Element Must Be Present but Is Missing (Profile Conformance)
A conformance profile or custom spec declares an element as required (a present constraint), and the resource does not contain it. This is profile-level, beyond base FHIR cardinality.
FHIR · Error
The error
must be present but is missingWhy it happens
Validating a base-valid resource against a stricter profile (US Core, IPS, or your own). The resource parses fine as raw FHIR but omits an element the profile mandates.
How to fix it
Add the element the profile requires. Read the rule rationale shown next to the failure: it names the profile and the reason. The Profile Coverage tool lists every required path for a given profile.
Example
The snippet below triggers the error:
{
"resourceType": "Patient",
"name": [{ "family": "Doe" }],
"gender": "male"
}The corrected version:
{
"resourceType": "Patient",
"identifier": [{ "system": "http://hospital.example.org/mrn", "value": "MRN12345" }],
"name": [{ "family": "Doe" }],
"gender": "male"
}Frequently asked questions
Why does my resource pass the validator but fail coverage?
The base FHIR validator checks the core specification. Profile coverage checks additional constraints from US Core, IPS, or a custom spec. A resource can be valid FHIR yet fail a stricter profile.