractResourceStatusCodeshttp://hl7.org/fhir/ValueSet/contract-status|4.0.1
      (required to http://hl7.org/fhir/ValueSet/contract-status|4.0.1)

      A code specifying the state of the resource instance.

      Typecode
      Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      This is the Contract Business Workflow Status.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Contract.instantiatesCanonical
      Definition

      The URL pointing to a FHIR-defined Contract Definition that is adhered to in whole or part by this Contract.

      ShortSource Contract Definition
      Control0..1
      TypeReference(Contract_eltss, Contract)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. Contract.domain
      Definition

      Recognized governance framework or system operating with a circumscribed scope in accordance with specified principles, policies, processes or procedures for managing rights, actions, or behaviors of parties or principals relative to resources.

      ShortA sphere of control governed by an authoritative jurisdiction, organization, or person
      Control0..*
      TypeReference(Location_eltss, Location)
      Is Modifierfalse
      Summaryfalse
      Requirements

      The entities bound by governance to comply with the enforcement of contracts or policies by a recognized authority.

      Alternate Namesscope of governance jurisdiction
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. Contract.site
      Definition

      Sites in which the contract is complied with, exercised, or in force.

      ShortSpecific Location
      Control0..*
      TypeReference(Location_eltss, Location)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. Contract.author
      Definition

      The individual or organization that authored the Contract definition, derivative, or instance in any legal state.

      ShortSource of Contract
      Control0..1
      TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, US Core Organization Profile, Patient, Practitioner, PractitionerRole, Organization)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. Contract.term
      Definition

      One or more Contract Provisions which may be related and conveyed as a group and may contain nested groups.


      One or more Contract Provisions, which may be related and conveyed as a group, and may contain nested groups.

      ShortContract Term List
      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Contract.term.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      24. Contract.term.offer
      Definition

      The matter of concern in the context of this agreement provision.


      The matter of concern in the context of this provision of the agrement.

      ShortContext of the Contract term
      Control1..1
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. Contract.term.offer.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      28. Contract.term.offer.party
      Definition

      Recipient of the Offer


      Offer Recipient.

      ShortOffer Recipient
      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. Contract.term.offer.party.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      32. Contract.term.offer.party.reference
      Definition

      Participant in the offer.

      ShortReferenced entity
      Control1..*
      TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, Group, US Core Organization Profile, Patient, RelatedPerson, Practitioner, PractitionerRole, Device, Organization)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. Contract.term.offer.party.role
      Definition

      How the party participates in the offer.

      ShortParticipant engagement type
      Control1..1
      BindingFor example codes, see ContractResourcePartyRoleCodeshttp://hl7.org/fhir/ValueSet/contract-party-role
      (example to http://hl7.org/fhir/ValueSet/contract-party-role)

      Codes for offer participant roles.

      TypeCodeableConcept
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. Contract.signer
      Definition

      Person, Guardian / Legal Representative, Support Planner, or Service Provider Signature


      Parties with legal standing in the Contract, including the principal parties, the grantor(s) and grantee(s), which are any person or organization bound by the contract, and any ancillary parties, which facilitate the execution of the contract such as a notary or witness.

      ShortPerson, Guardian / Legal Representative, Support Planner, or Service Provider SignatureContract Signatory
      Comments

      FHIR includes a preferred coding for contract signatory roles, which map well to the eLTSS signatories. The primary one for the patient/beneficiary is "PAT" (patient), although implementers may use others as well. However, implementers must realize that type may be used to differentiate between the patient, service provider, planner, etc. so there need to be distinct role types utilized.


      Signers who are principal parties to the contract are bound by the Contract.activity related to the Contract.topic, and the Contract.term(s), which either extend or restrict the overall action on the topic by, for example, stipulating specific policies or obligations constraining actions, action reason, or agents with respect to some or all of the topic. For example, specifying how policies or obligations shall constrain actions and action reasons permitted or denied on all or a subset of the Contract.topic (e.g., all or a portion of property being transferred by the contract), agents (e.g., who can resell, assign interests, or alter the property being transferred by the contract), actions, and action reasons; or with respect to Contract.terms, stipulating, extending, or limiting the Contract.period of applicability or valuation of items under consideration.

      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      The Contract.signer applies a signature to the Contract.binding referenced resource, which is the documentation that is the legal "source of truth". The Contract.signer may delegate, such as a legally recognized personal representative, or have a delegate assigned e.g., by a court of law, to actually sign the Contract, such as a trustee in the case of incompetence.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. Contract.signer.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      40. Contract.signer.type
      Definition

      Role of this Contract signer, e.g. notary, grantee.

      ShortContract Signatory Role
      Comments

      Would probably use "CONSENTER" which represents "consent signature" in this use case.

      Control1..1
      BindingThe codes SHOULD be taken from ContractSignerTypeCodeshttp://hl7.org/fhir/ValueSet/contract-signer-type
      (preferred to http://hl7.org/fhir/ValueSet/contract-signer-type)

      List of parties who may be signing.

      TypeCoding
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. Contract.signer.party
      Definition

      Person, Guardian / Legal Representative, Support Planner, or Service Provider Printed Name


      Party which is a signator to this Contract.

      ShortPerson, Guardian / Legal Representative, Support Planner, or Service Provider Printed NameContract Signatory Party
      Comments

      Must match signature.who.

      Control1..1
      TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, eLTSS RelatedPerson Profile, US Core Organization Profile, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. Contract.signer.signature
      Definition

      Legally binding Contract DSIG signature contents encoded in Base64.


      Legally binding Contract DSIG signature contents in Base64.

      ShortContract Documentation Signature
      Control1..*
      TypeSignature
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. Contract.signer.signature.type
      Definition

      An indication of the reason that the entity signed this document. This may be explicitly included as part of the signature information and can be used when determining accountability for various actions concerning the document.

      ShortIndication of the reason the entity signed the object(s)
      Comments

      Would probably use "1.2.840.10065.1.12.1.7" which represents "consent signature" in this use case.


      Examples include attesting to: authorship, correct transcription, and witness of specific event. Also known as a "Commitment Type Indication".

      Control1..*
      BindingThe codes SHOULD be taken from SignatureTypeCodeshttp://hl7.org/fhir/ValueSet/signature-type
      (preferred to http://hl7.org/fhir/ValueSet/signature-type)

      An indication of the reason that an entity signed the object.

      TypeCoding
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      48. Contract.signer.signature.when
      Definition

      Person, Guardian / Legal Representative, Support Planner, or Service Provider Signature Date


      When the digital signature was signed.

      ShortPerson, Guardian / Legal Representative, Support Planner, or Service Provider Signature DateWhen the signature was created
      Comments

      This should agree with the information in the signature.

      Control1..1
      Typeinstant
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. Contract.signer.signature.who
      Definition

      Person, Guardian / Legal Representative, Support Planner, or Service Provider Signature


      A reference to an application-usable description of the identity that signed (e.g. the signature used their private key).

