# NHSN Situational Awareness Framework for Reporting Home - CDC NHSN Situational Awareness Framework for Reporting (NHSN SAFR) Content Implementation Guide v1.0.0

* [**Table of Contents**](toc.md)
* **NHSN Situational Awareness Framework for Reporting Home**

## NHSN Situational Awareness Framework for Reporting Home

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| :--- | :--- | :--- |
| *Official URL*:http://www.cdc.gov/nhsn/fhirportal/safr/ig/ImplementationGuide/gov.cdc.nhsn.safr | *Version*:1.0.0 | |
| * IG Standards status: *[Trial-use](http://hl7.org/fhir/R4/versions.html#std-process) | [Maturity Level](http://hl7.org/fhir/versions.html#maturity): 1 | *Computable Name*:NHSNSAFR |

### Overview

The Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network Situational Awareness Framework for Reporting (NHSN SAFR) Implementation Guide (IG) establishes a standardized, FHIR-based approach to support public health decision-making during emergencies. By enhancing situational awareness, this IG aims to provide a real-time, national or jurisdictional view of healthcare system capacity, respiratory disease trends, and other critical public health metrics. The guide is designed to facilitate seamless data exchange between healthcare facilities and public health authorities (federal and/or jurisdictional),thereby strengthening the nation’s emergency preparedness and response capabilities.

### Purpose

This specification seeks to achieve the following objectives:

1. **Standardized FHIR Interfaces:**Enable interoperable data exchange with the National Healthcare Safety Network (NHSN) of the Centers for Disease Control and Prevention (CDC) and other federal or jurisdictional public health agencies.
1. **Automated Data Collection:**Minimize manual intervention through real-time data collection.
1. **Increased Situational Awareness:**Provide a comprehensive view of healthcare capacity and trends, serving as a foundation for future data reporting needs.

By addressing these goals, NHSN SAFR supports healthcare facilities and public health authorities in reporting critical data efficiently, ensuring patient safety and informed decision-making during public health emergencies.

### Background

The COVID-19 pandemic revealed significant gaps in the ability to monitor healthcare system stress and capacity. This project integrates and generalizes previous initiatives, including [SANER - Situational Awareness for Novel Epidemic Response IG (universal realm)](https://hl7.org/fhir/uv/saner/index.html) and [DEQM - Data Exchange for Quality Measure IG (US realm)](http://hl7.org/fhir/us/davinci-deqm/STU5/index.html), into a unified framework tailored for the US. Key highlights include:

1. Standardized definitions of healthcare bed capacity and other metrics.
1. Compatibility with existing federal systems and regulatory requirements.
1. Development of at least one IG tailored for US-specific needs, leveraging United States Core Data for Interoperability (USCDI) and US terminology. The NHSN SAFR IG builds upon lessons learned during the pandemic to create a reliable, automated, and standardized reporting framework for the future.

### Audience

This guide is intended for a broad range of interoperability partners, including:

* **Healthcare Organizations:** Hospitals, acute care centers, and other providers with public health reporting obligations.
* **Federal Agencies:** CDC, ASTP/ONC, CMS, ASPR, and other federal public health entities.
* **Provider HIT Vendors:** Developers of provider HIT such as EHRs, administrative, and logistics systems that are the source of NHSN SAFR data.
* **Standards Development Organizations:** Stakeholders involved in advancing FHIR and other health data standards.
* **Public Health Authorities:** State, tribal, local, and territorial (STLTs) public health agencies seeking to improve situational awareness and emergency response.

### Design Considerations

The design of NHSN SAFR emphasizes:

* **Interoperability:** Seamless data exchange between hospitals, jurisdictions, and federal systems via FHIR.
* **Scalability:** A framework capable of addressing both current and future situational awareness needs.
* **Data Uniformity:** Consistent definitions and structures to facilitate regional and national collaboration.
* **Automated Compliance:** Streamlined reporting aligned with federal regulations to reduce the administrative burden.

The guide ensures alignment with existing initiatives, such as SANER and DEQM, while addressing US-specific requirements and terminology.

