A Care Plan is a consensus-driven dynamic plan that represents a patient’s and Care Team Members’ prioritized concerns, goals, and planned interventions. It serves as a blueprint shared by all Care Team Members (including the patient, their caregivers, and providers), to guide the patient’s care. A Care Plan integrates multiple interventions proposed by multiple providers and disciplines for multiple conditions. A Care Plan may represent one or more Care Plans and serves to reconcile and resolve conflicts between the various plans developed for a specific patient by different providers. It supports the following use cases:

• Query for patient data across providers and compile into a consolidated care plan representation.
• Encourage capture of and communication of a patient's health concerns and related goals, interventions, and outcomes.
• Gather and aggregate patient data for uses beyond the point of care (e.g. public health, population health, quality measurement, risk adjustment, quality improvement, and research.)

Important Implementation guidance

See Structure and Design considerations

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from USCoreCarePlanProfile

Name	Flags	Card.	Type	Description & Constraints
CarePlan		0..*	USCoreCarePlanProfile	Healthcare plan for patient or group
Slices for extension				Content/Rules for all slices
custodian		0..1	Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team)	When populated, the custodian is responsible for the care and maintenance of the care plan. The care plan is attributed to the custodian. The custodian might or might not be a contributor. This CarePlan.custodian extension should be used instead of CarePlan.author which in R4 is currently identified as the designated responsible party and in R5 has been removed. URL: http://hl7.org/fhir/us/mcc/StructureDefinition/custodian
author		0..1	Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)	Use the CarePlan custodian extension instead. Use of CarePlan.author is discouraged, it is removed in R5.
contributor	S	0..*	Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team)	Who provided the content of the care plan
careTeam	S	0..*	Reference(Multiple Chronic Condition Care Plan Care Team S | US Core CareTeam Profile)	Who's involved in plan?
addresses	S	0..*	Reference(MCC Chronic Condition and Health Concern Profile | US Core Condition Encounter Diagnosis Profile)	Health issues this plan addresses
supportingInfo	S	0..*	Reference(US Core Blood Pressure Profile | US Core BMI Profile | US Core Body Weight Profile | MCC Chronic Condition and Health Concern Profile | Multiple Chronic Condition Care Plan Laboratory Result Observation | Multiple Chronic Condition Care Plan Diagnostic Report and Note | Multiple Chronic Condition Care Plan Procedure | US Core Immunization Profile | Multiple Chronic Condition Care Plan Family History | Document Reference to Patient's Personal Advance Care Plan (Advance Directive) | SDC Questionnaire Response | Multiple Chronic Condition Care Plan Symptom Observation | Multiple Chronic Condition Care Plan Service Request | Multiple Chronic Condition Care Plan Observation SDOH Assessment | Multiple Chronic Condition Care Plan Immunization | Multiple Chronic Condition Care Plan Nutrition Order | Multiple Chronic Condition Care Plan Clinical Impression | Multiple Chronic Condition Care Plan Patient/Caregiver Condition Status Observation | Multiple Chronic Condition Care Plan Questionnaire Response | Multiple Chronic Condition Care Plan Caregiver Considerations Observation | Multiple Chronic Condition Care Plan Clinical Test Observation | US Core RelatedPerson Profile | US Core Observation Occupation Profile | Resource)	Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.supportingInfo
goal		0..*	Reference(Multiple Chronic Condition Care Plan Goal)	This Goal represents one or more overarching goal applicable to the entire care plan
activity	S	0..*	BackboneElement	Action to occur as part of plan. This is the backbone element of the care plan that is the root of care coordination activities. While there can be many activities in a care plan, each activity has only one planned.activityRefence
outcomeReference	S	0..*	Reference(Multiple Chronic Condition Care Plan Procedure | Multiple Chronic Condition Care Plan Laboratory Result Observation | US Core Immunization Profile | Multiple Chronic Condition Care Plan Diagnostic Report and Note | US Core Immunization Profile | Multiple Chronic Condition Care Plan Medication Request | MCC Chronic Condition and Health Concern Profile | US Core Body Weight Profile | US Core Blood Pressure Profile | Multiple Chronic Condition Care Plan Goal | US Core BMI Profile | Multiple Chronic Condition Care Plan Symptom Observation | Resource)	This CarePlan element represents a PERFORMED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.outcomeReference
reference	S	0..1	Reference(NutritionOrder | Multiple Chronic Condition Care Plan Medication Request | CommunicationRequest | DeviceRequest | Task | ServiceRequest | VisionPrescription | RequestGroup | Appointment)	This CarePlan element represents a PLANNED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.reference
detail		0..0
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
CarePlan		0..*	USCoreCarePlanProfile	Healthcare plan for patient or group
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
text	S	0..1	Narrative	(USCDI) Text summary of the resource, for human interpretation
status	S	1..1	code	(USCDI) generated | extensions | additional | empty Binding: US Core Narrative Status (required): Constrained value set of narrative statuses.