      ShortPerson, Guardian/Legal Representative, Support Planner, or Service Provider Printed NameWho signed
      Comments

      Must match signer.party.


      This should agree with the information in the signature.

      Control1..1
      TypeReference(eLTSS PractitionerRole Profile, eLTSS RelatedPerson Profile, US Core Organization Profile, Practitioner_eltss, Patient_eltss, Practitioner, PractitionerRole, RelatedPerson, Patient, Device, Organization)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      52. Contract.signer.signature.data
      Definition

      The base64 encoding of the Signature content. When signature is not recorded electronically this element would be empty.

      ShortThe actual signature content (XML DigSig. JWS, picture, etc.)
      Comments

      Where the signature type is an XML DigSig, the signed content is a FHIR Resource(s), the signature is of the XML form of the Resource(s) using XML-Signature (XMLDIG) "Detached Signature" form.

      Control0..1
      Typebase64Binary
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      54. Contract.rule
      Definition

      List of Computable Policy Rule Language Representation(s) of this Contract.


      List of Computable Policy Rule Language Representations of this Contract.

      ShortComputable Contract Language
      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      56. Contract.rule.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      58. Contract.rule.content[x]
      Definition

      Computable Contract conveyed using a policy rule language (e.g. XACML, DKAL, SecPal).

      ShortComputable Contract Rule(s)Computable Contract Rules
      Control1..1
      TypeChoice of: Attachment, Reference(DocumentReference)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Guidance on how to interpret the contents of this table can be found here

      0. Contract
      Definition

      A legally enforceable, formally recorded unilateral or bilateral directive (i.e., a policy or agreement).

      ShortLegal Agreement
      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. Contract.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. Contract.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. Contract.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. Contract.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Contract.text
      Definition

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Contract.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

      ShortContained, inline Resources
      Comments

      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

      Control0..*
      TypeResource
      Is Modifierfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. Contract.extension
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Contract.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • type @ url
      • 16. Contract.extension:resource-pertainsToGoal
        Slice Nameresource-pertainsToGoal
        Definition

        Indicates that the resource is related to either the measurement, achievement or progress towards the referenced goal. For example, a Procedure to exercise pertainsToGoal of losing weight.

        ShortThe resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources.
        Comments

        This extension is limited to subject-specific activity-related resources (events & intents). I.e. This can't be put on Goal or Patient. This association isn't for the purpose of goal management, but for things such as noting that a particular observation result, prescription or other activity is pertinent to the achievement (or possibly non-achievement) of the referenced goal.

        Control0..*
        TypeExtension(ServiceRequest Pertains To Goal) (Extension Type: Reference(Goal))
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        18. Contract.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        20. Contract.identifier
        Definition

        Unique identifier for this Contract or a derivative that references a Source Contract.

        ShortContract number
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        Requirements

        This is the business identifier of the contract content conveyed. It may be a derivative of the legally binding contract, in which case, the identifier of the basal contract is contained in the Contract.binding referenced Contract.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. Contract.url
        Definition

        Canonical identifier for this contract, represented as a URI (globally unique).

        ShortBasal definition
        Comments

        Used in a domain that uses a supplied contract repository.

        Control0..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Requirements

        An absolute URI that is used to identify this contract when it is referenced in a specification, model, design, instance or a contract derivative; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which this plan definition is (or will be) published.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. Contract.version
        Definition

        An edition identifier used for business purposes to label business significant variants.

        ShortBusiness edition
        Comments

        Note - This is a business versionId, not a resource version id (see discussion http://build.fhir.org/resource.html#versions) Comments - There may be different contract instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the plan definition with the format [url]|[version].

        NoteThis is a business version Id, not a resource version Id (see discussion)
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        The identifier that is used to identify this version of the contract when it is referenced in a specification, model, design, instance, or contract derivative. This is an arbitrary value managed by the contract author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. Contract.status
        Definition

        The status of the resource instance.

        Shortamended | appended | cancelled | disputed | entered-in-error | executable | executed | negotiable | offered | policy | rejected | renewed | revoked | resolved | terminated
        Comments

        This element is labeled as a modifier because the status contains codes that mark the contract as not currently valid or active.

        Control0..1
        BindingThe codes SHALL be taken from ContractResourceStatusCodes
        (required to http://hl7.org/fhir/ValueSet/contract-status|4.0.1)

        A code specifying the state of the resource instance.

        Typecode
        Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        This is the Contract Business Workflow Status.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. Contract.legalState
        Definition

        Legal states of the formation of a legal instrument, which is a formally executed written document that can be formally attributed to its author, records and formally expresses a legally enforceable act, process, or contractual duty, obligation, or right, and therefore evidences that act, process, or agreement.

        ShortNegotiation status
        Control0..1
        BindingUnless not suitable, these codes SHALL be taken from ContractResourceLegalStateCodes
        (extensible to http://hl7.org/fhir/ValueSet/contract-legalstate)

        Detailed codes for the legal state of a contract.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Requirements

        The legal state of a contract follows a prescribed flow as defined by the legal community and these state may be indepenedent of the workflow state.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. Contract.instantiatesCanonical
        Definition

        The URL pointing to a FHIR-defined Contract Definition that is adhered to in whole or part by this Contract.

        ShortSource Contract Definition
        Control0..1
        TypeReference(Contract_eltss)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. Contract.instantiatesUri
        Definition

        The URL pointing to an externally maintained definition that is adhered to in whole or in part by this Contract.

        ShortExternal Contract Definition
        Control0..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. Contract.contentDerivative
        Definition

        The minimal content derived from the basal information source at a specific stage in its lifecycle.

        ShortContent derived from the basal information
        Control0..1
        BindingFor example codes, see ContractContentDerivationCodes
        (example to http://hl7.org/fhir/ValueSet/contract-content-derivative)

        This is an example set of Content Derivative type codes, which represent the minimal content derived from the basal information source.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Requirements

        In the context of a contract, the information source of the content derivative shall be the information referenced by the contract.binding. The Contract Resource may function simply as the computable representation of the executed contract, which may be the attached to the Contract Resource as the “binding” or as the “friendly” electronic form. For example, a Contract Resource may be automatically populated with the values expressed in a related QuestionnaireResponse. However, the Contract Resource may be considered the legally binding contract if it is the only “executed” form of this contract, and includes the signatures as *The Contract Resource may function as the computable representation of an application or offer in a pre-executed Contract if the grantor has not entered any values. In this case, it is populated with values in a “legal” form of the application or offer or by the values in an associated Questionnaire. If the grantor has filled in the legal form or the associated Questionnaire Response, then these values are used to populate a pre-executed Contract Resource. If the Contract.topic is considered an application or offer, then the policy is often required to be attached as the “legal” basis for the application to ensure “informed consent” to the contract, and that any discrepancy between the application and the policy are interpreted against the policy. Implementers should check organizational and jurisdictional policies to determine the relationship among multiple representations of a contract pre- and post-execution.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. Contract.issued
        Definition

        When this Contract was issued.

