Child - Recognized Coordinating Entity (RCE) Implementation Guide v1.6.1

Resource Profile: Child

Official URL: https://sequoiaproject.org/fhir/rce/StructureDefinition/Child				Version: 1.6.1
Active as of 2025-06-11				Computable Name: Child

The Child profile represents the individual components (such as member organizations, facilities, locations, etc.) that make up a QHIN, Participant, or Subparticipant. A Child can be the parent of other Child organizations. A Child can not be an endpoint (node). It can be part of an endpoint (node) but does not meet the definition of an endpoint (node) itself. The maximum cardinality for an endpoint (node) element under a child is 0.

Usages:

Refer to this Profile: Child
Examples for this Profile: Sub X and RCE Child Example

Formal Views of Profile Content

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

Key Elements Table
Differential Table
Snapshot Table
Statistics/References
All

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Organization	C	0..*	RCEOrganization	A grouping of people or organizations with a common purpose Constraints: org-1, so-1, so-2
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:domains	S	1..*	Coding	Extension URL: https://sequoiaproject.org/fhir/sphd/StructureDefinition/Domains Binding: Domains (required)
extension:hubservicesubscriptions		0..*	Coding	Extension URL: https://sequoiaproject.org/fhir/sphd/StructureDefinition/HubServiceSubscriptions Binding: Hub Service Subscriptions (required)
extension:administrativestatus		0..1	Coding	Extension URL: https://sequoiaproject.org/fhir/sphd/StructureDefinition/AdministrativeStatus Binding: Administrative Status (required)
extension:hubroutingstatus		0..1	Coding	Extension URL: https://sequoiaproject.org/fhir/sphd/StructureDefinition/HubRoutingStatus Binding: Hub Routing Status (required)
extension:initiatoronly	S	0..1	Coding	Extension URL: https://sequoiaproject.org/fhir/sphd/StructureDefinition/InitiatorOnly Binding: Initiator Only (required)
extension:org-managing-org	S	1..1	Reference(Sequoia Organization)	Optional Extensions Element URL: https://sequoiaproject.org/fhir/sphd/StructureDefinition/org-managing-org
extension:purposesofuse	S	0..*	(Complex)	Extension URL: https://sequoiaproject.org/fhir/sphd/StructureDefinition/PurposesOfUse
extension		0..0
url		1..1	uri	"https://sequoiaproject.org/fhir/sphd/StructureDefinition/PurposesOfUse"
value[x]		1..1	CodeableConcept	Value of extension Binding: RCE Purpose ValueSet (required)
extension:stateofoperation	S	0..*	Address	Optional Extensions Element URL: https://sequoiaproject.org/fhir/sphd/StructureDefinition/StateOfOperation
extension:usecases		0..*	CodeableConcept	Optional Extensions Element URL: https://sequoiaproject.org/fhir/sphd/StructureDefinition/UseCases Binding: Endpoint Use Case Codes (required)
extension:doa	S	0..*	Reference(Sequoia Organization)	Extension URL: https://sequoiaproject.org/fhir/sphd/StructureDefinition/DOA
extension:transaction	S	0..*	CodeableConcept	When used on an organization, this represents initiating transactions URL: https://sequoiaproject.org/fhir/sphd/StructureDefinition/Transaction Binding: Transactions (required)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣC	1..*	Identifier	Identifies this organization across multiple systems Slice: Unordered, Open by pattern:$this
identifier:NPI	SΣC	0..1	Identifier	National Provider Identifier (NPI) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual \| official \| temp \| secondary \| old (If known)
type		0..1	CodeableConcept	Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:CLIA	ΣC	0..1	Identifier	Clinical Laboratory Improvement Amendments (CLIA) Number for laboratories Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual \| official \| temp \| secondary \| old (If known)
type		0..1	CodeableConcept	Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: urn:oid:2.16.840.1.113883.4.7
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:CCN	SΣC	0..1	Identifier	CMS Certification Number (CCN) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual \| official \| temp \| secondary \| old (If known)
type		0..1	CodeableConcept	Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: urn:oid:2.16.840.1.113883.4.336
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:HCID	SΣC	1..1	Identifier	OID (such as a Home Community ID) or UUID Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual \| official \| temp \| secondary \| old (If known)
type		1..1	CodeableConcept	Description of identifier Fixed Value: (complex)
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: https://sequoiaproject.org/fhir/sphd/CodeSystem/SequoiaIdentifierCodes
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: HCID
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
system		1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:AAID	SΣC	0..*	Identifier	OID (such as an Assiging Authority ID) or UUID Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual \| official \| temp \| secondary \| old (If known)
type		1..1	CodeableConcept	Description of identifier Fixed Value: (complex)
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: https://sequoiaproject.org/fhir/sphd/CodeSystem/SequoiaIdentifierCodes
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: AAID
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
system		1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:NAIC	SΣC	0..*	Identifier	NAIC Code Constraints: us-core-19 Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual \| official \| temp \| secondary \| old (If known)