div	SC	1..1	xhtml	(USCDI) Limited xhtml content txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes txt-2: The narrative SHALL have some non-whitespace content
Slices for extension				Content/Rules for all slices
custodian		0..1	Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team)	When populated, the custodian is responsible for the care and maintenance of the care plan. The care plan is attributed to the custodian. The custodian might or might not be a contributor. This CarePlan.custodian extension should be used instead of CarePlan.author which in R4 is currently identified as the designated responsible party and in R5 has been removed. URL: http://hl7.org/fhir/us/mcc/StructureDefinition/custodian
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	(USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
intent	?!SΣ	1..1	code	(USCDI) proposal | plan | order | option Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan
Slices for category	SΣ	1..*	CodeableConcept	(USCDI) Type of plan Slice: Unordered, Open by pattern:$this Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.
category:AssessPlan	SΣ	1..1	CodeableConcept	(USCDI) Type of plan Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/careplan-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: assess-plan
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who the care plan is for
author	Σ	0..1	Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)	Use the CarePlan custodian extension instead. Use of CarePlan.author is discouraged, it is removed in R5.
contributor	S	0..*	Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team)	Who provided the content of the care plan
careTeam	S	0..*	Reference(Multiple Chronic Condition Care Plan Care Team)	Who's involved in plan?
addresses	SΣ	0..*	Reference(MCC Chronic Condition and Health Concern Profile | US Core Condition Encounter Diagnosis Profile)	Health issues this plan addresses
supportingInfo	S	0..*	Reference(US Core Blood Pressure Profile | US Core BMI Profile | US Core Body Weight Profile | MCC Chronic Condition and Health Concern Profile | Multiple Chronic Condition Care Plan Laboratory Result Observation | Multiple Chronic Condition Care Plan Diagnostic Report and Note | Multiple Chronic Condition Care Plan Procedure | US Core Immunization Profile | Multiple Chronic Condition Care Plan Family History | Document Reference to Patient's Personal Advance Care Plan (Advance Directive) | SDC Questionnaire Response | Multiple Chronic Condition Care Plan Symptom Observation | Multiple Chronic Condition Care Plan Service Request | Multiple Chronic Condition Care Plan Observation SDOH Assessment | Multiple Chronic Condition Care Plan Immunization | Multiple Chronic Condition Care Plan Nutrition Order | Multiple Chronic Condition Care Plan Clinical Impression | Multiple Chronic Condition Care Plan Patient/Caregiver Condition Status Observation | Multiple Chronic Condition Care Plan Questionnaire Response | Multiple Chronic Condition Care Plan Caregiver Considerations Observation | Multiple Chronic Condition Care Plan Clinical Test Observation | US Core RelatedPerson Profile | US Core Observation Occupation Profile | Resource)	Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.supportingInfo
goal		0..*	Reference(Multiple Chronic Condition Care Plan Goal)	This Goal represents one or more overarching goal applicable to the entire care plan
activity	SC	0..*	BackboneElement	Action to occur as part of plan. This is the backbone element of the care plan that is the root of care coordination activities. While there can be many activities in a care plan, each activity has only one planned.activityRefence cpl-3: Provide a reference or detail, not both
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
outcomeReference	S	0..*	Reference(Multiple Chronic Condition Care Plan Procedure | Multiple Chronic Condition Care Plan Laboratory Result Observation | US Core Immunization Profile | Multiple Chronic Condition Care Plan Diagnostic Report and Note | US Core Immunization Profile | Multiple Chronic Condition Care Plan Medication Request | MCC Chronic Condition and Health Concern Profile | US Core Body Weight Profile | US Core Blood Pressure Profile | Multiple Chronic Condition Care Plan Goal | US Core BMI Profile | Multiple Chronic Condition Care Plan Symptom Observation | Resource)	This CarePlan element represents a PERFORMED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.outcomeReference
reference	SC	0..1	Reference(NutritionOrder | Multiple Chronic Condition Care Plan Medication Request | CommunicationRequest | DeviceRequest | Task | ServiceRequest | VisionPrescription | RequestGroup | Appointment)	This CarePlan element represents a PLANNED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.reference
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
CarePlan.text.status	required	NarrativeStatus http://hl7.org/fhir/us/core/ValueSet/us-core-narrative-status
CarePlan.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status from the FHIR Standard
CarePlan.intent	required	CarePlanIntent http://hl7.org/fhir/ValueSet/care-plan-intent from the FHIR Standard
CarePlan.category	example	CarePlanCategory http://hl7.org/fhir/ValueSet/care-plan-category from the FHIR Standard
CarePlan.category:AssessPlan	example	Pattern: assess-plan http://hl7.org/fhir/ValueSet/care-plan-category from the FHIR Standard
CarePlan.activity.detail.status	required	CarePlanActivityStatus http://hl7.org/fhir/ValueSet/care-plan-activity-status|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cpl-3	error	CarePlan.activity	Provide a reference or detail, not both : detail.empty() or reference.empty()