### Relationship to Other Standards

The NHSN SAFR IG harmonizes with and extends the following standards:

1. **[US Situational Awareness Framework for Reporting (US SAFR)](http://hl7.org/fhir/us/davinci-deqm/STU5/index.html)**Establishes a standardized, FHIR-based approach to support public health decision-making during emergencies and is designed to facilitate seamless data exchange between healthcare facilities and public health authorities (federal and/or jurisdictional),thereby strengthening the nation’s emergency preparedness and response capabilities.
1. **[Situational Awareness for Novel Epidemic Response (SANER) (Universal Realm):](https://hl7.org/fhir/uv/saner/index.html)**Provides the foundation for situational awareness reporting globally. NHSN SAFR adapts SANER for US-specific requirements while maintaining interoperability.
1. **[Data Exchange For Quality Measures (DEQM) (US Realm):](http://hl7.org/fhir/us/davinci-deqm/STU5/index.html)**Ensures alignment with existing US-specific quality measurement standards.
1. **[NHSN Bed Connectivity Initiative:](https://www.cdc.gov/nhsn/bed-capacity/index.html)**Standardizes real-time bed capacity reporting across hospitals and jurisdictions.
1. **[Hospital Respiratory Data Reporting:](https://www.cdc.gov/nhsn/psc/hospital-respiratory-reporting.html)**Establishes reporting standards for COVID-19, influenza, RSV, and related data.
1. **[National Healthcare Safety Network (NHSN) Digital Quality Measure (dQM) Reporting:](http://hl7.org/fhir/us/nhsn-dqm)**Defines the standard framework for reporting patient line-level clinical data using a digital Quality Measure (dQM). Whereas, NHSN SAFR focuses on situational awareness reporting excluding protected health information.

By aligning with these standards, NHSN SAFR supports a unified reporting framework for healthcare capacity and situational awareness data.

Other FHIR standard related dependencies:

















### Out of Scope

Subscriptions is not covered in this IG currently, but future versions will plan to incorporate [FHIR Subscriptions R5 Backport](https://build.fhir.org/ig/HL7/fhir-subscription-backport-ig/) to support emergencies that require rapid changes in reporting.

### Acknowledgements

Lantana Consulting Group, Inc. produced and developed the content in this IG under contract to the Division of Healthcare Quality Promotion (DHQP) in the National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) at the Centers for Disease Control and Prevention (CDC).

| | | | |
| :--- | :--- | :--- | :--- |
| Primary Editor | Shanai Thornton | Lantana Consulting Group | shanai.thornton@lantanagroup.com |
| Primary Editor | Rick Geimer | Lantana Consulting Group | rick.geimer@lantanagroup.com |
| Primary Editor | Corey Spears | Lantana Consulting Group | corey.spears@lantanagroup.com |
| Co-Editor | Andrea Benin | CDC | aqb4@cdc.gov |
| Co-Editor | Kristina Betz | CDC | rly7@cdc.gov |
| Co-Editor | Arvind Jagannathan | Lantana Consulting Group | arvind.jagannathan@lantanagroup.com |
| Co-Editor | Beth Golshir | CDC | kqo9@cdc.gov |
| Co-Editor | Ally Binder | CDC | wpq5@cdc.gov |
| Co-Editor | Joey Sach | CDC | squ7@cdc.gov |
| Co-Editor | Jeenal Patel | CDC | ujo2@cdc.gov |
| Co-Editor | Matt Heym | CDC | twz0.cdc.gov |
| Co-Editor | Christopher Uga | CDC | uto2@cdc.gov |
| Co-Editor | Tami Funk | Lantana | tami.funk@lantanagroup.com |
| Co-Editor | Maggie Dudeck | CDC | xzd7@cdc.gov |
| Co-Editor | Bass Toure | Leidos | mamadou.b.toure@leidos.com |
| Co-Editor | Karthick Seshadri | CDC | qax2@cdc.gov |
| Co-Editor | Heath Dinkins | CDC | ldx6@cdc.gov |
| Co-Editor | David deRoode | Lantana Consulting Group | david.deroode@lantanagroup.com |
| Co-Editor | Ming Dunajick | Lantana Consulting Group | ming.dunajick@lantanagroup.com |
| Co-Editor | Aaron Nusstein | Lantana Consulting Group | aaron.nusstein@lantanagroup.com |