type		0..1	CodeableConcept	Description of identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: urn:oid:2.16.840.1.113883.6.300
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:TEFCAID	SΣC	0..1	Identifier	TEFCA Identifier Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual \| official \| temp \| secondary \| old (If known)
type		1..1	CodeableConcept	Description of identifier Fixed Value: (complex)
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: https://sequoiaproject.org/fhir/sphd/CodeSystem/SequoiaIdentifierCodes
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: TEFCAID
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
system		1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
active	?!SΣ	1..1	boolean	Whether the organization's record is still in active use
Slices for type	SΣ	1..*	CodeableConcept	Kind of organization Slice: Unordered, Open by pattern:$this Binding: OrganizationType (example): Used to categorize the organization.
type:sequoiaorgtype	SΣ	1..1	CodeableConcept	Kind of organization Binding: Organization Type (required) 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: https://sequoiaproject.org/fhir/sphd/CodeSystem/OrganizationType
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: Child
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
type:hl7orgrole	SΣ	0..*	CodeableConcept	Kind of organization Binding: OrganizationAffiliationRole (required)
name	SΣC	1..1	string	Name used for the organization
alias	S	0..*	string	A list of alternate names that the organization is known as, or was known as in the past
Slices for telecom	SC	0..*	ContactPoint	A contact detail for the organization Slice: Unordered, Open by value:system Constraints: org-3
telecom:phone	SC	0..1	ContactPoint	A contact detail for the organization Constraints: org-3
system	SΣC	1..1	code	phone \| fax \| email \| pager \| url \| sms \| other Binding: ContactPointSystem (required): Telecommunications form for contact point. Fixed Value: phone
value	SΣ	0..1	string	The actual contact point details
use	?!Σ	0..1	code	home \| work \| temp \| old \| mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
telecom:email	SC	0..1	ContactPoint	A contact detail for the organization Constraints: org-3
system	SΣC	1..1	code	phone \| fax \| email \| pager \| url \| sms \| other Binding: ContactPointSystem (required): Telecommunications form for contact point. Fixed Value: email
value	SΣ	0..1	string	The actual contact point details
use	?!Σ	0..1	code	home \| work \| temp \| old \| mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
Slices for address	SC	1..*	Address	An address for the organization Slice: Unordered, Open by value:country Constraints: org-2
address:All Slices				Content/Rules for all slices
extension	S	1..*	Reference(Sequoia Location)	Extension URL: https://sequoiaproject.org/fhir/sphd/StructureDefinition/OrgLocation Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	home \| work \| temp \| old \| billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
text	SΣ	1..1	string	Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line	SΣ	0..1	string	Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city	SΣ	0..1	string	Name of city, town etc. Example General: Erewhon
state	SΣ	0..1	string	Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.
postalCode	SΣ	0..1	string	US Zip Codes Example General: 9132
country	SΣ	1..1	string	Must be an ISO 3166 2 or 3 letter code, with 2 letter codes preferred for compliance with later versions of US Core Organization
address:united-states-address	SC	1..*	Address	An address for the organization Constraints: org-2
extension	S	1..*	Reference(Sequoia Location)	Extension URL: https://sequoiaproject.org/fhir/sphd/StructureDefinition/OrgLocation Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	home \| work \| temp \| old \| billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
text	SΣ	1..1	string	Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line	SΣ	0..1	string	Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city	SΣ	1..1	string	Name of city, town etc. Example General: Erewhon
state	SΣ	1..1	string	Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (required): Two letter USPS alphabetic codes.
postalCode	SΣ	1..1	string	US Zip Codes Example General: 9132
country	SΣ	1..1	string	Must be an ISO 3166 2 or 3 letter code, with 2 letter codes preferred for compliance with later versions of US Core Organization Fixed Value: US
partOf	SΣ	1..1	Reference(QHIN \| Participant \| Subparticipant \| Child)	The organization of which this organization forms a part
contact	S	0..*	BackboneElement	Contact for the organization for a certain purpose
Slices for extension				Content/Rules for all slices
extension:company	S	0..*	string	Optional Extensions Element URL: https://sequoiaproject.org/fhir/sphd/StructureDefinition/company
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
purpose	S	1..1	CodeableConcept	The type of contact Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party.
name	S	1..1	HumanName	A name associated with the contact
Slices for telecom	S	2..*	ContactPoint	Contact details (telephone, email, etc.) for a contact Slice: Unordered, Open by value:system
telecom:phone	S	1..*	ContactPoint	Contact details (telephone, email, etc.) for a contact
system	SΣC	1..1	code	phone \| fax \| email \| pager \| url \| sms \| other Binding: ContactPointSystem (required): Telecommunications form for contact point. Fixed Value: phone
