German Practice Management FHIR Profiles (R4)
0.90.0 - STU1 Germany

German Practice Management FHIR Profiles (R4) - Local Development build (v0.90.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Praxis Nursing Home Residency DE

Official URL: https://fhir.cognovis.de/praxis/StructureDefinition/praxis-nursing-home-residency-de Version: 0.90.0
Active as of 2026-07-29 Computable Name: PraxisNursingHomeResidencyDE
Other Identifiers: OID:2.16.840.1.113883.3.7985.42.314

Standing fact that a patient resides in a nursing home (Pflegeheim). An active residency drives ambulatory billing code selection for home visits (Hausbesuch): nursing-home-specific EBM codes and Mitbesuch rules apply when the patient is an active resident. Physical placement (facility -> ward -> room) is expressed through gematik ISiK Location profiles (ISiKStandort / ISiKStandortRaum) and their partOf hierarchy, not through free-text fields. EpisodeOfCare has no native location element, so the Location is carried by the nursingHomeLocation extension.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. EpisodeOfCare 0..* EpisodeOfCare An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:nursingHomeLocation S 1..1 Reference(ISiKStandort | ISiKStandortRaum | ISiKStandortBettenstellplatz) Reference to the patient's place within the nursing home
URL: https://fhir.cognovis.de/praxis/StructureDefinition/nursing-home-location
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... patient SΣ 1..1 Reference(Patient) The patient who is the focus of this episode of care
... managingOrganization SΣ 0..1 Reference(Organization) Operator of the nursing home, if recorded
... period SΣ 0..1 Period Interval during responsibility is assumed

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
EpisodeOfCare.status Base required EpisodeOfCareStatus 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error EpisodeOfCare If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error EpisodeOfCare 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 EpisodeOfCare 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 EpisodeOfCare If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice EpisodeOfCare 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()

This structure is derived from EpisodeOfCare

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. EpisodeOfCare 0..* EpisodeOfCare An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:nursingHomeLocation S 1..1 Reference(ISiKStandort | ISiKStandortRaum | ISiKStandortBettenstellplatz) Reference to the patient's place within the nursing home
URL: https://fhir.cognovis.de/praxis/StructureDefinition/nursing-home-location
... status S 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
... patient S 1..1 Reference(Patient) The patient who is the focus of this episode of care
... period S 0..1 Period Interval during responsibility is assumed

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. EpisodeOfCare 0..* EpisodeOfCare An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
... 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
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:nursingHomeLocation S 1..1 Reference(ISiKStandort | ISiKStandortRaum | ISiKStandortBettenstellplatz) Reference to the patient's place within the nursing home
URL: https://fhir.cognovis.de/praxis/StructureDefinition/nursing-home-location
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier Business Identifier(s) relevant for this EpisodeOfCare
... status ?!SΣ 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required): The status of the episode of care.
... statusHistory 0..* BackboneElement Past list of status codes (the current status may be included to cover the start date of the status)
.... 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
.... status 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required): The status of the episode of care.
.... period 1..1 Period Duration the EpisodeOfCare was in the specified status
... type Σ 0..* CodeableConcept Type/class - e.g. specialist referral, disease management
Binding: EpisodeOfCareType (example): The type of the episode of care.
... diagnosis Σ 0..* BackboneElement The list of diagnosis relevant to this episode of care
.... 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
.... condition Σ 1..1 Reference(Condition) Conditions/problems/diagnoses this episode of care is for
.... role Σ 0..1 CodeableConcept Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …)
Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
.... rank Σ 0..1 positiveInt Ranking of the diagnosis (for each role type)
... patient SΣ 1..1 Reference(Patient) The patient who is the focus of this episode of care
... managingOrganization SΣ 0..1 Reference(Organization) Operator of the nursing home, if recorded
... period SΣ 0..1 Period Interval during responsibility is assumed
... referralRequest 0..* Reference(ServiceRequest) Originating Referral Request(s)
... careManager 0..1 Reference(Practitioner | PractitionerRole) Care manager/care coordinator for the patient
... team 0..* Reference(CareTeam) Other practitioners facilitating this episode of care
... account 0..* Reference(Account) The set of accounts that may be used for billing for this EpisodeOfCare

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
EpisodeOfCare.language Base preferred Common Languages 📍4.0.1 FHIR Std.
EpisodeOfCare.status Base required EpisodeOfCareStatus 📍4.0.1 FHIR Std.
EpisodeOfCare.statusHistory.​status Base required EpisodeOfCareStatus 📍4.0.1 FHIR Std.
EpisodeOfCare.type Base example Episode of care type 📍4.0.1 FHIR Std.
EpisodeOfCare.diagnosis.​role Base preferred DiagnosisRole 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error EpisodeOfCare If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error EpisodeOfCare 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 EpisodeOfCare 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 EpisodeOfCare If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice EpisodeOfCare 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()