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    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "path-output"
      },
      {
        "url" : "value",
        "valueString" : "output"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "path-suppressed-warnings"
      },
      {
        "url" : "value",
        "valueString" : "input/ignoreWarnings.txt"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "path-history"
      },
      {
        "url" : "value",
        "valueString" : "http://www.cdc.gov/nhsn/fhirportal/safr/ig/history.html"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "template-html"
      },
      {
        "url" : "value",
        "valueString" : "template-page.html"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "template-md"
      },
      {
        "url" : "value",
        "valueString" : "template-page-md.html"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "apply-contact"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "apply-context"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "apply-copyright"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "apply-license"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "apply-version"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "apply-wg"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "active-tables"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "fmm-definition"
      },
      {
        "url" : "value",
        "valueString" : "http://hl7.org/fhir/versions.html#maturity"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "propagate-status"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "excludelogbinaryformat"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    },
    {
      "extension" : [{
        "url" : "code",
        "valueCode" : "tabbed-snapshots"
      },
      {
        "url" : "value",
        "valueString" : "true"
      }],
      "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
    }],
    "resource" : [{
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Measure"
      }],
      "reference" : {
        "reference" : "Measure/BedCapacityMeasure"
      },
      "name" : "Bed Capacity Measure",
      "description" : "Bed Capacity Measure includes counts of specific bed types within the context of a given healthcare context or setting.",
      "exampleBoolean" : false
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Library"
      }],
      "reference" : {
        "reference" : "Library/BedCapacityMeasure"
      },
      "name" : "BedCapacityMeasure",
      "description" : "Library containing the Bed Capacity Measure.",
      "exampleBoolean" : false
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Bundle"
      }],
      "reference" : {
        "reference" : "Bundle/HospitalBedCapacityReportBundle"
      },
      "name" : "Bundle - Bed Capacity Report Bundle Example",
      "description" : "Bundle containing a measure report and all referenced resources for NHSN bed capacity reporting.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Bundle"
      }],
      "reference" : {
        "reference" : "Bundle/HRDMeasureReportBundle"
      },
      "name" : "Bundle - HRD Measure Report Bundle Example",
      "description" : "Bundle containing a measure report and all referenced resources for NHSN Hospital Respiratory Disease (HRD) reporting",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Bundle"
      }],
      "reference" : {
        "reference" : "Bundle/NHSNSAFRMeasureBundleExample"
      },
      "name" : "Bundle - NHSN SAFR Measure Bundle Example",
      "description" : "Bundle containing a measure for NHSN reporting.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Location"
      }],
      "reference" : {
        "reference" : "Location/CHLDBed4"
      },
      "name" : "Children's Bed 4",
      "description" : "A bed located in the Children's Department of the hospital.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Device"
      }],
      "reference" : {
        "reference" : "Device/cqf-tooling"
      },
      "name" : "CQL Testing Tooling",
      "description" : "This Device resource is used to represent the CQL tooling software. It is referenced by the Library resources to indicate that the CQL tooling used to execute the CQL in those libraries.",
      "exampleBoolean" : false
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Location"
      }],
      "reference" : {
        "reference" : "Location/EDBed1"
      },
      "name" : "Emergency Dept. Bed 1",
      "description" : "A bed located in the Emergency Department.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Encounter"
      }],
      "reference" : {
        "reference" : "Encounter/encounter-example-ach-ach-pass2-emergency"
      },
      "name" : "Encounter - Example ED Patient 1 - Emergency",
      "description" : "Encounter - Example ED Patient 1 - Emergency department visit",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Library"
      }],
      "reference" : {
        "reference" : "Library/FHIRHelpers"
      },
      "name" : "FHIR Helpers",