dom-2	error	CarePlan	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CarePlan	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	CarePlan	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	CarePlan	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CarePlan	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
txt-1	error	CarePlan.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes : htmlChecks()
txt-2	error	CarePlan.text.div	The narrative SHALL have some non-whitespace content : htmlChecks()

Name	Flags	Card.	Type	Description & Constraints
CarePlan		0..*	USCoreCarePlanProfile	Healthcare plan for patient or group
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text	S	0..1	Narrative	(USCDI) Text summary of the resource, for human interpretation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
status	S	1..1	code	(USCDI) generated | extensions | additional | empty Binding: US Core Narrative Status (required): Constrained value set of narrative statuses.
div	SC	1..1	xhtml	(USCDI) Limited xhtml content txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes txt-2: The narrative SHALL have some non-whitespace content
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
custodian		0..1	Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team)	When populated, the custodian is responsible for the care and maintenance of the care plan. The care plan is attributed to the custodian. The custodian might or might not be a contributor. This CarePlan.custodian extension should be used instead of CarePlan.author which in R4 is currently identified as the designated responsible party and in R5 has been removed. URL: http://hl7.org/fhir/us/mcc/StructureDefinition/custodian
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this plan
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan)	Fulfills CarePlan
replaces	Σ	0..*	Reference(CarePlan)	CarePlan replaced by this CarePlan
partOf	Σ	0..*	Reference(CarePlan)	Part of referenced CarePlan
status	?!SΣ	1..1	code	(USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
intent	?!SΣ	1..1	code	(USCDI) proposal | plan | order | option Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan
Slices for category	SΣ	1..*	CodeableConcept	(USCDI) Type of plan Slice: Unordered, Open by pattern:$this Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.
category:AssessPlan	SΣ	1..1	CodeableConcept	(USCDI) Type of plan Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/careplan-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: assess-plan
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
title	Σ	0..1	string	Human-friendly name for the care plan
description	Σ	0..1	string	Summary of nature of plan
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who the care plan is for
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
period	Σ	0..1	Period	Time period plan covers
created	Σ	0..1	dateTime	Date record was first recorded
author	Σ	0..1	Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)	Use the CarePlan custodian extension instead. Use of CarePlan.author is discouraged, it is removed in R5.
contributor	S	0..*	Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team)	Who provided the content of the care plan
careTeam	S	0..*	Reference(Multiple Chronic Condition Care Plan Care Team S | US Core CareTeam Profile)	Who's involved in plan?
addresses	SΣ	0..*	Reference(MCC Chronic Condition and Health Concern Profile | US Core Condition Encounter Diagnosis Profile)	Health issues this plan addresses
supportingInfo	S	0..*	Reference(US Core Blood Pressure Profile | US Core BMI Profile | US Core Body Weight Profile | MCC Chronic Condition and Health Concern Profile | Multiple Chronic Condition Care Plan Laboratory Result Observation | Multiple Chronic Condition Care Plan Diagnostic Report and Note | Multiple Chronic Condition Care Plan Procedure | US Core Immunization Profile | Multiple Chronic Condition Care Plan Family History | Document Reference to Patient's Personal Advance Care Plan (Advance Directive) | SDC Questionnaire Response | Multiple Chronic Condition Care Plan Symptom Observation | Multiple Chronic Condition Care Plan Service Request | Multiple Chronic Condition Care Plan Observation SDOH Assessment | Multiple Chronic Condition Care Plan Immunization | Multiple Chronic Condition Care Plan Nutrition Order | Multiple Chronic Condition Care Plan Clinical Impression | Multiple Chronic Condition Care Plan Patient/Caregiver Condition Status Observation | Multiple Chronic Condition Care Plan Questionnaire Response | Multiple Chronic Condition Care Plan Caregiver Considerations Observation | Multiple Chronic Condition Care Plan Clinical Test Observation | US Core RelatedPerson Profile | US Core Observation Occupation Profile | Resource)	Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.supportingInfo
goal		0..*	Reference(Multiple Chronic Condition Care Plan Goal)	This Goal represents one or more overarching goal applicable to the entire care plan
activity	SC	0..*	BackboneElement	Action to occur as part of plan. This is the backbone element of the care plan that is the root of care coordination activities. While there can be many activities in a care plan, each activity has only one planned.activityRefence cpl-3: Provide a reference or detail, not both
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
outcomeCodeableConcept		0..*	CodeableConcept	Results of the activity Binding: CarePlanActivityOutcome (example): Identifies the results of the activity.
