@the-cascade-protocol/cli 0.3.3 → 0.3.4

package/dist/commands/capabilities.d.ts.map

@@ -1 +1 @@
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+{"version":3,"file":"capabilities.d.ts","sourceRoot":"","sources":["../../src/commands/capabilities.ts"],"names":[],"mappings":"AAAA;;;;;GAKG;AAEH,OAAO,EAAE,OAAO,EAAE,MAAM,WAAW,CAAC;AA6RpC,wBAAgB,2BAA2B,CAAC,OAAO,EAAE,OAAO,GAAG,IAAI,CAkBlE"}

package/dist/commands/capabilities.js

@@ -98,6 +98,23 @@ function getCapabilities(version) {
                     'cascade pod query ./my-pod --encounters --conditions --json',
                     'cascade pod query ./my-pod --all --json',
                 ],
+                outputSchema: {
+                    description: 'JSON output structure for --json flag',
+                    shape: '{ pod: string, dataTypes: { [type]: { count: number, file: string, records: Record[] } } }',
+                    recordShape: '{ id: string, type: string, properties: { [prefixed-property]: string } }',
+                    propertyPrefixes: {
+                        'health:': 'wellness/device data — health:testName, health:resultValue, health:resultUnit, health:performedDate, health:testCode (LOINC URI), health:conditionName, health:conditionCategory (FHIR category: problem-list-item|encounter-diagnosis|social-history), health:snomedSemanticTag (semantic type from SNOMED display name: disorder|finding|situation|procedure|observable entity), health:status (active/inactive/resolved), health:onsetDate, health:medicationName, health:isActive (true/false string), health:rxNormCode',
+                        'clinical:': 'EHR-imported clinical data — clinical:encounterDate, clinical:encounterType, clinical:procedureName, clinical:procedureDate, clinical:drugCode, clinical:clinicalIntent',
+                        'core:': 'provenance — core:sourceSystem, core:dataProvenance, core:schemaVersion, core:reconciliationStatus, core:mergedSources',
+                    },
+                    jqExamples: [
+                        "# Clinical conditions only (excludes social findings): jq '[.dataTypes.conditions.records[] | select(.properties.\"health:status\" == \"active\" and .properties.\"health:snomedSemanticTag\" == \"disorder\") | .properties.\"health:conditionName\"]'",
+                        "# All active conditions including findings: jq '[.dataTypes.conditions.records[] | select(.properties.\"health:status\" == \"active\") | {name: .properties.\"health:conditionName\", type: .properties.\"health:snomedSemanticTag\"}]'",
+                        "# HbA1c trend (most recent first): jq '[.dataTypes.\"lab-results\".records[] | select(.properties.\"health:testName\" | test(\"A1c|Hemoglobin A1c\"; \"i\")) | {date: .properties.\"health:performedDate\", value: .properties.\"health:resultValue\", unit: .properties.\"health:resultUnit\"}] | sort_by(.date) | reverse'",
+                        "# Active medications: jq '[.dataTypes.medications.records[] | select(.properties.\"health:isActive\" == \"true\") | .properties.\"health:medicationName\"]'",
+                        "# Medications with source provenance: jq '[.dataTypes.medications.records[] | {name: .properties.\"health:medicationName\", active: .properties.\"health:isActive\", sources: .properties.\"core:mergedSources\"}]'",
+                    ],
+                },
                 status: 'implemented',
             },
             {

package/dist/commands/capabilities.js.map

@@ -1 +1 @@
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package/dist/lib/fhir-converter/converters-clinical.d.ts.map

@@ -1 +1 @@
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package/dist/lib/fhir-converter/converters-clinical.js

@@ -117,6 +117,18 @@ export function convertCondition(resource) {
     quads.push(...commonTriples(subjectUri));
     const condName = codeableConceptText(resource.code) ?? 'Unknown Condition';
     quads.push(tripleStr(subjectUri, NS.health + 'conditionName', condName));
+    // FHIR Condition.category — e.g. problem-list-item, encounter-diagnosis, social-history
+    const fhirCategory = resource.category?.[0]?.coding?.[0]?.code ?? resource.category?.[0]?.text;
+    if (fhirCategory) {
+        quads.push(tripleStr(subjectUri, NS.health + 'conditionCategory', fhirCategory));
+    }
+    // SNOMED semantic tag — the parenthetical type suffix in the display name, e.g. "(disorder)",
+    // "(finding)", "(situation)". Lets downstream tools distinguish clinical from administrative records
+    // without a full SNOMED hierarchy lookup.
+    const semanticTagMatch = condName.match(/\(([^)]+)\)$/);
+    if (semanticTagMatch) {
+        quads.push(tripleStr(subjectUri, NS.health + 'snomedSemanticTag', semanticTagMatch[1]));
+    }
     const clinicalStatus = resource.clinicalStatus?.coding?.[0]?.code ?? 'active';
     quads.push(tripleStr(subjectUri, NS.health + 'status', clinicalStatus));
     if (resource.onsetDateTime) {

package/dist/lib/fhir-converter/converters-clinical.js.map

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package/dist/shapes/clinical.ttl

@@ -20,8 +20,8 @@
     dct:description "Vocabulary for clinical documents, narratives, and structured notes imported from EHR systems via Apple HealthKit"@en ;
     dct:creator "Cascade Agentic Labs" ;
     dct:created "2025-12-26"^^xsd:date ;
-    dct:modified "2026-02-22"^^xsd:date ;
-    owl:versionInfo "1.6" ;
+    dct:modified "2026-03-12"^^xsd:date ;
+    owl:versionInfo "1.7" ;
     rdfs:comment "Domain-specific vocabulary for clinical documentation and structured records imported from patient portals (MyChart, Epic, etc.). Contains EHR-verified clinical data."@en ;
     rdfs:seeAlso <https://cascadeprotocol.org/docs/clinical/v1.0/> .
 
@@ -752,7 +752,7 @@ clinical:icd10Code a owl:DatatypeProperty ;
 
 clinical:linkedConditionIds a owl:DatatypeProperty ;
     rdfs:label "Linked Condition IDs"@en ;
-    rdfs:comment "Space-separated UUIDs of related ConditionSummary records. Enables graph traversal between related diagnoses (e.g., complication to root condition)."@en ;
+    rdfs:comment "Space-separated UUIDs of related ConditionSummary records (e.g., linking a complication to its root condition). Enables graph traversal between related diagnoses."@en ;
     rdfs:domain clinical:Condition ;
     rdfs:range xsd:string .
 
@@ -768,7 +768,7 @@ clinical:vaccineName a owl:DatatypeProperty ;
 
 clinical:vaccineCode a owl:DatatypeProperty ;
     rdfs:label "Vaccine Code"@en ;
-    rdfs:comment "CVX code for the vaccine"@en ;
+    rdfs:comment "CVX code for the vaccine (legacy — use clinical:cvxCode for new serialization; v1.6)"@en ;
     rdfs:domain clinical:Immunization ;
     rdfs:range xsd:string .
 
