The name “Observation Category” implies that this is for all observations when it fact it is actually scoped for assessments. This ValueSet seems to have been repurposed from US Core 5.0.1 where it was previously being used for all sorts of observation categories (This valueset was also not bound to any element which seems to suggest it was used as a convience for tagging and searching). That is no longer the case (and now it it bound to a particular element). Please consider changing the name/id of the ValueSet (creating a new VS) to be something more inline with the purpose of the value set, such as “US Core Assessment Observation Category” or “US Core Observation Assessment Category”.