outcomeReference	S	0..*	Reference(Multiple Chronic Condition Care Plan Procedure | Multiple Chronic Condition Care Plan Laboratory Result Observation | US Core Immunization Profile | Multiple Chronic Condition Care Plan Diagnostic Report and Note | US Core Immunization Profile | Multiple Chronic Condition Care Plan Medication Request | MCC Chronic Condition and Health Concern Profile | US Core Body Weight Profile | US Core Blood Pressure Profile | Multiple Chronic Condition Care Plan Goal | US Core BMI Profile | Multiple Chronic Condition Care Plan Symptom Observation | Resource)	This CarePlan element represents a PERFORMED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.outcomeReference
progress		0..*	Annotation	Comments about the activity status/progress
reference	SC	0..1	Reference(NutritionOrder | Multiple Chronic Condition Care Plan Medication Request | CommunicationRequest | DeviceRequest | Task | ServiceRequest | VisionPrescription | RequestGroup | Appointment)	This CarePlan element represents a PLANNED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.reference
note		0..*	Annotation	Comments about the plan
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
CarePlan.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
CarePlan.text.status	required	NarrativeStatus http://hl7.org/fhir/us/core/ValueSet/us-core-narrative-status
CarePlan.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status from the FHIR Standard
CarePlan.intent	required	CarePlanIntent http://hl7.org/fhir/ValueSet/care-plan-intent from the FHIR Standard
CarePlan.category	example	CarePlanCategory http://hl7.org/fhir/ValueSet/care-plan-category from the FHIR Standard
CarePlan.category:AssessPlan	example	Pattern: assess-plan http://hl7.org/fhir/ValueSet/care-plan-category from the FHIR Standard
CarePlan.activity.outcomeCodeableConcept	example	CarePlanActivityOutcome http://hl7.org/fhir/ValueSet/care-plan-activity-outcome from the FHIR Standard
CarePlan.activity.detail.kind	required	CarePlanActivityKind http://hl7.org/fhir/ValueSet/care-plan-activity-kind|4.0.1 from the FHIR Standard
CarePlan.activity.detail.code	example	ProcedureCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-code from the FHIR Standard
CarePlan.activity.detail.reasonCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard
CarePlan.activity.detail.status	required	CarePlanActivityStatus http://hl7.org/fhir/ValueSet/care-plan-activity-status|4.0.1 from the FHIR Standard
CarePlan.activity.detail.product[x]	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cpl-3	error	CarePlan.activity	Provide a reference or detail, not both : detail.empty() or reference.empty()
dom-2	error	CarePlan	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CarePlan	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	CarePlan	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	CarePlan	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CarePlan	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
txt-1	error	CarePlan.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes : htmlChecks()
txt-2	error	CarePlan.text.div	The narrative SHALL have some non-whitespace content : htmlChecks()

Differential View

This structure is derived from USCoreCarePlanProfile

Name	Flags	Card.	Type	Description & Constraints
CarePlan		0..*	USCoreCarePlanProfile	Healthcare plan for patient or group
Slices for extension				Content/Rules for all slices
custodian		0..1	Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team)	When populated, the custodian is responsible for the care and maintenance of the care plan. The care plan is attributed to the custodian. The custodian might or might not be a contributor. This CarePlan.custodian extension should be used instead of CarePlan.author which in R4 is currently identified as the designated responsible party and in R5 has been removed. URL: http://hl7.org/fhir/us/mcc/StructureDefinition/custodian
author		0..1	Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)	Use the CarePlan custodian extension instead. Use of CarePlan.author is discouraged, it is removed in R5.