@@ -1298,6 +1298,15 @@ clinical:isActive a owl:DatatypeProperty ;
 # Changelog
 # ============================================================================
 #
+# Version 1.6 (2026-02-22)
+# - Added clinical:linkedConditionIds DatatypeProperty on clinical:Condition
+#   for linking related ConditionSummary records via space-separated UUIDs.
+#   Enables graph traversal between related diagnoses (e.g., complication to
+#   root condition). Part of Health Map v3 Pre-Phase Track A (Task A2).
+# - Annotated clinical:vaccineCode as legacy in favor of clinical:cvxCode
+#   (both defined; cvxCode added v1.1, vaccineCode retained for backward
+#   compatibility).
+#
 # Version 1.5 (2026-02-10)
 # - Added CoverageRecord class (11 properties) for insurance coverage data
 #   Maps to fhir:Coverage. Layer 2 complement to checkup:InsuranceInfo (Layer 3).
@@ -1367,3 +1376,182 @@ clinical:isActive a owl:DatatypeProperty ;
 # All documents imported via clinical: vocabulary use cascade:ClinicalGenerated provenance
 # Source: Apple HealthKit HKClinicalRecord API
 # Privacy: Documents may contain PHI - encrypted storage required
+
+# ============================================================================
+# New Class: clinical:Encounter
+# Added in v1.7 — supports FHIR Encounter conversion
+# ============================================================================
+
+clinical:Encounter a owl:Class ;
+    rdfs:label "Clinical Encounter"@en ;
+    rdfs:comment "A clinical encounter — any interaction between a patient and a healthcare provider. Enables grouping of clinical events (procedures, observations, prescriptions) that occurred in the same visit context."@en ;
+    rdfs:subClassOf prov:Entity .
+
+clinical:encounterClass a owl:DatatypeProperty ;
+    rdfs:domain clinical:Encounter ;
+    rdfs:range xsd:string ;
+    rdfs:label "Encounter Class"@en ;
+    rdfs:comment "Values: ambulatory, emergency, inpatient, home-health"@en .
+
+clinical:encounterStatus a owl:DatatypeProperty ;
+    rdfs:domain clinical:Encounter ;
+    rdfs:range xsd:string ;
+    rdfs:label "Encounter Status"@en ;
+    rdfs:comment "Values: finished, in-progress, cancelled"@en .
+
+clinical:encounterType a owl:DatatypeProperty ;
+    rdfs:domain clinical:Encounter ;
+    rdfs:range xsd:string ;
+    rdfs:label "Encounter Type"@en ;
+    rdfs:comment "Display name from SNOMED/FHIR code"@en .
+
+clinical:encounterStart a owl:DatatypeProperty ;
+    rdfs:domain clinical:Encounter ;
+    rdfs:range xsd:dateTime ;
+    rdfs:label "Encounter Start"@en .
+
+clinical:encounterEnd a owl:DatatypeProperty ;
+    rdfs:domain clinical:Encounter ;
+    rdfs:range xsd:dateTime ;
+    rdfs:label "Encounter End"@en .
+
+clinical:facilityName a owl:DatatypeProperty ;
+    rdfs:domain clinical:Encounter ;
+    rdfs:range xsd:string ;
+    rdfs:label "Facility Name"@en .
+
+# ============================================================================
+# New Class: clinical:MedicationAdministration
+# Added in v1.7 — supports FHIR MedicationAdministration conversion
+# ============================================================================
+
+clinical:MedicationAdministration a owl:Class ;
+    rdfs:label "Medication Administration"@en ;
+    rdfs:comment "A single administration event of a medication given at a specific time by a provider (e.g., IV antibiotics administered pre-surgery, vaccine injection at visit). Semantically distinct from clinical:Medication (ongoing prescription regimens): represents a one-time event, not an ongoing regimen."@en ;
+    rdfs:subClassOf prov:Entity .
+
+clinical:administeredDate a owl:DatatypeProperty ;
+    rdfs:domain clinical:MedicationAdministration ;
+    rdfs:range xsd:dateTime ;
+    rdfs:label "Administered Date"@en .
+
+clinical:administeredDose a owl:DatatypeProperty ;
+    rdfs:domain clinical:MedicationAdministration ;
+    rdfs:range xsd:string ;
+    rdfs:label "Administered Dose"@en ;
+    rdfs:comment "e.g., '1g', '500mg'"@en .
+
+clinical:administeredRoute a owl:DatatypeProperty ;
+    rdfs:domain clinical:MedicationAdministration ;
+    rdfs:range xsd:string ;
+    rdfs:label "Administered Route"@en ;
+    rdfs:comment "Values: oral, IV, IM, subcutaneous, topical"@en .
+
+clinical:administrationStatus a owl:DatatypeProperty ;
+    rdfs:domain clinical:MedicationAdministration ;
+    rdfs:range xsd:string ;
+    rdfs:label "Administration Status"@en ;
+    rdfs:comment "Values: completed, not-done, in-progress"@en .
+
+# ============================================================================
+# New Class: clinical:ImplantedDevice
+# Added in v1.7 — supports FHIR Device conversion
+# ============================================================================
+
+clinical:ImplantedDevice a owl:Class ;
+    rdfs:label "Implanted Device"@en ;
+    rdfs:comment "A medical device implanted in or attached to the patient as a permanent part of their health profile (e.g., pacemaker, cardiac stent, cochlear implant, insulin pump). Presence affects medication safety, imaging eligibility (MRI contraindications), and surgical risk."@en ;
+    rdfs:subClassOf prov:Entity .
+
+clinical:deviceType a owl:DatatypeProperty ;
+    rdfs:domain clinical:ImplantedDevice ;
+    rdfs:range xsd:string ;
+    rdfs:label "Device Type"@en ;
+    rdfs:comment "e.g., pacemaker, stent, cochlear-implant"@en .
+
+clinical:implantDate a owl:DatatypeProperty ;
+    rdfs:domain clinical:ImplantedDevice ;
+    rdfs:range xsd:dateTime ;
+    rdfs:label "Implant Date"@en .
+
+clinical:deviceManufacturer a owl:DatatypeProperty ;
+    rdfs:domain clinical:ImplantedDevice ;
+    rdfs:range xsd:string ;
+    rdfs:label "Device Manufacturer"@en .
+
+clinical:udiCarrier a owl:DatatypeProperty ;
+    rdfs:domain clinical:ImplantedDevice ;
+    rdfs:range xsd:string ;
+    rdfs:label "UDI Carrier"@en ;
+    rdfs:comment "Unique Device Identifier"@en .
+
+clinical:deviceStatus a owl:DatatypeProperty ;
+    rdfs:domain clinical:ImplantedDevice ;
+    rdfs:range xsd:string ;
+    rdfs:label "Device Status"@en ;
+    rdfs:comment "Values: active, inactive, entered-in-error"@en .
+
+# ============================================================================
+# New Class: clinical:ImagingStudy
+# Added in v1.7 — supports FHIR ImagingStudy conversion
+# ============================================================================
+
+clinical:ImagingStudy a owl:Class ;
+    rdfs:label "Imaging Study"@en ;
+    rdfs:comment "Metadata record for a diagnostic imaging study (CT, MRI, X-ray, ultrasound). Records that imaging exists and its key characteristics without requiring access to DICOM images. Useful for clinical timeline, pre-procedure review, and agent reasoning about the patient's imaging history."@en ;
+    rdfs:subClassOf prov:Entity .
+
+clinical:imagingModality a owl:DatatypeProperty ;
+    rdfs:domain clinical:ImagingStudy ;
+    rdfs:range xsd:string ;
+    rdfs:label "Imaging Modality"@en ;
+    rdfs:comment "Values: CT, MR, DX, US, NM"@en .
+
+clinical:studyDescription a owl:DatatypeProperty ;
+    rdfs:domain clinical:ImagingStudy ;
+    rdfs:range xsd:string ;
+    rdfs:label "Study Description"@en .
+
+clinical:numberOfSeries a owl:DatatypeProperty ;
+    rdfs:domain clinical:ImagingStudy ;
+    rdfs:range xsd:integer ;
+    rdfs:label "Number of Series"@en .
+
+clinical:studyDate a owl:DatatypeProperty ;
+    rdfs:domain clinical:ImagingStudy ;
+    rdfs:range xsd:dateTime ;
+    rdfs:label "Study Date"@en .
+
+clinical:dicomStudyUid a owl:DatatypeProperty ;
+    rdfs:domain clinical:ImagingStudy ;
+    rdfs:range xsd:string ;
+    rdfs:label "DICOM Study UID"@en .
+
+clinical:retrieveUrl a owl:DatatypeProperty ;
+    rdfs:domain clinical:ImagingStudy ;
+    rdfs:range xsd:anyURI ;
+    rdfs:label "Retrieve URL"@en ;
+    rdfs:comment "URL to DICOM server if available"@en .
+
+# ============================================================================
+# New Properties on existing class: clinical:LaboratoryReport
+# Added in v1.7 — supports DiagnosticReport panel grouping
+# ============================================================================
+
+clinical:hasLabResult a owl:ObjectProperty ;
+    rdfs:label "Has Lab Result"@en ;
+    rdfs:comment "Links a LaboratoryReport panel to its constituent clinical:LabResult observations. Enables grouping of lab values (e.g., CBC components) under the ordering panel. FHIR alignment: fhir:DiagnosticReport.result."@en ;
+    rdfs:domain clinical:LaboratoryReport ;
+    rdfs:range clinical:LabResult .
+
+clinical:panelName a owl:DatatypeProperty ;
+    rdfs:domain clinical:LaboratoryReport ;
+    rdfs:range xsd:string ;
+    rdfs:label "Panel Name"@en ;
+    rdfs:comment "e.g., 'Complete Blood Count'"@en .
+
+clinical:reportCategory a owl:DatatypeProperty ;
+    rdfs:domain clinical:LaboratoryReport ;
+    rdfs:range xsd:string ;
+    rdfs:label "Report Category"@en ;
+    rdfs:comment "Values: LAB, RAD, PATH"@en .