      "description" : "This library defines functions to convert between FHIR data types and CQL system-defined types, as well as functions to support FHIRPath implementation. For more information, the FHIRHelpers wiki page: https://github.com/cqframework/clinical_quality_language/wiki/FHIRHelpers. This locally defined version includes modifications from the original library.",
      "exampleBoolean" : false
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "CodeSystem"
      }],
      "reference" : {
        "reference" : "CodeSystem/nhsn-safr-bed-capacity-codes"
      },
      "name" : "Healthcare Bed Capacity Reporting Code System",
      "description" : "This CodeSystem defines coded concepts for Healthcare Capacity reporting for NHSN SAFR.",
      "exampleBoolean" : false
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "CodeSystem"
      }],
      "reference" : {
        "reference" : "CodeSystem/nhsn-safr-hrd-codes"
      },
      "name" : "Hospital Respiratory Data Reporting Code System",
      "description" : "This CodeSystem defines coded concepts for Hospital Respiratory Data reporting for NHSN SAFR.",
      "exampleBoolean" : false
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Measure"
      }],
      "reference" : {
        "reference" : "Measure/HRDMeasure"
      },
      "name" : "HRD Measure",
      "description" : "Hospital Respiratory Data Measure",
      "exampleBoolean" : false
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Library"
      }],
      "reference" : {
        "reference" : "Library/HRDMeasure"
      },
      "name" : "HRDMeasure",
      "description" : "Library for the Hospital Respiratory Data (HRD) Measure.",
      "exampleBoolean" : false
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Location"
      }],
      "reference" : {
        "reference" : "Location/IPFBed3"
      },
      "name" : "Inpatient Psychiatric Bed 3",
      "description" : "A bed located in the Inpatient Psychiatric Department of the hospital.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Location"
      }],
      "reference" : {
        "reference" : "Location/IRFBed2"
      },
      "name" : "Inpatient Rehabilitation Bed 2",
      "description" : "A bed located in Inpatient Rehabilitation department of the hospital.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Location"
      }],
      "reference" : {
        "reference" : "Location/ICUBed6"
      },
      "name" : "Intensive Care Unit Bed 6",
      "description" : "A bed located in the ICU Unit of the hospital.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Location"
      }],
      "reference" : {
        "reference" : "Location/MemorialHospitalFacility"
      },
      "name" : "Location - Hospital Facility Example",
      "description" : "Example of a Hospital Facility for NHSN reporting.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "MeasureReport"
      }],
      "reference" : {
        "reference" : "MeasureReport/BedCapacityMeasureReport"
      },
      "name" : "MeasureReport - Bed Capacity MeasureReport Example",
      "description" : "Example MeasureReport for NHSN bed capacity monitoring showing ICU, ED, and Pediatric bed capacity",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "MeasureReport"
      }],
      "reference" : {
        "reference" : "MeasureReport/HRDMeasureReport"
      },
      "name" : "MeasureReport - HRD MeasureReport Example",
      "description" : "This Bundle resource is an example of a Hospital Respiratory Data (HRD) MeasureReport.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "CapabilityStatement"
      }],
      "reference" : {
        "reference" : "CapabilityStatement/SafrCapabilityStatementDataAggregator"
      },
      "name" : "NHSN SAFR Data Aggregator CapabilityStatement",
      "description" : "This statement defines the expected capabilities of a system that aggregates data from multiple Data Source actors before measure evaluation and then plays the role of a Data Source once aggregation is complete. An example would be a state public health agency aggregating data from all facilities in the state before using those data to produce a MeasureReport containing bed capacity data for the entire state. When FHIR enabled, a Data Aggregator acts as a [US Core Server](http://hl7.org/fhir/us/core/STU6.1/CapabilityStatement-us-core-server.html) when playing the role of a Data Source after aggregation. During aggregation, the Data Aggregator acts similar to the SANER options for aggregation, but implements its own CapabilityStatement due to the incompatibilities between DEQM and SANER.",
      "exampleBoolean" : false
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "CapabilityStatement"
      }],
      "reference" : {
        "reference" : "CapabilityStatement/SafrCapabilityStatementEvaluationEngine"
      },
      "name" : "NHSN SAFR Data Evaluation Engine CapabilityStatement",