        ShortWhen this Contract was issued
        Control0..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        The Contract issuance dateTime often precedes the Contract effective dateTime.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. Contract.applies
        Definition

        Relevant time or time-period when this Contract is applicable.

        ShortEffective time
        Control0..1
        TypePeriod
        Is Modifierfalse
        Summarytrue
        Requirements

        The dateTime upon which the Contract is binding.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. Contract.expirationType
        Definition

        Event resulting in discontinuation or termination of this Contract instance by one or more parties to the contract.

        ShortContract cessation cause
        Control0..1
        BindingFor example codes, see ContractResourceExpirationTypeCodes
        (example to http://hl7.org/fhir/ValueSet/contract-expiration-type)

        Codes for the Cessation of Contracts.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. Contract.subject
        Definition

        The target entity impacted by or of interest to parties to the agreement.

        ShortContract Target Entity
        Comments

        The Contract.subject is an entity that has some role with respect to the Contract.topic and Contract.topic.term, which is of focal interest to the parties to the contract and likely impacted in a significant way by the Contract.action/Contract.action.reason and the Contract.term.action/Contract.action.reason. In many cases, the Contract.subject is a Contract.signer if the subject is an adult; has a legal interest in the contract; and incompetent to participate in the contract agreement.

        Control0..*
        TypeReference(Resource)
        Is Modifierfalse
        Summarytrue
        Requirements

        The Contract.subject is an entity that has some role with respect to the Contract.topic and Contract.topic.term, which is of focal interest to the parties to the contract and likely impacted in a significant way by the Contract.action/Contract.action.reason and the Contract.term.action/Contract.action.reason. In many cases, the Contract.subject is a Contract.signer if the subject is an adult; has a legal interest in the contract; and incompetent to participate in the contract agreement.

        Alternate NamesPatient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. Contract.authority
        Definition

        A formally or informally recognized grouping of people, principals, organizations, or jurisdictions formed for the purpose of achieving some form of collective action such as the promulgation, administration and enforcement of contracts and policies.

        ShortAuthority under which this Contract has standing
        Control0..*
        TypeReference(Organization)
        Is Modifierfalse
        Summaryfalse
        Requirements

        The governance framework responsible for ensuring compliance with or enforcement of the contract or policy.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. Contract.domain
        Definition

        Recognized governance framework or system operating with a circumscribed scope in accordance with specified principles, policies, processes or procedures for managing rights, actions, or behaviors of parties or principals relative to resources.

        ShortA sphere of control governed by an authoritative jurisdiction, organization, or person
        Control0..*
        TypeReference(Location_eltss)
        Is Modifierfalse
        Summaryfalse
        Requirements

        The entities bound by governance to comply with the enforcement of contracts or policies by a recognized authority.

        Alternate Namesscope of governance jurisdiction
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. Contract.site
        Definition

        Sites in which the contract is complied with, exercised, or in force.

        ShortSpecific Location
        Control0..*
        TypeReference(Location_eltss)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. Contract.name
        Definition

        A natural language name identifying this Contract definition, derivative, or instance in any legal state. Provides additional information about its content. This name should be usable as an identifier for the module by machine processing applications such as code generation.

        ShortComputer friendly designation
        Comments

        The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Support human navigation and code generation.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. Contract.title
        Definition

        A short, descriptive, user-friendly title for this Contract definition, derivative, or instance in any legal state.t giving additional information about its content.

        ShortHuman Friendly name
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. Contract.subtitle
        Definition

        An explanatory or alternate user-friendly title for this Contract definition, derivative, or instance in any legal state.t giving additional information about its content.

        ShortSubordinate Friendly name
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. Contract.alias
        Definition

        Alternative representation of the title for this Contract definition, derivative, or instance in any legal state., e.g., a domain specific contract number related to legislation.

        ShortAcronym or short name
        Control0..*
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. Contract.author
        Definition

        The individual or organization that authored the Contract definition, derivative, or instance in any legal state.

        ShortSource of Contract
        Control0..1
        TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, US Core Organization Profile)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. Contract.scope
        Definition

        A selector of legal concerns for this Contract definition, derivative, or instance in any legal state.

        ShortRange of Legal Concerns
        Control0..1
        BindingFor example codes, see ContractResourceScopeCodes
        (example to http://hl7.org/fhir/ValueSet/contract-scope)

        Codes for the range of legal concerns.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. Contract.topic[x]
        Definition

        Narrows the range of legal concerns to focus on the achievement of specific contractual objectives.

        ShortFocus of contract interest
        Control0..1
        TypeChoice of: CodeableConcept, Reference(Resource)
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summaryfalse
        Requirements

        Requirement: May be used to focus the topic of a Contract definition, derivative, or instance in any legal state. Comment: Contractual areas of concern are very broad. This element supports narrowing the area of concern to more specific term topics within this Contract. Given the wide range of contract topics, implementers need to be cognizant of the business use case for which they are designing a FHIR Contract, and narrowly specify the topic being represented with respect to the Contract.type and any specializing Contract.subtype. The same topic, e.g., an asset such as a good or service, such as a real property, medical supply, insurance, information, a procedure or employment, or a manner of conduct, such adherence to a privacy, trust, or security policy, may be the topic of multiple types of contracts. One way to determine the Contract.topic is to answer the question: “What is the overall objective of this legal instrument. The Contract.topic is described with more detail by the terms of the Contract.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. Contract.type
        Definition

        A high-level category for the legal instrument, whether constructed as a Contract definition, derivative, or instance in any legal state. Provides additional information about its content within the context of the Contract's scope to distinguish the kinds of systems that would be interested in the contract.

        ShortLegal instrument category
        Control0..1
        BindingFor example codes, see ContractTypeCodes
        (example to http://hl7.org/fhir/ValueSet/contract-type)

        List of overall contract codes.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. Contract.subType
        Definition

        Sub-category for the Contract that distinguishes the kinds of systems that would be interested in the Contract within the context of the Contract's scope.

        ShortSubtype within the context of type
        Control0..*
        BindingFor example codes, see ContractSubtypeCodes
        (example to http://hl7.org/fhir/ValueSet/contract-subtype)

        Detailed codes within the above.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. Contract.contentDefinition
        Definition

        Precusory content developed with a focus and intent of supporting the formation a Contract instance, which may be associated with and transformable into a Contract.

        ShortContract precursor content
        Control0..1
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. Contract.contentDefinition.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        72. Contract.contentDefinition.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        74. Contract.contentDefinition.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        76. Contract.contentDefinition.type
        Definition

        Precusory content structure and use, i.e., a boilerplate, template, application for a contract such as an insurance policy or benefits under a program, e.g., workers compensation.

        ShortContent structure and use
        Control1..1
        BindingFor example codes, see ContractResourceDefinitionTypeCodes
        (example to http://hl7.org/fhir/ValueSet/contract-definition-type)

        Detailed codes for the definition of contracts.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        78. Contract.contentDefinition.subType
        Definition

        Detailed Precusory content type.