package/dist/shapes/core.ttl

@@ -17,8 +17,8 @@
     dct:description "Core vocabulary for schema versioning, data provenance, identity management, and patient demographics across all Cascade Protocol applications"@en ;
     dct:creator "Cascade Agentic Labs" ;
     dct:created "2025-10-31"^^xsd:date ;
-    dct:modified "2026-02-22"^^xsd:date ;
-    owl:versionInfo "2.3" ;
+    dct:modified "2026-03-12"^^xsd:date ;
+    owl:versionInfo "2.8" ;
     rdfs:comment "This vocabulary defines cross-cutting concepts used by all Cascade Protocol health data applications: schema versioning, data provenance, patient demographics (PatientProfile), and supporting identity classes (Address, PharmacyInfo, AdvanceDirectives). Domain-specific vocabularies (e.g., pots:, ecg:, glucose:) import this core vocabulary."@en ;
     rdfs:seeAlso <https://cascadeprotocol.org/docs/core/v1.0/> .
 
@@ -153,10 +153,20 @@ cascade:sourceMetricCoverage a owl:ObjectProperty ;
     rdfs:comment "A wellness metric this source provides. Use multiple triples for multiple metrics (e.g., two triples linking to health:restingHeartRate and health:heartRateVariability). Preferred over comma-separated strings for proper RDF graph traversal."@en ;
     rdfs:domain cascade:DataSource .
 
-# ============================================================================
 # ============================================================================
 # Provenance Detail Properties (v2.3)
 # ============================================================================
+# Lightweight provenance detail properties for record-level attribution.
+# These properties are placed on record instances directly (not on DataSource
+# objects) for display in Health Map provenance badges without requiring
+# full DataSource graph traversal.
+#
+# cascade:sourceOrganization — populated from FHIR meta.source or contained
+# Organization reference during clinical record import. Examples: "Kaiser
+# Permanente", "Mayo Clinic".
+#
+# cascade:sourceDeviceName — populated from HealthKit HKSource contributing
+# app/device name. Examples: "Apple Watch Series 9", "Omron BP Monitor".
 
 cascade:sourceOrganization a owl:DatatypeProperty ;
     rdfs:label "Source Organization"@en ;
@@ -168,6 +178,7 @@ cascade:sourceDeviceName a owl:DatatypeProperty ;
     rdfs:comment "Device or app that recorded this measurement (e.g., 'Apple Watch Series 9', 'Omron BP Monitor'). Populated from HealthKit HKSource contributing app/device name."@en ;
     rdfs:range xsd:string .
 
+# ============================================================================
 # Vocabulary Organization (v1.3)
 # ============================================================================
 
@@ -531,6 +542,117 @@ cascade:advanceDirectiveNotes a owl:DatatypeProperty ;
     rdfs:domain cascade:AdvanceDirectives ;
     rdfs:range xsd:string .
 
