{
  "description": "This Questionnaire instance defines the questions and possible answers in the MDRO and CDI LabID Event Reporting Monthly Summary Data for LTCF. It records the monthly aggregate data for Multi-Drug Resistant Organisms (MDRO) and Clostridium difficile (C. diff, CDI).",
  "_filename": "example/Questionnaire-hai-ltcf-questionnaire-mdro-cdi-summary.json",
  "package_name": "hl7.fhir.us.hai-ltcf",
  "subjectType": [ "Group" ],
  "date": "2019-08-01",
  "meta": {
    "source": "#K2RsXoEFureVKCw2",
    "profile": [ "http://hl7.org/fhir/us/hai-ltcf/StructureDefinition/hai-ltc-population-summary-questionnaire" ],
    "versionId": "28",
    "lastUpdated": "2022-02-11T03:42:58.063+00:00"
  },
  "publisher": "HL7 Public Health Work Group (http://www.hl7.org/Special/committees/pher/index.cfm)",
  "jurisdiction": [ {
    "coding": [ {
      "code": "US",
      "system": "urn:iso:std:iso:3166"
    } ]
  } ],
  "name": "HAI_LTCF_questionnaire_mdro_cdi_summary",
  "item": [ {
    "text": "Facility ID",
    "type": "url",
    "linkId": "facility-id",
    "repeats": false,
    "required": true
  }, {
    "text": "First Day of Period Reported",
    "type": "date",
    "linkId": "report-period-start",
    "repeats": false,
    "required": true
  }, {
    "text": "Last Day of Period Reported",
    "type": "date",
    "linkId": "report-period-end",
    "repeats": false,
    "required": true
  }, {
    "text": "Facility Location Code",
    "type": "choice",
    "linkId": "facility-location-code",
    "repeats": false,
    "required": true,
    "answerValueSet": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.13.19"
  }, {
    "code": [ {
      "code": "51900-9",
      "system": "http://loinc.org",
      "display": "Population Summary note"
    } ],
    "item": [ {
      "text": "The Summary Data Group a set of summary data for a population in the defined NHSN protocol.",
      "type": "display",
      "linkId": "summary-data-group-display"
    }, {
      "code": [ {
        "code": "1369-8",
        "system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
        "display": "Resident days"
      } ],
      "text": "Resident Days",
      "type": "integer",
      "linkId": "resident-days",
      "repeats": false,
      "required": true
    }, {
      "code": [ {
        "code": "1370-6",
        "system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
        "display": "Resident admissions"
      } ],
      "text": "Resident Admissions",
      "type": "integer",
      "linkId": "resident-admissions",
      "repeats": false,
      "required": true
    }, {
      "code": [ {
        "code": "1371-4",
        "system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
        "display": "Number of admissions on C. difficile treatment"
      } ],
      "text": "Number of admissions on C. difficile treatment",
      "type": "integer",
      "linkId": "number-admissions-on-c-diff-treatment",
      "repeats": false,
      "required": true
    }, {
      "code": [ {
        "code": "1372-2",
        "system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
        "display": "Number of C. difficile treatment starts"
      } ],
      "text": "Number of C. difficile treatment starts",
      "type": "integer",
      "linkId": "number-c-diff-treatment-starts",
      "repeats": false,
      "required": true
    } ],
    "text": "Summary Data Group",
    "type": "group",
    "linkId": "summary-data-group",
    "repeats": false,
    "required": true
  }, {
    "code": [ {
      "code": "90252-8",
      "system": "http://loinc.org",
      "display": "Report no events"
    } ],
    "item": [ {
      "text": "The Report No Events Group contains statements that there are no events to report for a particular type of event.",
      "type": "display",
      "linkId": "report-no-events-group-display"
    }, {
      "code": [ {
        "code": "3030-4",
        "system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
        "display": "Report No Events: LabID Event (All specimens): MRSA"
      } ],
      "text": "Report No Events: LabID Event (All specimens): MRSA",
      "type": "boolean",
      "linkId": "no-lab-id-event-mrsa",
      "repeats": false,
      "required": false
    }, {
      "code": [ {
        "code": "1307-8",
        "system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