        ShortDetailed Content Type Definition
        Control0..1
        BindingFor example codes, see ContractResourceDefinitionSubtypeCodes
        (example to http://hl7.org/fhir/ValueSet/contract-definition-subtype)

        Detailed codes for the additional definition of contracts.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        80. Contract.contentDefinition.publisher
        Definition

        The individual or organization that published the Contract precursor content.

        ShortPublisher Entity
        Control0..1
        TypeReference(Practitioner_eltss, eLTSS PractitionerRole Profile, US Core Organization Profile)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        82. Contract.contentDefinition.publicationDate
        Definition

        The date (and optionally time) when the contract was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the contract changes.

        ShortWhen published
        Control0..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        84. Contract.contentDefinition.publicationStatus
        Definition

        amended | appended | cancelled | disputed | entered-in-error | executable | executed | negotiable | offered | policy | rejected | renewed | revoked | resolved | terminated.

        Shortamended | appended | cancelled | disputed | entered-in-error | executable | executed | negotiable | offered | policy | rejected | renewed | revoked | resolved | terminated
        Control1..1
        BindingThe codes SHALL be taken from ContractResourcePublicationStatusCodes
        (required to http://hl7.org/fhir/ValueSet/contract-publicationstatus|4.0.1)

        Status of the publication of contract content.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        86. Contract.contentDefinition.copyright
        Definition

        A copyright statement relating to Contract precursor content. Copyright statements are generally legal restrictions on the use and publishing of the Contract precursor content.

        ShortPublication Ownership
        Control0..1
        Typemarkdown
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        88. Contract.term
        Definition

        One or more Contract Provisions which may be related and conveyed as a group and may contain nested groups.

        ShortContract Term List
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        90. Contract.term.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        92. Contract.term.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        94. Contract.term.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        96. Contract.term.identifier
        Definition

        Unique identifier for this particular Contract Provision.

        ShortContract Term Number
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..1
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        98. Contract.term.issued
        Definition

        When this Contract Provision was issued.

        ShortContract Term Issue Date Time
        Control0..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        100. Contract.term.applies
        Definition

        Relevant time or time-period when this Contract Provision is applicable.

        ShortContract Term Effective Time
        Control0..1
        TypePeriod
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        102. Contract.term.topic[x]
        Definition

        The entity that the term applies to.

        ShortTerm Concern
        Control0..1
        TypeChoice of: CodeableConcept, Reference(Resource)
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        104. Contract.term.type
        Definition

        A legal clause or condition contained within a contract that requires one or both parties to perform a particular requirement by some specified time or prevents one or both parties from performing a particular requirement by some specified time.

        ShortContract Term Type or Form
        Control0..1
        BindingFor example codes, see ContractTermTypeCodes
        (example to http://hl7.org/fhir/ValueSet/contract-term-type)

        Detailed codes for the types of contract provisions.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        106. Contract.term.subType
        Definition

        A specialized legal clause or condition based on overarching contract type.

        ShortContract Term Type specific classification
        Control0..1
        BindingFor example codes, see ContractTermSubtypeCodes
        (example to http://hl7.org/fhir/ValueSet/contract-term-subtype)

        Detailed codes for the subtypes of contract provisions.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        108. Contract.term.text
        Definition

        Statement of a provision in a policy or a contract.

        ShortTerm Statement
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        110. Contract.term.securityLabel
        Definition

        Security labels that protect the handling of information about the term and its elements, which may be specifically identified..

        ShortProtection for the Term
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Requirements

        Requirement - Within a Contract, a security label may apply to the one to many nested group of terms or to a term, whether inside a group or a singleton. This security label protects the term and its contained provision elements. The security label on the entire set of term provision elements may be different from the security labels on a contained offer, asset, valuedItem, or data such as sensitive information, and must be the high water mark of all security labels within the term. Rationale is that a labelled term, which may be disaggregated from the Contract, and must persist the label on the term and on contained elements within other contexts. Requirement - If more than one policy dictates a level of confidentiality of the term, then each applicable policy may be represented by a security label specific to its requirements. Comment - A Security Label is comprised of 1..1 confidentiality code and 0..* other security label codes (aka "privacy tags". A Security Label is metadata assigned (aka "tagged") to Resources and Resource elements, which specify the confidentiality and sensitivity of the Resource or element and their related attributes, the purposes for which tagged items may be collected, access, used or disclosed, any limitation on the type of entities authorized to engage in permitted purposes, and handling instructions that obligate or prohibit certain actions on the tagged items.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        112. Contract.term.securityLabel.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        114. Contract.term.securityLabel.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        116. Contract.term.securityLabel.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        118. Contract.term.securityLabel.number
        Definition

        Number used to link this term or term element to the applicable Security Label.

        ShortLink to Security Labels
        Control0..*
        TypeunsignedInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        120. Contract.term.securityLabel.classification
        Definition

        Security label privacy tag that species the level of confidentiality protection required for this term and/or term elements.

        ShortConfidentiality Protection
        Control1..1
        BindingFor example codes, see ContractResourceScopeCodes
        (example to http://hl7.org/fhir/ValueSet/contract-security-classification)

        Codes for confidentiality protection.

        TypeCoding
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        122. Contract.term.securityLabel.category
        Definition

        Security label privacy tag that species the applicable privacy and security policies governing this term and/or term elements.

        ShortApplicable Policy
        Control0..*
        BindingFor example codes, see ContractResourceScopeCodes
        (example to http://hl7.org/fhir/ValueSet/contract-security-category)

        Codes for policy category.

        TypeCoding
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        124. Contract.term.securityLabel.control
        Definition

        Security label privacy tag that species the manner in which term and/or term elements are to be protected.

        ShortHandling Instructions
        Control0..*
        BindingFor example codes, see ContractResourceSecurityControlCodes
        (example to http://hl7.org/fhir/ValueSet/contract-security-control)

        Codes for handling instructions.

        TypeCoding
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        126. Contract.term.offer
        Definition

        The matter of concern in the context of this agreement provision.

        ShortContext of the Contract term
        Control1..1
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        128. Contract.term.offer.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        130. Contract.term.offer.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        132. Contract.term.offer.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        134. Contract.term.offer.identifier
        Definition

        Unique identifier for this particular Contract Provision.

        ShortOffer business ID
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        136. Contract.term.offer.party
        Definition

        Recipient of the Offer

        ShortOffer Recipient
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        138. Contract.term.offer.party.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        140. Contract.term.offer.party.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        142. Contract.term.offer.party.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        144. Contract.term.offer.party.reference
        Definition

        Participant in the offer.

        ShortReferenced entity
        Control1..*
        TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, Group, US Core Organization Profile)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        146. Contract.term.offer.party.role
        Definition

        How the party participates in the offer.

