The description, at minimum, needs to explain its relationship to 'score' and whether this is intended to be used in conjunction with or separate from.  A reference to the $match operation for Patient would also be useful - with an indication that this isn't only useful for patient matches.

Also, when reviewing this extension, we found https://jira.hl7.org/browse/FHIR-12594 which says it was applied, but doesn't seem to have been.  (Wording criticized by the tracker is still there.)

Finally, there's a required binding to a value set whose middle-two values are super fuzzy and don't seem to offer clear guidance as when to use which code, nor what to differently when receiving one code vs. the other.  More guidance is needed here too.

While the extension is nominally owned by FHIR-I, given that PA owns the operation, we think it makes sense for PA to own the extension.