Example of personal care services provided at person's home

{
  "resourceType": "Procedure",
  "id": "HCBS",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n\t\t\t<p>\n\t\t\t\t<b> Personal care services provided at person's home</b>\n\t\t\t</p>\n\t\t\t<p>\n\t\t\t\t<b> Based On</b> : Peter's Long Term Services and Supports (LTSS) care plan</p>\n\t\t\t<p>\n\t\t\t\t<b> Status</b> : completed</p>\n\t\t\t<p>\n\t\t\t\t<b> Beneficiary</b> : Peter James</p>\n\t\t\t<p>\n\t\t\t\t<b> Service Name/Code</b> : Personal care services <span> (Details : {HCPCS code 'T1019' = 'Personal care services, per 15 minutes'})</span>\n\t\t\t</p>\n\t\t\t<p>\n\t\t\t\t<b> Service Date</b> : Apr 5, 2018</p>\n\t\t\t<p>\n\t\t\t\t<b> Service Provider</b> : Adam Careful</p>\n\t\t\t<p>\n\t\t\t\t<b> Service Delivery Address</b> : Peter's home</p>\n\t\t\t<p>\n\t\t\t\t<b> Service Comment</b> : Assisted with bathing and dressing, doing laundry, and meal preparation</p>\n\t\t</div>"

  "resourceType" : "Procedure",
  "id" : "HCBS",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n\t\t\t<p>\n\t\t\t\t<b> Personal care services provided at person's home</b>\n\t\t\t</p>\n\t\t\t<p>\n\t\t\t\t<b> Based On</b> : Peter's Long Term Services and Supports (LTSS) care plan</p>\n\t\t\t<p>\n\t\t\t\t<b> Status</b> : completed</p>\n\t\t\t<p>\n\t\t\t\t<b> Beneficiary</b> : Peter James</p>\n\t\t\t<p>\n\t\t\t\t<b> Service Name/Code</b> : Personal care services <span> (Details : {HCPCS code 'T1019' = 'Personal care services, per 15 minutes'})</span>\n\t\t\t</p>\n\t\t\t<p>\n\t\t\t\t<b> Service Date</b> : Apr 5, 2018</p>\n\t\t\t<p>\n\t\t\t\t<b> Service Provider</b> : Adam Careful</p>\n\t\t\t<p>\n\t\t\t\t<b> Service Delivery Address</b> : Peter's home</p>\n\t\t\t<p>\n\t\t\t\t<b> Service Comment</b> : Assisted with bathing and dressing, doing laundry, and meal preparation</p>\n\t\t</div>"

  },
  "basedOn": [
    {
      "display": "Peter's Long Term Service and Supports (LTSS) Care Plan"
    }
  ],
  "status": "completed",
  "code": {
    "coding": [
      {
        "system": "https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/Alpha-Numeric-HCPCS.html",
        "code": "T1019",
        "display": "Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment."
      }
    ],
    "text": "Personal care services"

  "basedOn" : [{
    "display" : "Peter's Long Term Service and Supports (LTSS) Care Plan"
  }],
  "status" : "completed",
  "code" : {
    "coding" : [{
      "system" : "https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/Alpha-Numeric-HCPCS.html",
      "code" : "T1019",
      "display" : "Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment."
    }],
    "text" : "Personal care services"

  },
  "subject": {
    "reference": "Patient/example",
    "display": "Peter James"

  "subject" : {
    "reference" : "Patient/example",
    "display" : "Peter James"

  },
  "performedDateTime": "2018-04-05",
  "performer": [
    {
      "actor": {
        "reference": "Practitioner/example",
        "display": "Adam Careful"
      }

  "occurrenceDateTime" : "2018-04-05",
  "performer" : [{
    "actor" : {
      "reference" : "Practitioner/example",
      "display" : "Adam Careful"

    }
  ],
  "location": {
    "reference": "Location/ph",
    "display": "Peter's Home"

  }],
  "location" : {
    "reference" : "Location/ph",
    "display" : "Peter's Home"

  },
  "note": [
    {
      "text": "Assisted with bathing and dressing, doing laundry, and meal preparation"
    }
  ]

  "note" : [{
    "text" : "Assisted with bathing and dressing, doing laundry, and meal preparation"
  }]

}