        ShortParticipant engagement type
        Control1..1
        BindingFor example codes, see ContractResourcePartyRoleCodes
        (example to http://hl7.org/fhir/ValueSet/contract-party-role)

        Codes for offer participant roles.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        148. Contract.term.offer.topic
        Definition

        The owner of an asset has the residual control rights over the asset: the right to decide all usages of the asset in any way not inconsistent with a prior contract, custom, or law (Hart, 1995, p. 30).

        ShortNegotiable offer asset
        Comments

        The Contract.topic may be an application for or offer of a policy or service (e.g., uri to a consent directive form or a health insurance policy), which becomes the Contract once accepted by both the grantor and grantee. The Contract Resource may function simply as the computable representation of the executed contract, which may be the attached to the Contract Resource as the “binding” or as the “friendly” electronic form. For example, a Contract Resource may be automatically populated with the values expressed in a related QuestionnaireResponse. However, the Contract Resource may be considered the legally binding contract if it is the only “executed” form of this contract, and includes the signatures as *The Contract Resource may function as the computable representation of an application or offer in a pre-executed Contract if the grantor has not entered any values. In this case, it is populated with values in a “legal” form of the application or offer or by the values in an associated Questionnaire. If the grantor has filled in the legal form or the associated Questionnaire Response, then these values are used to populate a pre-executed Contract Resource. If the Contract.topic is considered an application or offer, then the policy is often required to be attached as the “legal” basis for the application to ensure “informed consent” to the contract, and that any discrepancy between the application and the policy are interpreted against the policy. Implementers should check organizational and jurisdictional policies to determine the relationship among multiple representations of a contract pre- and post-execution.

        Control0..1
        TypeReference(Resource)
        Is Modifierfalse
        Summarytrue
        Requirements

        In the context of a contract, the topic is the matter under consideration in regards to which specific rights, privileges, obligations, restrictions, and prohibitions are binding on any grantor and grantee parties upon the execution of the contract. Given the wide range of contract topics, implementers need to be cognizant of the business use case for which they are designing a FHIR Contract, and narrowly specify the topic being represented with respect to the Contract.type and any specializing Contract.subtype. The same topic, e.g., an asset such as a good or service, such as a real property, medical supply, insurance, information, a procedure or employment, or a manner of conduct, such adherence to a privacy, trust, or security policy, may be the topic of multiple types of contracts. One way to determine the Contract.topic is to answer the question: “What is the object of negotiation?” Answer: The Contract.topic, which may be described with more detail in the [0..*]Contract.valuedItem @ [0..1] Contract.valuedItem.entity[x] Definition: Specific type of Contract Valued Item that may be priced. CodeableConcept|Reference(Any) Contract.topic is “the what” that a grantor is exchanging with a grantee in return for some benefit. Contract.topic is “the what” to which any Contract.action is being applied for any stipulated Contract.action.reason. AContract.topic is “the what” governed by the execution of the contract to which any party’s rights, privileges, obligations, restrictions, and prohibitions apply.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        150. Contract.term.offer.type
        Definition

        Type of Contract Provision such as specific requirements, purposes for actions, obligations, prohibitions, e.g. life time maximum benefit.

        ShortContract Offer Type or Form
        Control0..1
        BindingFor example codes, see ContractTermTypeCodes
        (example to http://hl7.org/fhir/ValueSet/contract-term-type)

        Detailed codes for the types of contract provisions.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        152. Contract.term.offer.decision
        Definition

        Type of choice made by accepting party with respect to an offer made by an offeror/ grantee.

        ShortAccepting party choice
        Control0..1
        BindingUnless not suitable, these codes SHALL be taken from ActConsentDirective
        (extensible to http://terminology.hl7.org/ValueSet/v3-ActConsentDirective)

        The type of decision made by a grantor with respect to an offer made by a grantee.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Requirements

        In some policy or contract contexts, the "offer" is made by an offeror wishing to be the "grantee" of the offer topic by the grantor. From this perspective, the grantor is the "offeree".

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        154. Contract.term.offer.decisionMode
        Definition

        How the decision about a Contract was conveyed.

        ShortHow decision is conveyed
        Control0..*
        BindingFor example codes, see ContractResourceDecisionModeCodes
        (example to http://hl7.org/fhir/ValueSet/contract-decision-mode)

        Codes for conveying a decision.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        156. Contract.term.offer.answer
        Definition

        Response to offer text.

        ShortResponse to offer text
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        158. Contract.term.offer.answer.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        160. Contract.term.offer.answer.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        162. Contract.term.offer.answer.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        164. Contract.term.offer.answer.value[x]
        Definition

        Response to an offer clause or question text, which enables selection of values to be agreed to, e.g., the period of participation, the date of occupancy of a rental, warrently duration, or whether biospecimen may be used for further research.

        ShortThe actual answer response
        Control1..1
        TypeChoice of: boolean, decimal, integer, date, dateTime, time, string, uri, Attachment, Coding, Quantity, Reference(Resource)
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        166. Contract.term.offer.text
        Definition

        Human readable form of this Contract Offer.

        ShortHuman readable offer text
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        168. Contract.term.offer.linkId
        Definition

        The id of the clause or question text of the offer in the referenced questionnaire/response.

        ShortPointer to text
        Control0..*
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        170. Contract.term.offer.securityLabelNumber
        Definition

        Security labels that protects the offer.

        ShortOffer restriction numbers
        Control0..*
        TypeunsignedInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        172. Contract.term.asset
        Definition

        Contract Term Asset List.

        ShortContract Term Asset List
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        174. Contract.term.asset.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        176. Contract.term.asset.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        178. Contract.term.asset.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        180. Contract.term.asset.scope
        Definition

        Differentiates the kind of the asset .

        ShortRange of asset
        Control0..1
        BindingFor example codes, see ContractResourceAssetScopeCodes
        (example to http://hl7.org/fhir/ValueSet/contract-assetscope)

        Codes for scoping an asset.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        182. Contract.term.asset.type
        Definition

        Target entity type about which the term may be concerned.

        ShortAsset category
        Control0..*
        BindingFor example codes, see ContractResourceAssetTypeCodes
        (example to http://hl7.org/fhir/ValueSet/contract-assettype)

        Condes for the type of an asset.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        184. Contract.term.asset.typeReference
        Definition

        Associated entities.

        ShortAssociated entities
        Control0..*
        TypeReference(Resource)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        186. Contract.term.asset.subtype
        Definition

        May be a subtype or part of an offered asset.

        ShortAsset sub-category
        Control0..*
        BindingFor example codes, see ContractResourceAssetSub-TypeCodes
        (example to http://hl7.org/fhir/ValueSet/contract-assetsubtype)

        Condes for the sub-type of an asset.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        188. Contract.term.asset.relationship
        Definition

        Specifies the applicability of the term to an asset resource instance, and instances it refers to orinstances that refer to it, and/or are owned by the offeree.