      "description" : "This statement defines the expected capabilities of a system  that retrieves data from the Data Source and evaluates those data against one or more measures \r\nretrieved from the Measure Source. The resulting MeasureReport bundle and related resources are then sent to the MeasureReport recipient. The Measure Evaluation Engine acts as a \r\n[US Core Client](https://www.hl7.org/fhir/us/core/STU6.1/CapabilityStatement-us-core-client.html), \r\na [DEQM Reporter Client](https://www.hl7.org/fhir/us/davinci-deqm/STU4/CapabilityStatement-reporter-client.html), and implements the $evaluation-measure operation.\r\n\r\nNote: FHIR queries are not always required. In the case, an EHR retrieves data from it's own internal data store using non-FHIR methods or imports data from other systems that are not FHIR-enabled.",
      "exampleBoolean" : false
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "CapabilityStatement"
      }],
      "reference" : {
        "reference" : "CapabilityStatement/SafrCapabilityStatementDataSource"
      },
      "name" : "NHSN SAFR Data Source CapabilityStatement",
      "description" : "This statement defines the expected capabilities of a system containing data (typically patient data, but could be situational awareness data) \r\nthat will be evaluated against one or more measures. This may be a FHIR server, an EHR with a FHIR endpoint (facade), an internal data store when the Data Source \r\nand Measure Evaluation Engine actors are played by the same system such as an EHR that does it’s own measure evaluation, or it may be a system containing other data \r\nsuch as situational awareness data that is reporting via CSV or other format. When FHIR enabled, the Data Source acts as a \r\n[US Core Server](https://hl7.org/fhir/us/core/STU6.1/CapabilityStatement-us-core-server.html).\r\n\r\nNote: US Core Server is only needed for external evaluation engines. Examples of where this is not needed, is an EHR querying it's own data source using proprietary data access methods.",
      "exampleBoolean" : false
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "ValueSet"
      }],
      "reference" : {
        "reference" : "ValueSet/nhsn-safr-hrd-supply-days-codes"
      },
      "name" : "NHSN SAFR HRD Supply Day Time Period Ranges Value Set",
      "description" : "HRD Supply Day Time Period Ranges value set using codes from ISO 8601 for expressing time period ranges.",
      "exampleBoolean" : false
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "CapabilityStatement"
      }],
      "reference" : {
        "reference" : "CapabilityStatement/SafrCapabilityStatementmeasurerepository"
      },
      "name" : "NHSN SAFR Measure Source CapabilityStatement",
      "description" : "This statement defines the expected capabilities of a system at NHSN, federal and jurisdictional Public Health Agencies including State, Tribal, Local and Territorial (STLT) Health Departments that stores FHIR resources such as Measure, Library, ValueSet, etc. that are used for \r\nMeasure Reporting. The Measure Evaluation Engine queries the Measure Source for the latest Measure content before querying the Patient Data Source and performing measure evaluation. \r\nThe Measure Source acts as a [CQFM Publishable Measure Repository](https://hl7.org/fhir/us/cqfmeasures/measure-repository-service.html#publishable-measure-repository).",
      "exampleBoolean" : false
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "CapabilityStatement"
      }],
      "reference" : {
        "reference" : "CapabilityStatement/SafrCapabilityStatementMeasureReportRecipient"
      },
      "name" : "NHSN SAFR MeasureReport Recipient CapabilityStatement",
      "description" : "This statement defines the expected capabilities of a system at NHSN, federal and jurisdictional Public Health Agencies including State, Tribal, Local and Territorial (STLT) Health Departments that receives MeasureReport bundles from the Measure Evaluation Engine and validates \r\nthe result against the profiles in this implementation guide, and potentially other measure-specific profiles that are distributed with the measures themselves. The MeasureReport Recipient acts as a \r\n[DEQM Receiver Server](https://www.hl7.org/fhir/us/davinci-deqm/STU4/CapabilityStatement-receiver-server.html), provides write access to Bundle resources containing \r\nMeasureReport and other related resources, and implements the $validate operation.",
      "exampleBoolean" : false
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Organization"
      }],
      "reference" : {
        "reference" : "Organization/MemorialHospitalOrganization"
      },
      "name" : "Organization - Submitting Hospital Organization Example",
      "description" : "Organization - Example of a Submitting Hospital Organization",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Location"
      }],
      "reference" : {
        "reference" : "Location/OTHBed5"
      },
      "name" : "Other Facility Bed 3",
      "description" : "A bed located in an subunit of the facility.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Patient"
      }],
      "reference" : {
        "reference" : "Patient/ed-pat-1"
      },
      "name" : "Patient - Example ED Patient 1",
      "description" : "Example ED Patient 1 is a patient who has been seen in the emergency department.",