+# ============================================================================
+# Reconciliation Properties (v2.4)
+# ============================================================================
+# Used by the Cascade reconciliation pipeline to annotate merged records with
+# provenance and conflict resolution metadata.
+
+cascade:sourceSystem a owl:DatatypeProperty ;
+    rdfs:label "Source System"@en ;
+    rdfs:comment "The name of the EHR or health system that originally held this record (e.g. 'primary-care', 'hospital'). Added during cross-system conversion to enable reconciliation."@en ;
+    rdfs:domain owl:Thing ;
+    rdfs:range xsd:string .
+
+cascade:reconciliationStatus a owl:ObjectProperty ;
+    rdfs:label "Reconciliation Status"@en ;
+    rdfs:comment "The outcome of reconciliation for this record. Value is one of the cascade:ReconciliationStatus named individuals: cascade:Canonical, cascade:Merged, cascade:ConflictResolved, cascade:UnresolvedConflict."@en ;
+    rdfs:domain owl:Thing ;
+    rdfs:range cascade:ReconciliationStatus .
+
+cascade:ReconciliationStatus a owl:Class ;
+    rdfs:label "Reconciliation Status"@en ;
+    rdfs:comment "Closed enumeration of possible reconciliation outcomes."@en .
+
+cascade:Canonical a owl:NamedIndividual, cascade:ReconciliationStatus ;
+    rdfs:label "Canonical"@en ;
+    rdfs:comment "Record is unique — no matching record found across other source systems."@en .
+
+cascade:Merged a owl:NamedIndividual, cascade:ReconciliationStatus ;
+    rdfs:label "Merged"@en ;
+    rdfs:comment "Record was deduplicated from two or more identical or near-identical source records."@en .
+
+cascade:ConflictResolved a owl:NamedIndividual, cascade:ReconciliationStatus ;
+    rdfs:label "Conflict Resolved"@en ;
+    rdfs:comment "Conflicting values across source records were resolved automatically using a trust-priority or merge strategy."@en .
+
+cascade:UnresolvedConflict a owl:NamedIndividual, cascade:ReconciliationStatus ;
+    rdfs:label "Unresolved Conflict"@en ;
+    rdfs:comment "Conflicting values could not be automatically resolved (trust scores too similar). Requires manual clinical review."@en .
+
+cascade:WithinSourceDuplicate a owl:NamedIndividual, cascade:ReconciliationStatus ;
+    rdfs:label "Within-Source Duplicate"@en ;
+    rdfs:comment "Record is a duplicate of another record within the same source system (e.g. same condition recorded across multiple clinical encounters). Suppressed from cross-system reconciliation output during Pass 1 deduplication."@en .
+
+cascade:mergedFrom a owl:ObjectProperty ;
+    rdfs:label "Merged From"@en ;
+    rdfs:comment "Links a reconciled record to the source record URIs that were merged into it. Used together with prov:wasDerivedFrom for semantic interoperability."@en ;
+    rdfs:domain owl:Thing ;
+    rdfs:range owl:Thing ;
+    rdfs:subPropertyOf prov:wasDerivedFrom .
+
+cascade:conflictResolution a owl:ObjectProperty ;
+    rdfs:label "Conflict Resolution Strategy"@en ;
+    rdfs:comment "The strategy used to resolve a conflict. Value is one of the cascade:ConflictResolutionStrategy named individuals: cascade:TrustPriority, cascade:MergeValues, cascade:FlagUnresolved."@en ;
+    rdfs:domain owl:Thing ;
+    rdfs:range cascade:ConflictResolutionStrategy .
+
+cascade:ConflictResolutionStrategy a owl:Class ;
+    rdfs:label "Conflict Resolution Strategy"@en ;
+    rdfs:comment "Closed enumeration of reconciliation resolution strategies."@en .
+
+cascade:TrustPriority a owl:NamedIndividual, cascade:ConflictResolutionStrategy ;
+    rdfs:label "Trust Priority"@en ;
+    rdfs:comment "The record from the highest-trust source system is selected as canonical."@en .
+
+cascade:MergeValues a owl:NamedIndividual, cascade:ConflictResolutionStrategy ;
+    rdfs:label "Merge Values"@en ;
+    rdfs:comment "The canonical record is built by taking the winner's fields and filling any gaps from lower-trust sources."@en .
+
+cascade:FlagUnresolved a owl:NamedIndividual, cascade:ConflictResolutionStrategy ;
+    rdfs:label "Flag Unresolved"@en ;
+    rdfs:comment "The conflict could not be automatically resolved. Record is tagged cascade:UnresolvedConflict for manual clinical review."@en .
+
+cascade:conflictField a owl:ObjectProperty ;
+    rdfs:label "Conflict Field"@en ;
+    rdfs:comment "The predicate URI on which a conflict was detected during reconciliation (e.g. health:status, health:resultValue). Stored as a URI reference, not a prefixed name string."@en ;
+    rdfs:domain owl:Thing ;
+    rdfs:range rdfs:Resource .
+
+cascade:conflictDescription a owl:DatatypeProperty ;
+    rdfs:label "Conflict Description"@en ;
+    rdfs:comment "Removed v2.7. Was informational prose describing conflicting values per source system. Replaced by cascade:conflictDetail structured blank node (v2.5), which uses rdfs:comment on the blank node for human readability."@en ;
+    owl:deprecated true ;
+    rdfs:domain owl:Thing ;
+    rdfs:range xsd:string .
+
+cascade:conflictDetail a owl:ObjectProperty ;
+    rdfs:label "Conflict Detail"@en ;
+    rdfs:comment "Links a reconciled record to a structured cascade:ConflictDetail blank node describing the per-system values that conflicted. The blank node carries an rdfs:comment with a human-readable summary."@en ;
+    rdfs:domain owl:Thing ;
+    rdfs:range cascade:ConflictDetail .
+
+cascade:ConflictDetail a owl:Class ;
+    rdfs:label "Conflict Detail"@en ;
+    rdfs:comment "A structured representation of conflicting values across source systems for a single property. Used as a blank node linked from cascade:conflictDetail."@en .
+
+cascade:conflictFor a owl:ObjectProperty ;
+    rdfs:label "Conflict For"@en ;
+    rdfs:comment "The predicate URI on which the conflict was detected (e.g. <https://ns.cascadeprotocol.org/health/v1#status>). Links a cascade:ConflictDetail to the conflicting property."@en ;
+    rdfs:domain cascade:ConflictDetail ;
+    rdfs:range rdfs:Resource .
+
+cascade:systemValue a owl:ObjectProperty ;
+    rdfs:label "System Value"@en ;
+    rdfs:comment "Links a cascade:ConflictDetail to a blank node representing one source system's value for the conflicting property. Each participating source system has its own cascade:systemValue blank node."@en ;
+    rdfs:domain cascade:ConflictDetail .
+