        ShortKinship of the asset
        Control0..1
        BindingUnless not suitable, these codes SHALL be taken from ConsentContentClass
        (extensible to http://hl7.org/fhir/ValueSet/consent-content-class)

        The class (type) of information a consent rule covers.

        TypeCoding
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        190. Contract.term.asset.context
        Definition

        Circumstance of the asset.

        ShortCircumstance of the asset
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        192. Contract.term.asset.context.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        194. Contract.term.asset.context.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        196. Contract.term.asset.context.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        198. Contract.term.asset.context.reference
        Definition

        Asset context reference may include the creator, custodian, or owning Person or Organization (e.g., bank, repository), location held, e.g., building, jurisdiction.

        ShortCreator,custodian or owner
        Control0..1
        TypeReference(Resource)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        200. Contract.term.asset.context.code
        Definition

        Coded representation of the context generally or of the Referenced entity, such as the asset holder type or location.

        ShortCodeable asset context
        Control0..*
        BindingFor example codes, see ContractResourceAssetContextCodes
        (example to http://hl7.org/fhir/ValueSet/contract-assetcontext)

        Codes for the context of the asset.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        202. Contract.term.asset.context.text
        Definition

        Context description.

        ShortContext description
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        204. Contract.term.asset.condition
        Definition

        Description of the quality and completeness of the asset that imay be a factor in its valuation.

        ShortQuality desctiption of asset
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        206. Contract.term.asset.periodType
        Definition

        Type of Asset availability for use or ownership.

        ShortAsset availability types
        Control0..*
        BindingFor example codes, see ContractResourceAssetAvailiabilityCodes
        (example to http://hl7.org/fhir/ValueSet/asset-availability)

        Codes for asset availability.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        208. Contract.term.asset.period
        Definition

        Asset relevant contractual time period.

        ShortTime period of the asset
        Control0..*
        TypePeriod
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        210. Contract.term.asset.usePeriod
        Definition

        Time period of asset use.

        ShortTime period
        Control0..*
        TypePeriod
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        212. Contract.term.asset.text
        Definition

        Clause or question text (Prose Object) concerning the asset in a linked form, such as a QuestionnaireResponse used in the formation of the contract.

        ShortAsset clause or question text
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        214. Contract.term.asset.linkId
        Definition

        Id [identifier??] of the clause or question text about the asset in the referenced form or QuestionnaireResponse.

        ShortPointer to asset text
        Control0..*
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        216. Contract.term.asset.answer
        Definition

        Response to assets.

        ShortResponse to assets
        Control0..*
        TypeSeettp://hl7.org/fhir/StructureDefinition/Contract#Contract.term.offer.answer
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        218. Contract.term.asset.securityLabelNumber
        Definition

        Security labels that protects the asset.

        ShortAsset restriction numbers
        Control0..*
        TypeunsignedInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        220. Contract.term.asset.valuedItem
        Definition

        Contract Valued Item List.

        ShortContract Valued Item List
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        222. Contract.term.asset.valuedItem.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        224. Contract.term.asset.valuedItem.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        226. Contract.term.asset.valuedItem.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        228. Contract.term.asset.valuedItem.entity[x]
        Definition

        Specific type of Contract Valued Item that may be priced.

        ShortContract Valued Item Type
        Control0..1
        TypeChoice of: CodeableConcept, Reference(Resource)
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        230. Contract.term.asset.valuedItem.identifier
        Definition

        Identifies a Contract Valued Item instance.

        ShortContract Valued Item Number
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..1
        TypeIdentifier
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        232. Contract.term.asset.valuedItem.effectiveTime
        Definition

        Indicates the time during which this Contract ValuedItem information is effective.

        ShortContract Valued Item Effective Tiem
        Control0..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        234. Contract.term.asset.valuedItem.quantity
        Definition

        Specifies the units by which the Contract Valued Item is measured or counted, and quantifies the countable or measurable Contract Valued Item instances.

        ShortCount of Contract Valued Items
        Control0..1
        TypeQuantity(SimpleQuantity)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        236. Contract.term.asset.valuedItem.unitPrice
        Definition

        A Contract Valued Item unit valuation measure.

        ShortContract Valued Item fee, charge, or cost
        Control0..1
        TypeMoney
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        238. Contract.term.asset.valuedItem.factor
        Definition

        A real number that represents a multiplier used in determining the overall value of the Contract Valued Item delivered. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

        ShortContract Valued Item Price Scaling Factor
        Control0..1
        Typedecimal
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        240. Contract.term.asset.valuedItem.points
        Definition

        An amount that expresses the weighting (based on difficulty, cost and/or resource intensiveness) associated with the Contract Valued Item delivered. The concept of Points allows for assignment of point values for a Contract Valued Item, such that a monetary amount can be assigned to each point.

        ShortContract Valued Item Difficulty Scaling Factor
        Control0..1
        Typedecimal
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        242. Contract.term.asset.valuedItem.net
        Definition

        Expresses the product of the Contract Valued Item unitQuantity and the unitPriceAmt. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied.

        ShortTotal Contract Valued Item Value
        Control0..1
        TypeMoney
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        244. Contract.term.asset.valuedItem.payment
        Definition

        Terms of valuation.

        ShortTerms of valuation
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        246. Contract.term.asset.valuedItem.paymentDate
        Definition

        When payment is due.

        ShortWhen payment is due
        Control0..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        248. Contract.term.asset.valuedItem.responsible
        Definition

        Who will make payment.

        ShortWho will make payment
        Control0..1
        TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, eLTSS RelatedPerson Profile, US Core Organization Profile)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        250. Contract.term.asset.valuedItem.recipient
        Definition

        Who will receive payment.

        ShortWho will receive payment
        Control0..1
        TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, eLTSS RelatedPerson Profile, US Core Organization Profile)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        252. Contract.term.asset.valuedItem.linkId
        Definition

        Id of the clause or question text related to the context of this valuedItem in the referenced form or QuestionnaireResponse.

        ShortPointer to specific item
        Control0..*
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        254. Contract.term.asset.valuedItem.securityLabelNumber
        Definition

        A set of security labels that define which terms are controlled by this condition.

        ShortSecurity Labels that define affected terms
        Control0..*
        TypeunsignedInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        256. Contract.term.action
        Definition

        An actor taking a role in an activity for which it can be assigned some degree of responsibility for the activity taking place.

        ShortEntity being ascribed responsibility
        Comments

        Several agents may be associated (i.e. has some responsibility for an activity) with an activity and vice-versa. For example, in cases of actions initiated by one user for other users, or in events that involve more than one user, hardware device, software, or system process. However, only one user may be the initiator/requestor for the event.

        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Requirements

        An agent can be a person, an organization, software, device, or other entities that may be ascribed responsibility.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        258. Contract.term.action.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        260. Contract.term.action.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        262. Contract.term.action.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        264. Contract.term.action.doNotPerform
        Definition

        True if the term prohibits the action.