contributor	S	0..*	Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team)	Who provided the content of the care plan
careTeam	S	0..*	Reference(Multiple Chronic Condition Care Plan Care Team S | US Core CareTeam Profile)	Who's involved in plan?
addresses	S	0..*	Reference(MCC Chronic Condition and Health Concern Profile | US Core Condition Encounter Diagnosis Profile)	Health issues this plan addresses
supportingInfo	S	0..*	Reference(US Core Blood Pressure Profile | US Core BMI Profile | US Core Body Weight Profile | MCC Chronic Condition and Health Concern Profile | Multiple Chronic Condition Care Plan Laboratory Result Observation | Multiple Chronic Condition Care Plan Diagnostic Report and Note | Multiple Chronic Condition Care Plan Procedure | US Core Immunization Profile | Multiple Chronic Condition Care Plan Family History | Document Reference to Patient's Personal Advance Care Plan (Advance Directive) | SDC Questionnaire Response | Multiple Chronic Condition Care Plan Symptom Observation | Multiple Chronic Condition Care Plan Service Request | Multiple Chronic Condition Care Plan Observation SDOH Assessment | Multiple Chronic Condition Care Plan Immunization | Multiple Chronic Condition Care Plan Nutrition Order | Multiple Chronic Condition Care Plan Clinical Impression | Multiple Chronic Condition Care Plan Patient/Caregiver Condition Status Observation | Multiple Chronic Condition Care Plan Questionnaire Response | Multiple Chronic Condition Care Plan Caregiver Considerations Observation | Multiple Chronic Condition Care Plan Clinical Test Observation | US Core RelatedPerson Profile | US Core Observation Occupation Profile | Resource)	Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.supportingInfo
goal		0..*	Reference(Multiple Chronic Condition Care Plan Goal)	This Goal represents one or more overarching goal applicable to the entire care plan
activity	S	0..*	BackboneElement	Action to occur as part of plan. This is the backbone element of the care plan that is the root of care coordination activities. While there can be many activities in a care plan, each activity has only one planned.activityRefence
outcomeReference	S	0..*	Reference(Multiple Chronic Condition Care Plan Procedure | Multiple Chronic Condition Care Plan Laboratory Result Observation | US Core Immunization Profile | Multiple Chronic Condition Care Plan Diagnostic Report and Note | US Core Immunization Profile | Multiple Chronic Condition Care Plan Medication Request | MCC Chronic Condition and Health Concern Profile | US Core Body Weight Profile | US Core Blood Pressure Profile | Multiple Chronic Condition Care Plan Goal | US Core BMI Profile | Multiple Chronic Condition Care Plan Symptom Observation | Resource)	This CarePlan element represents a PERFORMED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.outcomeReference
reference	S	0..1	Reference(NutritionOrder | Multiple Chronic Condition Care Plan Medication Request | CommunicationRequest | DeviceRequest | Task | ServiceRequest | VisionPrescription | RequestGroup | Appointment)	This CarePlan element represents a PLANNED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.reference
detail		0..0
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
CarePlan		0..*	USCoreCarePlanProfile	Healthcare plan for patient or group
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
text	S	0..1	Narrative	(USCDI) Text summary of the resource, for human interpretation
status	S	1..1	code	(USCDI) generated | extensions | additional | empty Binding: US Core Narrative Status (required): Constrained value set of narrative statuses.
div	SC	1..1	xhtml	(USCDI) Limited xhtml content txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes txt-2: The narrative SHALL have some non-whitespace content
Slices for extension				Content/Rules for all slices
custodian		0..1	Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team)	When populated, the custodian is responsible for the care and maintenance of the care plan. The care plan is attributed to the custodian. The custodian might or might not be a contributor. This CarePlan.custodian extension should be used instead of CarePlan.author which in R4 is currently identified as the designated responsible party and in R5 has been removed. URL: http://hl7.org/fhir/us/mcc/StructureDefinition/custodian
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	(USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
intent	?!SΣ	1..1	code	(USCDI) proposal | plan | order | option Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan
Slices for category	SΣ	1..*	CodeableConcept	(USCDI) Type of plan Slice: Unordered, Open by pattern:$this Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.
category:AssessPlan	SΣ	1..1	CodeableConcept	(USCDI) Type of plan Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/careplan-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: assess-plan
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who the care plan is for
author	Σ	0..1	Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)	Use the CarePlan custodian extension instead. Use of CarePlan.author is discouraged, it is removed in R5.
contributor	S	0..*	Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team)	Who provided the content of the care plan
careTeam	S	0..*	Reference(Multiple Chronic Condition Care Plan Care Team)	Who's involved in plan?