+cascade:forSystem a owl:DatatypeProperty ;
+    rdfs:label "For System"@en ;
+    rdfs:comment "The name of the source EHR system (e.g. 'primary-care', 'specialist') within a cascade:systemValue blank node."@en ;
+    rdfs:domain cascade:ConflictDetail ;
+    rdfs:range xsd:string .
+
 # ============================================================================
 # Alignment with W3C PROV-O
 # ============================================================================
@@ -554,6 +676,42 @@ cascade:advanceDirectiveNotes a owl:DatatypeProperty ;
 # ============================================================================
 # Changelog
 # ============================================================================
+# v2.7 (2026-03-12): Removed cascade:conflictDescription (deprecated since v2.5).
+#     cascade:conflictDetail blank nodes now carry an rdfs:comment with a human-readable
+#     summary of the conflicting values, replacing the separate prose property.
+# v2.6 (2026-03-11): Within-source deduplication vocabulary. Added
+#     cascade:WithinSourceDuplicate named individual for cascade:ReconciliationStatus.
+#     Represents encounter-instance duplicate records suppressed during Pass 1
+#     within-source deduplication. Phase 6 of reconciliation pipeline.
+# v2.5 (2026-03-11): Structured conflict representation. Added cascade:ConflictDetail
+#     class and 4 supporting properties: cascade:conflictDetail (ObjectProperty,
+#     links record to ConflictDetail blank node), cascade:conflictFor (ObjectProperty,
+#     the conflicting predicate URI), cascade:systemValue (ObjectProperty, per-system
+#     value blank node), cascade:forSystem (DatatypeProperty, system name string).
+#     Deprecated cascade:conflictDescription (informational prose, replaced by
+#     cascade:conflictDetail structured blank node). Phase 5 of reconciliation pipeline.
+# v2.4 (2026-03-11): Added reconciliation vocabulary for multi-system EHR data
+#     merging. Properties: cascade:sourceSystem (EHR origin tag, xsd:string),
+#     cascade:reconciliationStatus (ObjectProperty, range cascade:ReconciliationStatus),
+#     cascade:mergedFrom (ObjectProperty, subPropertyOf prov:wasDerivedFrom),
+#     cascade:conflictResolution (ObjectProperty, range cascade:ConflictResolutionStrategy),
+#     cascade:conflictField (ObjectProperty, range rdfs:Resource, stores full predicate URI),
+#     cascade:conflictDescription (DatatypeProperty, informational prose).
+#     Declared named individuals: cascade:Canonical, cascade:Merged,
+#     cascade:ConflictResolved, cascade:UnresolvedConflict (ReconciliationStatus);
+#     cascade:TrustPriority, cascade:MergeValues, cascade:FlagUnresolved
+#     (ConflictResolutionStrategy). Note: cascade:mergedSources (dropped —
+#     redundant with mergedFrom+sourceSystem) and cascade:conflictValues
+#     (renamed to cascade:conflictDescription) were in the initial design but
+#     corrected before the TTL was finalized. Supports CLI v0.2.5 reconcile command.
+# v2.3 (2026-02-22): Added 2 provenance detail properties for record-level
+#     attribution: cascade:sourceOrganization (organization that provided a
+#     record, populated from FHIR meta.source or contained Organization
+#     reference during clinical import) and cascade:sourceDeviceName (device
+#     or app that recorded a measurement, populated from HealthKit HKSource
+#     contributing app/device name). Used across all 11 CheckupShared record
+#     models for Health Map provenance display. Part of Health Map v3
+#     Pre-Phase Track A (Task A4).
 # v2.2 (2026-02-18): FHIR-aligned Address expansion and PatientProfile
 #     completeness (Phase 3.5 ONT1 + ONT2).
 #     ONT1: Added 9 FHIR Address.* aligned properties (addressUse, addressType,
@@ -601,3 +759,40 @@ cascade:advanceDirectiveNotes a owl:DatatypeProperty ;
 #     AIExtracted (under ClinicalGenerated). Aligns with SDK DataProvenance
 #     enum (6 cases). Backward-compatible: existing data using
 #     cascade:ConsumerGenerated/ClinicalGenerated remains valid.
+
+# ============================================================================
+# Layer Promotion Status (FHIR Conversion)
+# Added in v2.8 — supports lossless FHIR ↔ Cascade round-trip conversion
+# ============================================================================
+
+cascade:LayerPromotionStatusValue a owl:Class ;
+    rdfs:label "Layer Promotion Status Value"@en ;
+    rdfs:comment "Closed enumeration of Layer 2 promotion states for converted FHIR records."@en .
+
+cascade:layerPromotionStatus a owl:ObjectProperty ;
+    rdfs:label "Layer Promotion Status"@en ;
+    rdfs:comment "Indicates whether a record has been fully mapped to Cascade Layer 2 vocabulary or is preserved as a Layer 1 FHIR passthrough pending future mapping."@en ;
+    rdfs:range cascade:LayerPromotionStatusValue .
+
+cascade:FullyMapped a owl:NamedIndividual, cascade:LayerPromotionStatusValue ;
+    rdfs:label "Fully Mapped"@en ;
+    rdfs:comment "Record has been fully mapped to Cascade Layer 2 vocabulary."@en .
+
+cascade:PendingLayerTwoPromotion a owl:NamedIndividual, cascade:LayerPromotionStatusValue ;
+    rdfs:label "Pending Layer 2 Promotion"@en ;
+    rdfs:comment "Record is preserved as Layer 1 FHIR passthrough. Full Layer 2 vocabulary mapping has not yet been defined. Original FHIR JSON is retained in cascade:fhirJson for round-trip export."@en .
+
+cascade:fhirJson a owl:DatatypeProperty ;
+    rdfs:label "Original FHIR JSON"@en ;
+    rdfs:comment "Preserves the complete original FHIR resource JSON for Layer 1 passthrough records. Always stored as plain xsd:string (FHIR JSON is always valid UTF-8). Used for lossless round-trip export. Self-contained — survives reconciliation without sidecar file dependencies."@en ;
+    rdfs:range xsd:string .
+
+cascade:fhirResourceType a owl:DatatypeProperty ;
+    rdfs:label "FHIR Resource Type"@en ;
+    rdfs:comment "FHIR R4 resourceType of the source record. Populated on Layer 1 passthrough records."@en ;
+    rdfs:range xsd:string .
+
+cascade:sourceRecordDate a owl:DatatypeProperty ;
+    rdfs:label "Source Record Date"@en ;
+    rdfs:comment "Minimal date projection triple for Layer 1 passthrough records. Copied from effectiveDateTime, date, period.start, or created field if present."@en ;
+    rdfs:range xsd:dateTime .