        "display": "Report No Events: LabID Event (All specimens): MSSA"
      } ],
      "text": "Report No Events: LabID Event (All specimens): MSSA",
      "type": "boolean",
      "linkId": "no-lab-id-event-mssa",
      "repeats": false,
      "required": false
    }, {
      "code": [ {
        "code": "3033-8",
        "system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
        "display": "Report No Events: LabID Event (All specimens): VRE"
      } ],
      "text": "Report No Events: LabID Event (All specimens): VRE",
      "type": "boolean",
      "linkId": "no-lab-id-event-vre",
      "repeats": false,
      "required": false
    }, {
      "code": [ {
        "code": "3036-1",
        "system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
        "display": "Report No Events: LabID Event (All specimens): CephR Klebsiella"
      } ],
      "text": "Report No Events: LabID Event (All specimens): CephR Klebsiella",
      "type": "boolean",
      "linkId": "no-lab-id-event-cephr-klebsiella",
      "repeats": false,
      "required": false
    }, {
      "code": [ {
        "code": "3039-5",
        "system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
        "display": "Report No Events: LabID Event (All specimens): CRE-E. coli"
      } ],
      "text": "Report No Events: LabID Event (All specimens): CRE-E. coli",
      "type": "boolean",
      "linkId": "no-lab-id-event-mrsa-cre-e-coli",
      "repeats": false,
      "required": false
    }, {
      "code": [ {
        "code": "3042-9",
        "system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
        "display": "Report No Events: LabID Event (All specimens): CRE-Enterobacter"
      } ],
      "text": "Report No Events: LabID Event (All specimens): CRE-Enterobacter",
      "type": "boolean",
      "linkId": "no-lab-id-event-mrsa-cre-enterobacter",
      "repeats": false,
      "required": false
    }, {
      "code": [ {
        "code": "3045-2",
        "system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
        "display": "Report No Events: LabID Event (All specimens): CRE-Klebsiella"
      } ],
      "text": "Report No Events: LabID Event (All specimens): CRE-Klebsiella",
      "type": "boolean",
      "linkId": "no-lab-id-event-cre-klebsiella",
      "repeats": false,
      "required": false
    }, {
      "code": [ {
        "code": "3048-6",
        "system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
        "display": "Report No Events: LabID Event (All specimens): MDR-Acinetobacter"
      } ],
      "text": "Report No Events: LabID Event (All specimens): MDR-Acinetobacter",
      "type": "boolean",
      "linkId": "no-lab-id-event-mdr-acinetobacter",
      "repeats": false,
      "required": false
    }, {
      "code": [ {
        "code": "3051-0",
        "system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
        "display": "Report No Events: LabID Event (All specimens): C. difficile"
      } ],
      "text": "Report No Events: LabID Event (All specimens): C. difficile",
      "type": "boolean",
      "linkId": "no-lab-id-event-c-difficile",
      "repeats": false,
      "required": false
    } ],
    "text": "Report no events",
    "type": "group",
    "linkId": "report-no-events-group",
    "repeats": false,
    "required": false
  } ],
  "type": null,
  "experimental": "false",
  "resourceType": "Questionnaire",
  "title": "MDRO and CDI LabID Event Reporting Monthly Summary Data for LTCF",
  "package_version": "1.0.0",
  "status": "draft",
  "language": "en-US",
  "id": "f2107345-092b-425d-ab8c-d1dcf02260c8",
  "kind": null,
  "url": "http://hl7.org/fhir/us/hai-ltcf/Questionnaire/hai-ltcf-questionnaire-mdro-cdi-summary",
  "code": [ {
    "code": "51897-7",
    "system": "http://loinc.org",
    "display": "Healthcare Associated Infection report Document"
  }, {
    "code": "1891-1",
    "system": "https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/cdcnhsn.html",
    "display": "Summary data reporting MDRO and CDI LabID Event for LTCF"
  } ],
  "identifier": [ {
    "value": "hai-ltcf-questionnaire-mdro-cdi-summary-v1"
  } ],
  "version": "1.0.0",
  "contact": [ {
    "name": "HL7 International - Public Health",
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/pher",
      "system": "url"
    } ]
  } ]
}