addresses	SΣ	0..*	Reference(MCC Chronic Condition and Health Concern Profile | US Core Condition Encounter Diagnosis Profile)	Health issues this plan addresses
supportingInfo	S	0..*	Reference(US Core Blood Pressure Profile | US Core BMI Profile | US Core Body Weight Profile | MCC Chronic Condition and Health Concern Profile | Multiple Chronic Condition Care Plan Laboratory Result Observation | Multiple Chronic Condition Care Plan Diagnostic Report and Note | Multiple Chronic Condition Care Plan Procedure | US Core Immunization Profile | Multiple Chronic Condition Care Plan Family History | Document Reference to Patient's Personal Advance Care Plan (Advance Directive) | SDC Questionnaire Response | Multiple Chronic Condition Care Plan Symptom Observation | Multiple Chronic Condition Care Plan Service Request | Multiple Chronic Condition Care Plan Observation SDOH Assessment | Multiple Chronic Condition Care Plan Immunization | Multiple Chronic Condition Care Plan Nutrition Order | Multiple Chronic Condition Care Plan Clinical Impression | Multiple Chronic Condition Care Plan Patient/Caregiver Condition Status Observation | Multiple Chronic Condition Care Plan Questionnaire Response | Multiple Chronic Condition Care Plan Caregiver Considerations Observation | Multiple Chronic Condition Care Plan Clinical Test Observation | US Core RelatedPerson Profile | US Core Observation Occupation Profile | Resource)	Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.supportingInfo
goal		0..*	Reference(Multiple Chronic Condition Care Plan Goal)	This Goal represents one or more overarching goal applicable to the entire care plan
activity	SC	0..*	BackboneElement	Action to occur as part of plan. This is the backbone element of the care plan that is the root of care coordination activities. While there can be many activities in a care plan, each activity has only one planned.activityRefence cpl-3: Provide a reference or detail, not both
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
outcomeReference	S	0..*	Reference(Multiple Chronic Condition Care Plan Procedure | Multiple Chronic Condition Care Plan Laboratory Result Observation | US Core Immunization Profile | Multiple Chronic Condition Care Plan Diagnostic Report and Note | US Core Immunization Profile | Multiple Chronic Condition Care Plan Medication Request | MCC Chronic Condition and Health Concern Profile | US Core Body Weight Profile | US Core Blood Pressure Profile | Multiple Chronic Condition Care Plan Goal | US Core BMI Profile | Multiple Chronic Condition Care Plan Symptom Observation | Resource)	This CarePlan element represents a PERFORMED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.outcomeReference
reference	SC	0..1	Reference(NutritionOrder | Multiple Chronic Condition Care Plan Medication Request | CommunicationRequest | DeviceRequest | Task | ServiceRequest | VisionPrescription | RequestGroup | Appointment)	This CarePlan element represents a PLANNED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.reference
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
CarePlan.text.status	required	NarrativeStatus http://hl7.org/fhir/us/core/ValueSet/us-core-narrative-status
CarePlan.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status from the FHIR Standard
CarePlan.intent	required	CarePlanIntent http://hl7.org/fhir/ValueSet/care-plan-intent from the FHIR Standard
CarePlan.category	example	CarePlanCategory http://hl7.org/fhir/ValueSet/care-plan-category from the FHIR Standard
CarePlan.category:AssessPlan	example	Pattern: assess-plan http://hl7.org/fhir/ValueSet/care-plan-category from the FHIR Standard
CarePlan.activity.detail.status	required	CarePlanActivityStatus http://hl7.org/fhir/ValueSet/care-plan-activity-status|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cpl-3	error	CarePlan.activity	Provide a reference or detail, not both : detail.empty() or reference.empty()
dom-2	error	CarePlan	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CarePlan	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	CarePlan	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	CarePlan	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CarePlan	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
txt-1	error	CarePlan.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes : htmlChecks()
txt-2	error	CarePlan.text.div	The narrative SHALL have some non-whitespace content : htmlChecks()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
CarePlan		0..*	USCoreCarePlanProfile	Healthcare plan for patient or group
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text	S	0..1	Narrative	(USCDI) Text summary of the resource, for human interpretation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
status	S	1..1	code	(USCDI) generated | extensions | additional | empty Binding: US Core Narrative Status (required): Constrained value set of narrative statuses.