      "exampleBoolean" : true
    },
    {
      "extension" : [{
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
        "valueString" : "Location"
      }],
      "reference" : {
        "reference" : "Location/PEDSBed7"
      },
      "name" : "Pediatric Bed 7",
      "description" : "A bed located in the Pediatrics Unit of the hospital.",
      "exampleBoolean" : true
    }],
    "page" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
        "valueCode" : "informative"
      },
      {
        "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
        "valueUrl" : "toc.html"
      }],
      "nameUrl" : "toc.html",
      "title" : "Table of Contents",
      "generation" : "html",
      "page" : [{
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "informative"
        },
        {
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
          "valueUrl" : "index.html"
        }],
        "nameUrl" : "index.html",
        "title" : "NHSN Situational Awareness Framework for Reporting Home",
        "generation" : "markdown"
      },
      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "informative"
        },
        {
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
          "valueUrl" : "actors.html"
        }],
        "nameUrl" : "actors.html",
        "title" : "Actors",
        "generation" : "markdown"
      },
      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "informative"
        },
        {
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
          "valueUrl" : "usecases.html"
        }],
        "nameUrl" : "usecases.html",
        "title" : "Use Cases",
        "generation" : "markdown"
      },
      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "informative"
        },
        {
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
          "valueUrl" : "specification.html"
        }],
        "nameUrl" : "specification.html",
        "title" : "Specification",
        "generation" : "markdown"
      },
      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "informative"
        },
        {
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
          "valueUrl" : "security.html"
        }],
        "nameUrl" : "security.html",
        "title" : "Privacy and Security Considerations",
        "generation" : "markdown"
      },
      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "informative"
        },
        {
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
          "valueUrl" : "bed-capacity-mapping.html"
        }],
        "nameUrl" : "bed-capacity-mapping.html",
        "title" : "Bed Capacity Code Mapping",
        "generation" : "markdown"
      },
      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "informative"
        },
        {
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
          "valueUrl" : "downloads.html"
        }],
        "nameUrl" : "downloads.html",
        "title" : "Downloads",
        "generation" : "markdown"
      },
      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "informative"
        },
        {
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
          "valueUrl" : "ImplementationGuide-gov.cdc.nhsn.safr.html"
        }],
        "nameUrl" : "ImplementationGuide-gov.cdc.nhsn.safr.html",
        "title" : "NHSN Implementation Guide Resource",
        "generation" : "markdown"
      },
      {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "informative"
        },
        {
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
          "valueUrl" : "license.html"
        }],
        "nameUrl" : "license.html",
        "title" : "License",
        "generation" : "markdown"
      }]
    },
    "parameter" : [{
      "code" : "path-pages",
      "value" : "input/pagecontent"
    },
    {
      "code" : "path-pages",
      "value" : "input/intro-notes"
    },
    {
      "code" : "path-pages",
      "value" : "fsh-generated/includes"
    },
    {
      "code" : "path-resource",
      "value" : "input/capabilities"
    },
    {
      "code" : "path-resource",
      "value" : "input/examples"
    },
    {
      "code" : "path-resource",
      "value" : "input/extensions"
    },
    {
      "code" : "path-resource",
      "value" : "input/models"
    },
    {
      "code" : "path-resource",
      "value" : "input/operations"
    },
    {
      "code" : "path-resource",
      "value" : "input/profiles"
    },
    {
      "code" : "path-resource",
      "value" : "input/resources"
    },
    {
      "code" : "path-resource",
      "value" : "input/vocabulary"
    },
    {
      "code" : "path-resource",
      "value" : "input/maps"
    },
    {
      "code" : "path-resource",
      "value" : "input/testing"
    },
    {
      "code" : "path-resource",
      "value" : "input/history"
    },
    {
      "code" : "path-resource",
      "value" : "fsh-generated/resources"
    },
    {
      "code" : "path-pages",
      "value" : "template/config"
    },
    {
      "code" : "path-pages",
      "value" : "input/images"
    },
    {
      "code" : "path-tx-cache",
      "value" : "input-cache/txcache"
    }]
  }
}

```