        ShortTrue if the term prohibits the action
        Control0..1
        Typeboolean
        Is Modifiertrue because If true this element negates the specified action. For Example, instead of a dictate to perform an action, it is a dictate not to perform the action.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        266. Contract.term.action.type
        Definition

        Activity or service obligation to be done or not done, performed or not performed, effectuated or not by this Contract term.

        ShortType or form of the action
        Control1..1
        BindingFor example codes, see ContractActionCodes
        (example to http://hl7.org/fhir/ValueSet/contract-action)

        Detailed codes for the contract action.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        268. Contract.term.action.subject
        Definition

        Entity of the action to be performed.

        ShortEntity of the action
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        270. Contract.term.action.subject.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        272. Contract.term.action.subject.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        274. Contract.term.action.subject.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        276. Contract.term.action.subject.reference
        Definition

        The entity the action is performed or not performed on or for.

        ShortEntity of the action
        Control1..*
        TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, Group, US Core Organization Profile)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        278. Contract.term.action.subject.role
        Definition

        Role type of agent assigned roles in this Contract.

        ShortRole type of the agent
        Control0..1
        BindingFor example codes, see ContractActorRoleCodes
        (example to http://hl7.org/fhir/ValueSet/contract-actorrole)

        Detailed codes for the contract actor role.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        280. Contract.term.action.intent
        Definition

        Reason or purpose for the action stipulated by this Contract Provision.

        ShortPurpose for the Contract Term Action
        Control1..1
        BindingFor example codes, see PurposeOfUse
        (example to http://terminology.hl7.org/ValueSet/v3-PurposeOfUse)

        Detailed codes for the contract action reason.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        282. Contract.term.action.linkId
        Definition

        Id [identifier??] of the clause or question text related to this action in the referenced form or QuestionnaireResponse.

        ShortPointer to specific item
        Control0..*
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        284. Contract.term.action.status
        Definition

        Current state of the term action.

        ShortState of the action
        Control1..1
        BindingFor example codes, see ContractResourceActionStatusCodes
        (example to http://hl7.org/fhir/ValueSet/contract-actionstatus)

        Codes for the status of an term action.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        286. Contract.term.action.context
        Definition

        Encounter or Episode with primary association to specified term activity.

        ShortEpisode associated with action
        Control0..1
        TypeReference(EpisodeOfCare_eltss, US Core Encounter Profile)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        288. Contract.term.action.contextLinkId
        Definition

        Id [identifier??] of the clause or question text related to the requester of this action in the referenced form or QuestionnaireResponse.

        ShortPointer to specific item
        Control0..*
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        290. Contract.term.action.occurrence[x]
        Definition

        When action happens.

        ShortWhen action happens
        Control0..1
        TypeChoice of: dateTime, Period, Timing
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        292. Contract.term.action.requester
        Definition

        Who or what initiated the action and has responsibility for its activation.

        ShortWho asked for action
        Control0..*
        TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, Group, US Core Organization Profile)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        294. Contract.term.action.requesterLinkId
        Definition

        Id [identifier??] of the clause or question text related to the requester of this action in the referenced form or QuestionnaireResponse.

        ShortPointer to specific item
        Control0..*
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        296. Contract.term.action.performerType
        Definition

        The type of individual that is desired or required to perform or not perform the action.

        ShortKind of service performer
        Control0..*
        BindingFor example codes, see ProvenanceParticipantType
        (example to http://hl7.org/fhir/ValueSet/provenance-agent-type)

        Codes for the types of action perfomer.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        298. Contract.term.action.performerRole
        Definition

        The type of role or competency of an individual desired or required to perform or not perform the action.

        ShortCompetency of the performer
        Control0..1
        BindingFor example codes, see ProvenanceParticipantRole
        (example to http://hl7.org/fhir/ValueSet/provenance-agent-role)

        Codes for the role of the action performer.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        300. Contract.term.action.performer
        Definition

        Indicates who or what is being asked to perform (or not perform) the ction.

        ShortActor that wil execute (or not) the action
        Control0..1
        TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, US Core Organization Profile)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        302. Contract.term.action.performerLinkId
        Definition

        Id [identifier??] of the clause or question text related to the reason type or reference of this action in the referenced form or QuestionnaireResponse.

        ShortPointer to specific item
        Control0..*
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        304. Contract.term.action.reasonCode
        Definition

        Rationale for the action to be performed or not performed. Describes why the action is permitted or prohibited.

        ShortWhy is action (not) needed?
        Control0..*
        BindingFor example codes, see PurposeOfUse
        (example to http://terminology.hl7.org/ValueSet/v3-PurposeOfUse)

        Detailed codes for the contract action reason.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        306. Contract.term.action.reasonReference
        Definition

        Indicates another resource whose existence justifies permitting or not permitting this action.

        ShortWhy is action (not) needed?
        Control0..*
        TypeReference(Condition_eltss, Observation_eltss, Questionnaire_eltss, US Core DocumentReference Profile, DiagnosticReport, QuestionnaireResponse)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        308. Contract.term.action.reason
        Definition

        Describes why the action is to be performed or not performed in textual form.

        ShortWhy action is to be performed
        Control0..*
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        310. Contract.term.action.reasonLinkId
        Definition

        Id [identifier??] of the clause or question text related to the reason type or reference of this action in the referenced form or QuestionnaireResponse.

        ShortPointer to specific item
        Control0..*
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        312. Contract.term.action.note
        Definition

        Comments made about the term action made by the requester, performer, subject or other participants.

        ShortComments about the action
        Control0..*
        TypeAnnotation
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        314. Contract.term.action.securityLabelNumber
        Definition

        Security labels that protects the action.

        ShortAction restriction numbers
        Control0..*
        TypeunsignedInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        316. Contract.term.group
        Definition

        Nested group of Contract Provisions.

        ShortNested Contract Term Group
        Control0..*
        TypeSeettp://hl7.org/fhir/StructureDefinition/Contract#Contract.term
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        318. Contract.supportingInfo
        Definition

        Information that may be needed by/relevant to the performer in their execution of this term action.

        ShortExtra Information
        Control0..*
        TypeReference(Resource)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        320. Contract.relevantHistory
        Definition

        Links to Provenance records for past versions of this Contract definition, derivative, or instance, which identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the Contract. The Provence.entity indicates the target that was changed in the update. http://build.fhir.org/provenance-definitions.html#Provenance.entity.

        ShortKey event in Contract History
        Control0..*
        TypeReference(Provenance)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        322. Contract.signer
        Definition

        Person, Guardian / Legal Representative, Support Planner, or Service Provider Signature

        ShortPerson, Guardian / Legal Representative, Support Planner, or Service Provider Signature
        Comments

        FHIR includes a preferred coding for contract signatory roles, which map well to the eLTSS signatories. The primary one for the patient/beneficiary is "PAT" (patient), although implementers may use others as well. However, implementers must realize that type may be used to differentiate between the patient, service provider, planner, etc. so there need to be distinct role types utilized.