div	SC	1..1	xhtml	(USCDI) Limited xhtml content txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes txt-2: The narrative SHALL have some non-whitespace content
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
custodian		0..1	Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team)	When populated, the custodian is responsible for the care and maintenance of the care plan. The care plan is attributed to the custodian. The custodian might or might not be a contributor. This CarePlan.custodian extension should be used instead of CarePlan.author which in R4 is currently identified as the designated responsible party and in R5 has been removed. URL: http://hl7.org/fhir/us/mcc/StructureDefinition/custodian
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this plan
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan)	Fulfills CarePlan
replaces	Σ	0..*	Reference(CarePlan)	CarePlan replaced by this CarePlan
partOf	Σ	0..*	Reference(CarePlan)	Part of referenced CarePlan
status	?!SΣ	1..1	code	(USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
intent	?!SΣ	1..1	code	(USCDI) proposal | plan | order | option Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan
Slices for category	SΣ	1..*	CodeableConcept	(USCDI) Type of plan Slice: Unordered, Open by pattern:$this Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.
category:AssessPlan	SΣ	1..1	CodeableConcept	(USCDI) Type of plan Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/careplan-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: assess-plan
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
title	Σ	0..1	string	Human-friendly name for the care plan
description	Σ	0..1	string	Summary of nature of plan
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who the care plan is for
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
period	Σ	0..1	Period	Time period plan covers
created	Σ	0..1	dateTime	Date record was first recorded
author	Σ	0..1	Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)	Use the CarePlan custodian extension instead. Use of CarePlan.author is discouraged, it is removed in R5.
contributor	S	0..*	Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team)	Who provided the content of the care plan
careTeam	S	0..*	Reference(Multiple Chronic Condition Care Plan Care Team S | US Core CareTeam Profile)	Who's involved in plan?
addresses	SΣ	0..*	Reference(MCC Chronic Condition and Health Concern Profile | US Core Condition Encounter Diagnosis Profile)	Health issues this plan addresses
supportingInfo	S	0..*	Reference(US Core Blood Pressure Profile | US Core BMI Profile | US Core Body Weight Profile | MCC Chronic Condition and Health Concern Profile | Multiple Chronic Condition Care Plan Laboratory Result Observation | Multiple Chronic Condition Care Plan Diagnostic Report and Note | Multiple Chronic Condition Care Plan Procedure | US Core Immunization Profile | Multiple Chronic Condition Care Plan Family History | Document Reference to Patient's Personal Advance Care Plan (Advance Directive) | SDC Questionnaire Response | Multiple Chronic Condition Care Plan Symptom Observation | Multiple Chronic Condition Care Plan Service Request | Multiple Chronic Condition Care Plan Observation SDOH Assessment | Multiple Chronic Condition Care Plan Immunization | Multiple Chronic Condition Care Plan Nutrition Order | Multiple Chronic Condition Care Plan Clinical Impression | Multiple Chronic Condition Care Plan Patient/Caregiver Condition Status Observation | Multiple Chronic Condition Care Plan Questionnaire Response | Multiple Chronic Condition Care Plan Caregiver Considerations Observation | Multiple Chronic Condition Care Plan Clinical Test Observation | US Core RelatedPerson Profile | US Core Observation Occupation Profile | Resource)	Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.supportingInfo
goal		0..*	Reference(Multiple Chronic Condition Care Plan Goal)	This Goal represents one or more overarching goal applicable to the entire care plan
activity	SC	0..*	BackboneElement	Action to occur as part of plan. This is the backbone element of the care plan that is the root of care coordination activities. While there can be many activities in a care plan, each activity has only one planned.activityRefence cpl-3: Provide a reference or detail, not both
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
outcomeCodeableConcept		0..*	CodeableConcept	Results of the activity Binding: CarePlanActivityOutcome (example): Identifies the results of the activity.
