1) yes, AR is wrong fit for fhirbase. I would suggest use Sequel, PORO (or even just hash/struct) and create facade for PostgreSQL functions calls . Fhirbase implements most of ORM functionality, not so convenient as in ROR, but compatible with FHIR spec.
Validation in terms of FHIR should be done by profiling. We are trying to convert profiles (structure definitions) to json schema (https://github.com/fhir-js/fhir-schema) and reuse existing json schema engines ( instead of code generation like in HAPI and .NET ref. implementation).
2) About custom resources - FHIR by design makes it little bit tricky, provides special resource https://www.hl7.org/FHIR/2015Sep/basic.html and encourages to discuss your needs with community, before inventing new one.
So rise discussion on chat.fhir.org about missing parts and join the community ;)
73's nicola
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