use	?!Σ	0..1	code	home \| work \| temp \| old \| mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
telecom:email	S	1..1	ContactPoint	Contact details (telephone, email, etc.) for a contact
system	SΣC	1..1	code	phone \| fax \| email \| pager \| url \| sms \| other Binding: ContactPointSystem (required): Telecommunications form for contact point. Fixed Value: email
use	?!Σ	0..1	code	home \| work \| temp \| old \| mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
address	S	0..1	Address	Visiting or postal addresses for the contact
use	?!Σ	0..1	code	home \| work \| temp \| old \| billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
line	SΣ	0..1	string	Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Organization.extension:purposesofuse.value[x]	required	RCEPurposeVS `https://sequoiaproject.org/fhir/sphd/ValueSet/RCEPurposeVS` From this IG
Organization.type	example	OrganizationType `http://hl7.org/fhir/ValueSet/organization-type` From the FHIR Standard
Organization.type:sequoiaorgtype	required	Pattern Value: Child `https://sequoiaproject.org/fhir/sphd/ValueSet/OrganizationType` From this IG
Organization.type:hl7orgrole	required	OrganizationAffiliationRole `http://hl7.org/fhir/ValueSet/organization-role` From the FHIR Standard
Organization.telecom:phone.system	required	Fixed Value: phone `http://hl7.org/fhir/ValueSet/contact-point-system\|4.0.1` From the FHIR Standard
Organization.telecom:phone.use	required	ContactPointUse `http://hl7.org/fhir/ValueSet/contact-point-use\|4.0.1` From the FHIR Standard
Organization.telecom:email.system	required	Fixed Value: email `http://hl7.org/fhir/ValueSet/contact-point-system\|4.0.1` From the FHIR Standard
Organization.telecom:email.use	required	ContactPointUse `http://hl7.org/fhir/ValueSet/contact-point-use\|4.0.1` From the FHIR Standard
Organization.address.use	required	AddressUse `http://hl7.org/fhir/ValueSet/address-use\|4.0.1` From the FHIR Standard
Organization.address.state	extensible	UspsTwoLetterAlphabeticCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state`
Organization.address:united-states-address.use	required	AddressUse `http://hl7.org/fhir/ValueSet/address-use\|4.0.1` From the FHIR Standard
Organization.address:united-states-address.state	required	UspsTwoLetterAlphabeticCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state`
Organization.contact.purpose	extensible	ContactEntityType `http://hl7.org/fhir/ValueSet/contactentity-type` From the FHIR Standard
Organization.contact.telecom:phone.system	required	Fixed Value: phone `http://hl7.org/fhir/ValueSet/contact-point-system\|4.0.1` From the FHIR Standard
Organization.contact.telecom:phone.use	required	ContactPointUse `http://hl7.org/fhir/ValueSet/contact-point-use\|4.0.1` From the FHIR Standard
Organization.contact.telecom:email.system	required	Fixed Value: email `http://hl7.org/fhir/ValueSet/contact-point-system\|4.0.1` From the FHIR Standard
Organization.contact.telecom:email.use	required	ContactPointUse `http://hl7.org/fhir/ValueSet/contact-point-use\|4.0.1` From the FHIR Standard
Organization.contact.address.use	required	AddressUse `http://hl7.org/fhir/ValueSet/address-use\|4.0.1` From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Organization	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Organization	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	Organization	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	Organization	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Organization	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()
org-1	error	Organization	The organization SHALL at least have a name or an identifier, and possibly more than one : (identifier.count() + name.count()) > 0
org-2	error	Organization.address, Organization.address:united-states-address	An address of an organization can never be of use 'home' : where(use = 'home').empty()
org-3	error	Organization.telecom, Organization.telecom:phone, Organization.telecom:email	The telecom of an organization can never be of use 'home' : where(use = 'home').empty()
so-1	error	Organization	For any organization entry with endpoints, the Organization.id value must match the HCID OID contained under Organization.identifier : endpoint.exists() implies identifier.where(type.coding.first().code='HCID').single().value.substring(8)=id
so-2	warning	Organization	If Organization.type:hl7orgrole = 'payer' then Organization.identifier:NAIC is required : type.where(coding.first().code='payer').exists() implies identifier.where(system='urn:oid:2.16.840.1.113883.6.300').exists()
us-core-19	error	Organization.identifier:NAIC	NAIC must be 5 digits : value.matches('^[0-9]{5}$')

This structure is derived from RCEOrganization

Name	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Organization	0..*	RCEOrganization	A grouping of people or organizations with a common purpose
extension	2..*	Extension	Extension
Slices for extension			Content/Rules for all slices
extension:org-managing-org	1..1	OrgManagingOrg	Optional Extensions Element
Slices for type			Content/Rules for all slices
type:sequoiaorgtype	1..1	CodeableConcept	Kind of organization 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: https://sequoiaproject.org/fhir/sphd/CodeSystem/OrganizationType
code	1..1	code	Symbol in syntax defined by the system Fixed Value: Child
partOf	1..1	Reference(QHIN \| Participant \| Subparticipant \| Child)	The organization of which this organization forms a part
endpoint	0..0
Documentation for this format