package/dist/shapes/coverage.ttl

@@ -18,8 +18,8 @@
     dct:description "Domain vocabulary for patient-owned insurance, benefits, and financial health data. Layer 2 vocabulary resolving the overlap between checkup:InsuranceInfo (patient-reported) and clinical:CoverageRecord (EHR-imported) with a unified, standardized representation."@en ;
     dct:creator "Cascade Agentic Labs" ;
     dct:created "2026-02-18"^^xsd:date ;
-    dct:modified "2026-02-18"^^xsd:date ;
-    owl:versionInfo "1.0" ;
+    dct:modified "2026-03-17"^^xsd:date ;
+    owl:versionInfo "1.3" ;
     rdfs:comment "Insurance and benefits data is cross-cutting: not clinical (it's administrative/financial), not app-specific (any health app benefits from knowing coverage), and contributed by both patient self-report and EHR import. This vocabulary provides a single Layer 2 domain model that both checkup: (Layer 3, patient-reported) and clinical: (Layer 2, EHR-imported) can reference via the mixed namespace pattern. Recommended Pod storage path: /coverage/"@en ;
     rdfs:seeAlso <https://cascadeprotocol.org/docs/coverage/v1/> .
 
@@ -166,6 +166,13 @@ coverage:rxGroup a owl:DatatypeProperty ;
 # Changelog
 # ============================================================================
 #
+# v1.3 (2026-03-17): Added coverage:deniedClinicalContext (ObjectProperty linking DenialNotice to clinical evidence in the Pod),
+#   coverage:outcomeReason (free-text explanation of appeal outcome), coverage:reversalAmount (reimbursement if approved),
+#   coverage:DenialReasonCode named individuals (standard-mapped enum values for denialReasonCode),
+#   rdfs:seeAlso mappings to HL7 ClaimResponse.adjudication and CARIN IG adjudication codes.
+#
+# v1.2 (2026-03-16): Added coverage:DenialNotice class, coverage:AppealRecord class, and 11 new properties for denial/appeal workflow.
+#
 # Version 1.0 (2026-02-18)
 # - Initial release as part of Schema Refactoring Plan Phase 2 (WS4)
 # - Created to resolve overlap between checkup:InsuranceInfo (L3, patient-reported)
@@ -180,3 +187,319 @@ coverage:rxGroup a owl:DatatypeProperty ;
 # - Layer 2 domain vocabulary per three-layer architecture
 # - Recommended Pod storage: /coverage/plans/{plan-id}.ttl
 #
+
+# ============================================================================
+# New Classes: ClaimRecord and BenefitStatement
+# Added in v1.1 — supports FHIR Claim and ExplanationOfBenefit conversion
+# ============================================================================
+
+coverage:ClaimRecord a owl:Class ;
+    rdfs:label "Claim Record"@en ;
+    rdfs:comment "A medical claim submitted to an insurer for reimbursement. FHIR alignment: fhir:Claim"@en .
+
+coverage:BenefitStatement a owl:Class ;
+    rdfs:label "Benefit Statement (EOB)"@en ;
+    rdfs:comment "An Explanation of Benefits document — the insurer's formal response to a claim, including adjudication, denial reasons, and patient cost responsibility. FHIR alignment: fhir:ExplanationOfBenefit. CMS mandates patient access via CARIN Alliance FHIR IG."@en .
+
+coverage:DenialNotice a owl:Class ;
+    rdfs:label "Denial Notice"@en ;
+    rdfs:comment "A formal denial of coverage issued by an insurer. Distinct from BenefitStatement — a DenialNotice initiates an appeal process, not a payment record. Recommended Pod storage: /coverage/denials/{id}.ttl"@en ;
+    rdfs:subClassOf prov:Entity ;
+    rdfs:seeAlso fhir:ExplanationOfBenefit .
+
+coverage:AppealRecord a owl:Class ;
+    rdfs:label "Appeal Record"@en ;
+    rdfs:comment "A formal appeal filing contesting a denial notice. One record per appeal level. Recommended Pod storage: /coverage/appeals/{id}.ttl"@en ;
+    rdfs:subClassOf prov:Activity ;
+    rdfs:seeAlso fhir:Task .
+
+# ============================================================================
+# New Properties: coverage:Deductible
+# ============================================================================
+
+coverage:deductibleAmount a owl:DatatypeProperty ;
+    rdfs:domain coverage:Deductible ;
+    rdfs:range xsd:decimal ;
+    rdfs:label "Deductible Amount"@en .
+
+coverage:deductibleCurrency a owl:DatatypeProperty ;
+    rdfs:domain coverage:Deductible ;
+    rdfs:range xsd:string ;
+    rdfs:label "Deductible Currency"@en .
+
+coverage:deductibleMetAmount a owl:DatatypeProperty ;
+    rdfs:domain coverage:Deductible ;
+    rdfs:range xsd:decimal ;
+    rdfs:label "Deductible Met Amount"@en .
+
+coverage:deductiblePeriod a owl:DatatypeProperty ;
+    rdfs:domain coverage:Deductible ;
+    rdfs:range xsd:string ;
+    rdfs:label "Deductible Period"@en .
+
+coverage:deductibleType a owl:DatatypeProperty ;
+    rdfs:domain coverage:Deductible ;
+    rdfs:range xsd:string ;
+    rdfs:label "Deductible Type"@en ;
+    rdfs:comment "Values: individual, family, in-network, out-of-network"@en .
+
+# ============================================================================
+# New Properties: coverage:CopaySchedule
+# ============================================================================
+
+coverage:copayAmount a owl:DatatypeProperty ;
+    rdfs:domain coverage:CopaySchedule ;
+    rdfs:range xsd:decimal ;
+    rdfs:label "Copay Amount"@en .
+
+coverage:copayCurrency a owl:DatatypeProperty ;
+    rdfs:domain coverage:CopaySchedule ;
+    rdfs:range xsd:string ;
+    rdfs:label "Copay Currency"@en .
+
+coverage:copayType a owl:DatatypeProperty ;
+    rdfs:domain coverage:CopaySchedule ;
+    rdfs:range xsd:string ;
+    rdfs:label "Copay Type"@en ;
+    rdfs:comment "Values: primary-care, specialist, emergency, prescription"@en .
+
+# ============================================================================
+# New Properties: coverage:ClaimRecord
+# ============================================================================
+
+coverage:claimDate a owl:DatatypeProperty ;
+    rdfs:domain coverage:ClaimRecord ;
+    rdfs:range xsd:dateTime ;
+    rdfs:label "Claim Date"@en .
+
+coverage:claimTotal a owl:DatatypeProperty ;
+    rdfs:domain coverage:ClaimRecord ;
+    rdfs:range xsd:decimal ;
+    rdfs:label "Claim Total"@en .
+
+coverage:claimStatus a owl:DatatypeProperty ;
+    rdfs:domain coverage:ClaimRecord ;
+    rdfs:range xsd:string ;
+    rdfs:label "Claim Status"@en ;
+    rdfs:comment "Values: active, cancelled, draft, entered-in-error"@en .
+
+coverage:claimType a owl:DatatypeProperty ;
+    rdfs:domain coverage:ClaimRecord ;
+    rdfs:range xsd:string ;
+    rdfs:label "Claim Type"@en ;
+    rdfs:comment "Values: professional, institutional, oral, pharmacy, vision"@en .
+
+coverage:billingProvider a owl:DatatypeProperty ;
+    rdfs:domain coverage:ClaimRecord ;
+    rdfs:range xsd:string ;
+    rdfs:label "Billing Provider"@en .
+
+coverage:hasDiagnosis a owl:DatatypeProperty ;
+    rdfs:domain coverage:ClaimRecord ;
+    rdfs:range xsd:string ;
+    rdfs:label "Has Diagnosis"@en ;
+    rdfs:comment "ICD-10 code URI"@en .
+
+coverage:hasProcedure a owl:DatatypeProperty ;
+    rdfs:domain coverage:ClaimRecord ;
+    rdfs:range xsd:string ;
+    rdfs:label "Has Procedure"@en ;
+    rdfs:comment "CPT/SNOMED code URI"@en .
+
+coverage:sourceRecordId a owl:DatatypeProperty ;
+    rdfs:range xsd:string ;
+    rdfs:label "Source Record ID"@en ;
+    rdfs:comment "Original source system record identifier. No domain restriction — shared by ClaimRecord and BenefitStatement."@en .
+
+# ============================================================================
+# New Properties: coverage:BenefitStatement
+# ============================================================================
+
+coverage:adjudicationDate a owl:DatatypeProperty ;
+    rdfs:domain coverage:BenefitStatement ;
+    rdfs:range xsd:dateTime ;
+    rdfs:label "Adjudication Date"@en .
+
+coverage:adjudicationStatus a owl:DatatypeProperty ;
+    rdfs:domain coverage:BenefitStatement ;
+    rdfs:range xsd:string ;
+    rdfs:label "Adjudication Status"@en ;
+    rdfs:comment "Values: completed, cancelled, entered-in-error"@en .
+
+coverage:outcomeCode a owl:DatatypeProperty ;
+    rdfs:domain coverage:BenefitStatement ;
+    rdfs:range xsd:string ;
+    rdfs:label "Outcome Code"@en ;
+    rdfs:comment "Values: queued, complete, error, partial"@en .
+
+coverage:denialReason a owl:DatatypeProperty ;
+    rdfs:domain coverage:BenefitStatement ;
+    rdfs:range xsd:string ;
+    rdfs:label "Denial Reason"@en .
+
+coverage:totalBilled a owl:DatatypeProperty ;
+    rdfs:domain coverage:BenefitStatement ;
+    rdfs:range xsd:decimal ;
+    rdfs:label "Total Billed"@en .
+
+coverage:totalAllowed a owl:DatatypeProperty ;
+    rdfs:domain coverage:BenefitStatement ;
+    rdfs:range xsd:decimal ;
+    rdfs:label "Total Allowed"@en .
+
+coverage:totalPaid a owl:DatatypeProperty ;
+    rdfs:domain coverage:BenefitStatement ;