outcomeReference	S	0..*	Reference(Multiple Chronic Condition Care Plan Procedure | Multiple Chronic Condition Care Plan Laboratory Result Observation | US Core Immunization Profile | Multiple Chronic Condition Care Plan Diagnostic Report and Note | US Core Immunization Profile | Multiple Chronic Condition Care Plan Medication Request | MCC Chronic Condition and Health Concern Profile | US Core Body Weight Profile | US Core Blood Pressure Profile | Multiple Chronic Condition Care Plan Goal | US Core BMI Profile | Multiple Chronic Condition Care Plan Symptom Observation | Resource)	This CarePlan element represents a PERFORMED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.outcomeReference
progress		0..*	Annotation	Comments about the activity status/progress
reference	SC	0..1	Reference(NutritionOrder | Multiple Chronic Condition Care Plan Medication Request | CommunicationRequest | DeviceRequest | Task | ServiceRequest | VisionPrescription | RequestGroup | Appointment)	This CarePlan element represents a PLANNED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.reference
note		0..*	Annotation	Comments about the plan
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
CarePlan.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
CarePlan.text.status	required	NarrativeStatus http://hl7.org/fhir/us/core/ValueSet/us-core-narrative-status
CarePlan.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status from the FHIR Standard
CarePlan.intent	required	CarePlanIntent http://hl7.org/fhir/ValueSet/care-plan-intent from the FHIR Standard
CarePlan.category	example	CarePlanCategory http://hl7.org/fhir/ValueSet/care-plan-category from the FHIR Standard
CarePlan.category:AssessPlan	example	Pattern: assess-plan http://hl7.org/fhir/ValueSet/care-plan-category from the FHIR Standard
CarePlan.activity.outcomeCodeableConcept	example	CarePlanActivityOutcome http://hl7.org/fhir/ValueSet/care-plan-activity-outcome from the FHIR Standard
CarePlan.activity.detail.kind	required	CarePlanActivityKind http://hl7.org/fhir/ValueSet/care-plan-activity-kind|4.0.1 from the FHIR Standard
CarePlan.activity.detail.code	example	ProcedureCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-code from the FHIR Standard
CarePlan.activity.detail.reasonCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard
CarePlan.activity.detail.status	required	CarePlanActivityStatus http://hl7.org/fhir/ValueSet/care-plan-activity-status|4.0.1 from the FHIR Standard
CarePlan.activity.detail.product[x]	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cpl-3	error	CarePlan.activity	Provide a reference or detail, not both : detail.empty() or reference.empty()
dom-2	error	CarePlan	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CarePlan	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	CarePlan	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	CarePlan	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CarePlan	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
txt-1	error	CarePlan.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes : htmlChecks()
txt-2	error	CarePlan.text.div	The narrative SHALL have some non-whitespace content : htmlChecks()

This structure is derived from USCoreCarePlanProfile

Summary

Must-Support: 7 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
• US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
• US Core PractitionerRole Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole)
• US Core CareTeam Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam)
• US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)
• Multiple Chronic Condition Care Plan Care Team (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCCareTeam)
• MCC Chronic Condition and Health Concern Profile (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCChronCondHealthConcern)
• US Core Condition Encounter Diagnosis Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis)
• US Core Blood Pressure Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure)
• US Core BMI Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-bmi)
• US Core Body Weight Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-body-weight)
• Multiple Chronic Condition Care Plan Laboratory Result Observation (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCLaboratoryResultObservation)
• Multiple Chronic Condition Care Plan Diagnostic Report and Note (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCDiagnosticReportAndNote)
• Multiple Chronic Condition Care Plan Procedure (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCProcedure)
• US Core Immunization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization)
• Multiple Chronic Condition Care Plan Family History (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCFamilyHistory)
• Document Reference to Patient's Personal Advance Care Plan (Advance Directive) (http://hl7.org/fhir/us/mcc/StructureDefinition/DocRefPACP)
• SDC Questionnaire Response (http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse)
• Multiple Chronic Condition Care Plan Symptom Observation (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCSymptomObservation)
• Multiple Chronic Condition Care Plan Service Request (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCServiceRequest)
• Multiple Chronic Condition Care Plan Observation SDOH Assessment (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCObservationSDOHAssessment)
• Multiple Chronic Condition Care Plan Immunization (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCImmunization)
• Multiple Chronic Condition Care Plan Nutrition Order (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCNutritionOrder)
• Multiple Chronic Condition Care Plan Clinical Impression (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCClinicalImpression)
• Multiple Chronic Condition Care Plan Patient/Caregiver Condition Status Observation (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCPatientCaregiverConditionStatus)
• Multiple Chronic Condition Care Plan Questionnaire Response (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCQuestionnaireResponse)
• Multiple Chronic Condition Care Plan Caregiver Considerations Observation (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCCaregiverConsiderationsObservation)
• Multiple Chronic Condition Care Plan Clinical Test Observation (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCClinicalResultObservation)
• US Core RelatedPerson Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson)
• US Core Observation Occupation Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-occupation)
• Multiple Chronic Condition Care Plan Goal (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCGoal)
• Multiple Chronic Condition Care Plan Medication Request (http://hl7.org/fhir/us/mcc/StructureDefinition/MCCMedicationRequest)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/mcc/StructureDefinition/custodian