This structure is derived from EpisodeOfCare

Summary

Mandatory: 2 elements
Must-Support: 5 elements

Extensions

This structure refers to these extensions:

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. EpisodeOfCare 0..* EpisodeOfCare An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:nursingHomeLocation S 1..1 Reference(ISiKStandort | ISiKStandortRaum | ISiKStandortBettenstellplatz) Reference to the patient's place within the nursing home
URL: https://fhir.cognovis.de/praxis/StructureDefinition/nursing-home-location
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... patient SΣ 1..1 Reference(Patient) The patient who is the focus of this episode of care
... managingOrganization SΣ 0..1 Reference(Organization) Operator of the nursing home, if recorded
... period SΣ 0..1 Period Interval during responsibility is assumed

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
EpisodeOfCare.status Base required EpisodeOfCareStatus 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error EpisodeOfCare If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error EpisodeOfCare 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 EpisodeOfCare 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 EpisodeOfCare If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice EpisodeOfCare 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()

Differential View

This structure is derived from EpisodeOfCare

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. EpisodeOfCare 0..* EpisodeOfCare An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:nursingHomeLocation S 1..1 Reference(ISiKStandort | ISiKStandortRaum | ISiKStandortBettenstellplatz) Reference to the patient's place within the nursing home
URL: https://fhir.cognovis.de/praxis/StructureDefinition/nursing-home-location
... status S 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
... patient S 1..1 Reference(Patient) The patient who is the focus of this episode of care
... period S 0..1 Period Interval during responsibility is assumed

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. EpisodeOfCare 0..* EpisodeOfCare An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
... 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
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:nursingHomeLocation S 1..1 Reference(ISiKStandort | ISiKStandortRaum | ISiKStandortBettenstellplatz) Reference to the patient's place within the nursing home
URL: https://fhir.cognovis.de/praxis/StructureDefinition/nursing-home-location
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier Business Identifier(s) relevant for this EpisodeOfCare
... status ?!SΣ 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required): The status of the episode of care.
... statusHistory 0..* BackboneElement Past list of status codes (the current status may be included to cover the start date of the status)
.... 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
.... status 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
Binding: EpisodeOfCareStatus (required): The status of the episode of care.
.... period 1..1 Period Duration the EpisodeOfCare was in the specified status
... type Σ 0..* CodeableConcept Type/class - e.g. specialist referral, disease management
Binding: EpisodeOfCareType (example): The type of the episode of care.
... diagnosis Σ 0..* BackboneElement The list of diagnosis relevant to this episode of care
.... 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
.... condition Σ 1..1 Reference(Condition) Conditions/problems/diagnoses this episode of care is for
.... role Σ 0..1 CodeableConcept Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …)
Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
.... rank Σ 0..1 positiveInt Ranking of the diagnosis (for each role type)
... patient SΣ 1..1 Reference(Patient) The patient who is the focus of this episode of care
... managingOrganization SΣ 0..1 Reference(Organization) Operator of the nursing home, if recorded
... period SΣ 0..1 Period Interval during responsibility is assumed
... referralRequest 0..* Reference(ServiceRequest) Originating Referral Request(s)
... careManager 0..1 Reference(Practitioner | PractitionerRole) Care manager/care coordinator for the patient
... team 0..* Reference(CareTeam) Other practitioners facilitating this episode of care
... account 0..* Reference(Account) The set of accounts that may be used for billing for this EpisodeOfCare

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
EpisodeOfCare.language Base preferred Common Languages 📍4.0.1 FHIR Std.
EpisodeOfCare.status Base required EpisodeOfCareStatus 📍4.0.1 FHIR Std.
EpisodeOfCare.statusHistory.​status Base required EpisodeOfCareStatus 📍4.0.1 FHIR Std.
EpisodeOfCare.type Base example Episode of care type 📍4.0.1 FHIR Std.
EpisodeOfCare.diagnosis.​role Base preferred DiagnosisRole 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error EpisodeOfCare If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error EpisodeOfCare 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 EpisodeOfCare 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 EpisodeOfCare If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice EpisodeOfCare 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()

This structure is derived from EpisodeOfCare

Summary

Mandatory: 2 elements
Must-Support: 5 elements

Extensions

This structure refers to these extensions:

 

Other representations of profile: CSV, Excel, Schematron