+    rdfs:range xsd:decimal ;
+    rdfs:label "Total Paid"@en .
+
+coverage:patientResponsibility a owl:DatatypeProperty ;
+    rdfs:domain coverage:BenefitStatement ;
+    rdfs:range xsd:decimal ;
+    rdfs:label "Patient Responsibility"@en .
+
+coverage:relatedClaim a owl:ObjectProperty ;
+    rdfs:domain coverage:BenefitStatement ;
+    rdfs:range coverage:ClaimRecord ;
+    rdfs:label "Related Claim"@en ;
+    rdfs:comment "Links an ExplanationOfBenefit to its corresponding Claim."@en .
+
+# ============================================================================
+# v1.2 DenialNotice Properties
+# ============================================================================
+
+coverage:deniedProcedureCode a owl:DatatypeProperty ;
+    rdfs:label "Denied Procedure Code"@en ;
+    rdfs:comment "CPT or HCPCS code of the denied service (e.g., E0787 for CGM)."@en ;
+    rdfs:domain coverage:DenialNotice ;
+    rdfs:range xsd:string .
+
+coverage:denialReasonCode a owl:DatatypeProperty ;
+    rdfs:label "Denial Reason Code"@en ;
+    rdfs:comment "Structured coded denial reason. Recommended values are coverage:DenialReasonCode named individuals (coverage:NotMedicallyNecessary, coverage:LCDCriteriaNotMet, coverage:NCDCriteriaNotMet, coverage:ServiceNotCovered, coverage:PriorAuthorizationRequired, coverage:DuplicateClaim, coverage:InformationRequested). Distinct from the free-text coverage:denialReason. Aligns with HL7 ClaimResponse adjudication and CARIN IG Blue Button STU2."@en ;
+    rdfs:domain coverage:DenialNotice ;
+    rdfs:range xsd:string ;
+    rdfs:seeAlso <http://terminology.hl7.org/CodeSystem/adjudication> ,
+                 <http://hl7.org/fhir/us/carin-bb/STU2/> .
+
+coverage:denialLetterDate a owl:DatatypeProperty ;
+    rdfs:label "Denial Letter Date"@en ;
+    rdfs:comment "Date the denial notice was issued. The appeal deadline clock starts from this date."@en ;
+    rdfs:domain coverage:DenialNotice ;
+    rdfs:range xsd:date .
+
+coverage:appealDeadline a owl:DatatypeProperty ;
+    rdfs:label "Appeal Deadline"@en ;
+    rdfs:comment "Computed deadline for filing an appeal, based on the denial date, plan type, and applicable jurisdiction rules."@en ;
+    rdfs:domain coverage:DenialNotice ;
+    rdfs:range xsd:date .
+
+coverage:coveragePolicyReference a owl:DatatypeProperty ;
+    rdfs:label "Coverage Policy Reference"@en ;
+    rdfs:comment "The LCD, NCD, or coverage policy cited as the basis for denial (e.g., LCD L33822)."@en ;
+    rdfs:domain coverage:DenialNotice ;
+    rdfs:range xsd:string .
+
+# ============================================================================
+# v1.2 AppealRecord Properties
+# ============================================================================
+
+coverage:appealLevel a owl:DatatypeProperty ;
+    rdfs:label "Appeal Level"@en ;
+    rdfs:comment "The administrative level of this appeal. Values: redetermination, qio_reconsideration, alj_hearing, mac_review, federal_court, internal_level1, internal_level2, external_review, state_insurance_dept, litigation."@en ;
+    rdfs:domain coverage:AppealRecord ;
+    rdfs:range xsd:string .
+
+coverage:appealFiledDate a owl:DatatypeProperty ;
+    rdfs:label "Appeal Filed Date"@en ;
+    rdfs:comment "Date the appeal was formally filed."@en ;
+    rdfs:domain coverage:AppealRecord ;
+    rdfs:range xsd:date .
+
+coverage:appealOutcome a owl:DatatypeProperty ;
+    rdfs:label "Appeal Outcome"@en ;
+    rdfs:comment "Outcome of the appeal. Values: approved, denied, partial, withdrawn, pending."@en ;
+    rdfs:domain coverage:AppealRecord ;
+    rdfs:range xsd:string .
+
+coverage:appealOutcomeDate a owl:DatatypeProperty ;
+    rdfs:label "Appeal Outcome Date"@en ;
+    rdfs:comment "Date the appeal outcome was received."@en ;
+    rdfs:domain coverage:AppealRecord ;
+    rdfs:range xsd:date .
+
+coverage:relatedDenialNotice a owl:ObjectProperty ;
+    rdfs:label "Related Denial Notice"@en ;
+    rdfs:comment "Links an AppealRecord to the DenialNotice it contests."@en ;
+    rdfs:domain coverage:AppealRecord ;
+    rdfs:range coverage:DenialNotice .
+
+# ============================================================================
+# v1.3 Properties
+# ============================================================================
+
+coverage:deniedClinicalContext a owl:ObjectProperty ;
+    rdfs:label "Denied Clinical Context"@en ;
+    rdfs:comment "References clinical or health records in the Pod that are relevant to this denial — procedures, lab results, diagnoses, device readings. Enables appeals to cite specific clinical evidence against policy criteria. Range is intentionally open (rdfs:Resource) to allow linking across clinical:, health:, and pots: namespaces."@en ;
+    rdfs:domain coverage:DenialNotice ;
+    rdfs:range rdfs:Resource .
+
+coverage:outcomeReason a owl:DatatypeProperty ;
+    rdfs:label "Outcome Reason"@en ;
+    rdfs:comment "Free-text explanation of why the appeal was approved, denied, or partially approved. Captures the insurer's stated rationale for the outcome."@en ;
+    rdfs:domain coverage:AppealRecord ;
+    rdfs:range xsd:string .
+
+coverage:reversalAmount a owl:DatatypeProperty ;
+    rdfs:label "Reversal Amount"@en ;
+    rdfs:comment "Reimbursement amount granted if the appeal was approved or partially approved. Expressed as a decimal in the currency of the related InsurancePlan."@en ;
+    rdfs:domain coverage:AppealRecord ;
+    rdfs:range xsd:decimal .
+
+# ============================================================================
+# v1.3 Named Individuals: DenialReasonCode
+# Standard-mapped enumeration values for coverage:denialReasonCode
+# Source mappings:
+#   HL7 ClaimResponse.adjudication: http://terminology.hl7.org/CodeSystem/adjudication
+#   CARIN IG for Blue Button: http://hl7.org/fhir/us/carin-bb/STU2/
+#   CMS Medicare denial codes: https://www.cms.gov/medicare/coding-billing/place-of-service-codes
+# ============================================================================
+
+coverage:NotMedicallyNecessary a coverage:DenialReasonCode ;
+    rdfs:label "Not Medically Necessary"@en ;
+    rdfs:comment "Service denied as not meeting medical necessity criteria for the diagnosis. HL7 alignment: adjudication code 'noauth'. CMS reason: 50 (not medically necessary)."@en ;
+    rdfs:seeAlso <http://terminology.hl7.org/CodeSystem/adjudication> .
+
+coverage:LCDCriteriaNotMet a coverage:DenialReasonCode ;
+    rdfs:label "LCD Criteria Not Met"@en ;
+    rdfs:comment "Service denied because the patient does not meet the criteria in the applicable Local Coverage Determination (LCD). CMS LCD search: https://www.cms.gov/medicare-coverage-database/"@en ;
+    rdfs:seeAlso <https://www.cms.gov/medicare-coverage-database/> .
+
+coverage:NCDCriteriaNotMet a coverage:DenialReasonCode ;
+    rdfs:label "NCD Criteria Not Met"@en ;
+    rdfs:comment "Service denied because the patient does not meet the criteria in the applicable National Coverage Determination (NCD)."@en ;
+    rdfs:seeAlso <https://www.cms.gov/medicare-coverage-database/> .
+
+coverage:ServiceNotCovered a coverage:DenialReasonCode ;
+    rdfs:label "Service Not Covered"@en ;
+    rdfs:comment "The requested service is explicitly excluded from the patient's plan benefits. HL7 alignment: adjudication code 'benefit'."@en ;
+    rdfs:seeAlso <http://terminology.hl7.org/CodeSystem/adjudication> .
+
+coverage:PriorAuthorizationRequired a coverage:DenialReasonCode ;
+    rdfs:label "Prior Authorization Required"@en ;
+    rdfs:comment "The service requires prior authorization which was not obtained before service delivery. HL7 alignment: adjudication code 'noauth'. CARIN IG: X12 835 reason code 4."@en ;
+    rdfs:seeAlso <http://hl7.org/fhir/us/carin-bb/STU2/> .
+
+coverage:DuplicateClaim a coverage:DenialReasonCode ;
+    rdfs:label "Duplicate Claim"@en ;
+    rdfs:comment "Claim denied as a duplicate of a previously processed claim. X12 835 reason code 18."@en .
+
+coverage:InformationRequested a coverage:DenialReasonCode ;
+    rdfs:label "Additional Information Requested"@en ;
+    rdfs:comment "Claim suspended or denied pending submission of additional clinical documentation. X12 835 reason code 16."@en .
+
+# DenialReasonCode type declaration (supports named individuals above)
+coverage:DenialReasonCode a owl:Class ;
+    rdfs:label "Denial Reason Code"@en ;
+    rdfs:comment "Enumeration class for structured denial reason codes. Use named individuals (coverage:NotMedicallyNecessary, etc.) as values for coverage:denialReasonCode. Aligns with HL7 ClaimResponse adjudication codes and CARIN IG for Blue Button (STU2)."@en ;
+    rdfs:seeAlso <http://terminology.hl7.org/CodeSystem/adjudication> ,
+                 <http://hl7.org/fhir/us/carin-bb/STU2/> .