        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

        The Contract.signer applies a signature to the Contract.binding referenced resource, which is the documentation that is the legal "source of truth". The Contract.signer may delegate, such as a legally recognized personal representative, or have a delegate assigned e.g., by a court of law, to actually sign the Contract, such as a trustee in the case of incompetence.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        324. Contract.signer.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        326. Contract.signer.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        328. Contract.signer.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        330. Contract.signer.type
        Definition

        Role of this Contract signer, e.g. notary, grantee.

        ShortContract Signatory Role
        Comments

        Would probably use "CONSENTER" which represents "consent signature" in this use case.

        Control1..1
        BindingThe codes SHOULD be taken from ContractSignerTypeCodes
        (preferred to http://hl7.org/fhir/ValueSet/contract-signer-type)

        List of parties who may be signing.

        TypeCoding
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        332. Contract.signer.party
        Definition

        Person, Guardian / Legal Representative, Support Planner, or Service Provider Printed Name

        ShortPerson, Guardian / Legal Representative, Support Planner, or Service Provider Printed Name
        Comments

        Must match signature.who.

        Control1..1
        TypeReference(Patient_eltss, Practitioner_eltss, eLTSS PractitionerRole Profile, eLTSS RelatedPerson Profile, US Core Organization Profile)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        334. Contract.signer.signature
        Definition

        Legally binding Contract DSIG signature contents encoded in Base64.

        ShortContract Documentation Signature
        Control1..*
        TypeSignature
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        336. Contract.signer.signature.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        338. Contract.signer.signature.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Contract.signer.signature.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 340. Contract.signer.signature.type
          Definition

          An indication of the reason that the entity signed this document. This may be explicitly included as part of the signature information and can be used when determining accountability for various actions concerning the document.

          ShortIndication of the reason the entity signed the object(s)
          Comments

          Would probably use "1.2.840.10065.1.12.1.7" which represents "consent signature" in this use case.

          Control1..*
          BindingThe codes SHOULD be taken from SignatureTypeCodes
          (preferred to http://hl7.org/fhir/ValueSet/signature-type)

          An indication of the reason that an entity signed the object.

          TypeCoding
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          342. Contract.signer.signature.when
          Definition

          Person, Guardian / Legal Representative, Support Planner, or Service Provider Signature Date

          ShortPerson, Guardian / Legal Representative, Support Planner, or Service Provider Signature Date
          Comments

          This should agree with the information in the signature.

          Control1..1
          Typeinstant
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          344. Contract.signer.signature.who
          Definition

          Person, Guardian / Legal Representative, Support Planner, or Service Provider Signature

          ShortPerson, Guardian/Legal Representative, Support Planner, or Service Provider Printed Name
          Comments

          Must match signer.party.

          Control1..1
          TypeReference(eLTSS PractitionerRole Profile, eLTSS RelatedPerson Profile, US Core Organization Profile, Practitioner_eltss, Patient_eltss)
          Is Modifierfalse
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          346. Contract.signer.signature.onBehalfOf
          Definition

          A reference to an application-usable description of the identity that is represented by the signature.

          ShortThe party represented
          Comments

          The party that can't sign. For example a child.

          Control0..1
          TypeReference(Practitioner, PractitionerRole, RelatedPerson, Patient, Device, Organization)
          Is Modifierfalse
          Summarytrue
          Requirements

          used when the signature is on behalf of a non-signer.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          348. Contract.signer.signature.targetFormat
          Definition

          A mime type that indicates the technical format of the target resources signed by the signature.

          ShortThe technical format of the signed resources
          Comments

          "xml", "json" and "ttl" are allowed, which describe the simple encodings described in the specification (and imply appropriate bundle support). Otherwise, mime types are legal here.

          Control0..1
          BindingThe codes SHALL be taken from Mime Types
          (required to http://hl7.org/fhir/ValueSet/mimetypes|4.0.1)

          The mime type of an attachment. Any valid mime type is allowed.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          350. Contract.signer.signature.sigFormat
          Definition

          A mime type that indicates the technical format of the signature. Important mime types are application/signature+xml for X ML DigSig, application/jose for JWS, and image/* for a graphical image of a signature, etc.

          ShortThe technical format of the signature
          Control0..1
          BindingThe codes SHALL be taken from Mime Types
          (required to http://hl7.org/fhir/ValueSet/mimetypes|4.0.1)

          The mime type of an attachment. Any valid mime type is allowed.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          352. Contract.signer.signature.data
          Definition

          The base64 encoding of the Signature content. When signature is not recorded electronically this element would be empty.

          ShortThe actual signature content (XML DigSig. JWS, picture, etc.)
          Comments

          Where the signature type is an XML DigSig, the signed content is a FHIR Resource(s), the signature is of the XML form of the Resource(s) using XML-Signature (XMLDIG) "Detached Signature" form.

          Control0..1
          Typebase64Binary
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          354. Contract.friendly
          Definition

          The "patient friendly language" versionof the Contract in whole or in parts. "Patient friendly language" means the representation of the Contract and Contract Provisions in a manner that is readily accessible and understandable by a layperson in accordance with best practices for communication styles that ensure that those agreeing to or signing the Contract understand the roles, actions, obligations, responsibilities, and implication of the agreement.

          ShortContract Friendly Language
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          356. Contract.friendly.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          358. Contract.friendly.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          360. Contract.friendly.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          362. Contract.friendly.content[x]
          Definition

          Human readable rendering of this Contract in a format and representation intended to enhance comprehension and ensure understandability.

          ShortEasily comprehended representation of this Contract
          Control1..1
          TypeChoice of: Attachment, Reference(Composition, DocumentReference, QuestionnaireResponse)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          364. Contract.legal
          Definition

          List of Legal expressions or representations of this Contract.

          ShortContract Legal Language
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          366. Contract.legal.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          368. Contract.legal.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          370. Contract.legal.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          372. Contract.legal.content[x]
          Definition

          Contract legal text in human renderable form.

          ShortContract Legal Text
          Control1..1
          TypeChoice of: Attachment, Reference(Composition, DocumentReference, QuestionnaireResponse)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          374. Contract.rule
          Definition

          List of Computable Policy Rule Language Representation(s) of this Contract.

          ShortComputable Contract Language
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          376. Contract.rule.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          378. Contract.rule.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          380. Contract.rule.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          382. Contract.rule.content[x]
          Definition

          Computable Contract conveyed using a policy rule language (e.g. XACML, DKAL, SecPal).

          ShortComputable Contract Rule(s)
          Control1..1
          TypeChoice of: Attachment, Reference(DocumentReference)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          384. Contract.legallyBinding[x]
          Definition

          Legally binding Contract: This is the signed and legally recognized representation of the Contract, which is considered the "source of truth" and which would be the basis for legal action related to enforcement of this Contract.

          ShortBinding Contract
          Control0..1
          TypeChoice of: Attachment, Reference(Composition, DocumentReference, QuestionnaireResponse, Contract)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))