package/dist/shapes/health.ttl

@@ -21,8 +21,8 @@
     dct:description "Vocabulary for consumer-generated wellness observations from wearable devices and HealthKit. Maps Cascade wellness properties to established SNOMED CT and LOINC codes following the three-layer ontology architecture."@en ;
     dct:creator "Cascade Agentic Labs" ;
     dct:created "2026-01-29"^^xsd:date ;
-    dct:modified "2026-02-17"^^xsd:date ;
-    owl:versionInfo "2.2" ;
+    dct:modified "2026-02-28"^^xsd:date ;
+    owl:versionInfo "2.3" ;
     rdfs:comment """Three-layer ontology for wellness data:
         Layer 1 (Established standards): SNOMED CT concept IDs + LOINC observation codes
         Layer 2 (Cascade health vocabulary): health: namespace properties linking to Layer 1
@@ -30,6 +30,14 @@
     rdfs:seeAlso <https://cascadeprotocol.org/docs/health/v1/> .
 
 # Changelog:
+# v2.3 (2026-02-28): BUG-006 — Added 6 Pattern A flat-property vocabulary terms
+#     for VitalSignReading blank nodes: health:value (generic numeric value),
+#     health:date (observation timestamp), health:sdnn (HRV SDNN measurement),
+#     health:systolic and health:diastolic (blood pressure components),
+#     health:walkingSteadinessLevel (enum ObjectProperty). Also added
+#     health:WalkingSteadinessUnknown individual. These replace the Pattern B
+#     fhir:Observation nesting in HealthProfileSerializer.
+#
 # v2.2 (2026-02-17): Added 2 container linking ObjectProperties:
 #     health:hasHRVStatistics, health:hasBPStatistics. These link a wellness
 #     profile or intake form to its statistical summary nodes. Previously dark
@@ -201,7 +209,8 @@ health:walkingSteadiness a owl:DatatypeProperty ;
     health:snomedCode sct:364832000 ;  # Balance finding
     rdfs:comment "SNOMED mapping note: 364832000 (Balance finding) is the closest available concept. Alternatives considered: 250043000 (Gait finding), 282097004 (Ability to walk). Apple's OK/Low/Very Low classification is proprietary."@en .
 
-# Valid values for walkingSteadiness
+# Valid values for walkingSteadiness (legacy named individuals)
+# health:WalkingSteadinessUnknown also defined in Pattern A section (v2.3)
 health:WalkingSteadinessOK a health:WalkingSteadinessLevel ;
     rdfs:label "OK" .
 health:WalkingSteadinessLow a health:WalkingSteadinessLevel ;
@@ -543,6 +552,56 @@ health:trendPolarity a owl:AnnotationProperty ;
     rdfs:label "Trend Polarity"@en ;
     rdfs:comment "Whether an increase in this metric is generally favorable ('higher_is_better'), unfavorable ('lower_is_better'), or context-dependent ('neutral'). Used by presentation layers to determine trend arrow color semantics. This is a general heuristic — individual clinical context may differ."@en .
 
+# ============================================================================
+# Pattern A Flat Observation Properties (v2.3 — BUG-006)
+# ============================================================================
+# These properties are used in Pattern A flat blank nodes emitted by
+# HealthProfileSerializer. They replace the fhir:Observation nesting
+# (Pattern B) for all wellness vital sign readings.
+
+health:value a owl:DatatypeProperty ;
+    rdfs:label "Observation Value"@en ;
+    rdfs:comment "Generic numeric value for a wellness observation blank node. Used in Pattern A flat serialization where the observation type is identified by the enclosing property (e.g., health:restingHeartRate). The unit is carried by health:unit on the same blank node."@en ;
+    rdfs:range xsd:double .
+
+health:date a owl:DatatypeProperty ;
+    rdfs:label "Observation Date"@en ;
+    rdfs:comment "Timestamp of a wellness observation in Pattern A flat serialization. Equivalent in role to fhir:effectiveDateTime but scoped to health: namespace blank nodes."@en ;
+    rdfs:range xsd:dateTime .
+
+health:sdnn a owl:DatatypeProperty ;
+    rdfs:label "SDNN (HRV)"@en ;
+    rdfs:comment "Standard deviation of normal-to-normal R-R intervals. The primary HRV scalar emitted in Pattern A HRVReading blank nodes."@en ;
+    rdfs:range xsd:double ;
+    health:snomedCode sct:80404004 ;
+    health:loincCode loinc:80404-7 ;
+    health:unit "ms" .
+
+health:systolic a owl:DatatypeProperty ;
+    rdfs:label "Systolic Blood Pressure (reading)"@en ;
+    rdfs:comment "Systolic component value in a Pattern A BloodPressureReading blank node. Distinct from health:systolicBP which is a domain-level property on fhir:Observation."@en ;
+    rdfs:range xsd:double ;
+    health:snomedCode sct:271649006 ;
+    health:loincCode loinc:8480-6 ;
+    health:unit "mmHg" .
+
+health:diastolic a owl:DatatypeProperty ;
+    rdfs:label "Diastolic Blood Pressure (reading)"@en ;
+    rdfs:comment "Diastolic component value in a Pattern A BloodPressureReading blank node. Distinct from health:diastolicBP which is a domain-level property on fhir:Observation."@en ;
+    rdfs:range xsd:double ;
+    health:snomedCode sct:271650006 ;
+    health:loincCode loinc:8462-4 ;
+    health:unit "mmHg" .
+
+health:walkingSteadinessLevel a owl:ObjectProperty ;
+    rdfs:label "Walking Steadiness Level"@en ;
+    rdfs:comment "Links a Pattern A WalkingSteadiness blank node to its level individual (health:WalkingSteadinessOK, health:WalkingSteadinessLow, health:WalkingSteadinessVeryLow, health:WalkingSteadinessUnknown)."@en ;
+    rdfs:range health:WalkingSteadinessLevel .
+
+# health:WalkingSteadinessUnknown added v2.3 (previously only OK/Low/VeryLow defined)
+health:WalkingSteadinessUnknown a health:WalkingSteadinessLevel ;
+    rdfs:label "Unknown" .
+
 # ============================================================================
 # VO2 Max Statistics Properties (v1.7)
 # ============================================================================
@@ -837,6 +896,16 @@ health:hasBPStatistics a owl:ObjectProperty ;
     rdfs:comment "Links a wellness profile to its blood pressure statistical summary."@en ;
     rdfs:range health:BPStatistics .
 
+# Named individuals for walkingSteadinessLevel (Pattern A short-form, v2.3)
+health:OK a health:WalkingSteadinessLevel ;
+    rdfs:label "OK" .
+health:Low a health:WalkingSteadinessLevel ;
+    rdfs:label "Low" .
+health:VeryLow a health:WalkingSteadinessLevel ;
+    rdfs:label "Very Low" .
+health:Unknown a health:WalkingSteadinessLevel ;
+    rdfs:label "Unknown" .
+
 # ============================================================================
 # Standard Code Reference Table (for documentation)
 # ============================================================================

package/package.json

@@ -1,6 +1,6 @@
 {
   "name": "@the-cascade-protocol/cli",
-  "version": "0.3.3",
+  "version": "0.3.4",
   "description": "Cascade Protocol CLI - Validate, convert, and manage health data",
   "bin": {
     "cascade": "dist/index.js"