The HOPE Assessment Tool Series: CMS Question and Answer Repository
The following questions and Answers about the HOPE Assessment tool come from CMS postings on the Hospice Quality Reporting Program (HQRP) Website or from direct CMS contact.
CHAP has gathered Q&As in one place and organized them by topic for your convenience. We will continue to update this repository as CMS posts additional Q&As.
Last update: 4/23/2025
HOPE Assessment Tool Implementation and Application
Topic: Data Specifications for HOPE Implementation
- Question: Software vendors need technical data specifications to program EHR software for HOPE implementation. When will CMS publish the data specifications for HOPE, and does the user interface in our software need to look like the forms in the draft HOPE Guidance Manual?
Answer: The technical data specifications and other materials related to HOPE, including the final HOPE Guidance Manual and the item sets will be available soon after the publication of the FY2025 Hospice Final Rule (CMS-1810-F). Regarding your EHR user interface, CMS does not provide guidance on what that interface should look like. CMS requires that the software comply with the final HOPE data specifications.
Source: Help Desk Questions and Answers: Quarter 2, 2024
Topic: HOPE Implementation Information
- Question: Is October 1, 2025, the final implementation date for HOPE?
Answer: Yes, October 1, 2025, is the final implementation date for HOPE. Only HOPE data will be accepted for all patients admitted or discharged on or after October 1, 2025.
Source: Help Desk Questions and Answers: Quarter 3, 2024
- Question: Do hospice providers need to contract with a vendor to submit their future HOPE data?
Answer: As noted in the December 12, 2024 HQRP Forum slides (posted in the Downloads here: Provider and Stakeholder Engagement | CMS), Hospice providers will need to select a private vendor to complete and submit HOPE data. Providers can choose to submit the records themselves or arrange with a 3rd party to submit on their behalf. Providers are not required to contract with a third-party vendor for submission of HOPE data to IQIES. However, all HOPE records must be in an XML format in a zip file for submission, which requires a software application. The CMS HART software will sunset with the HIS.
Source: The Hospice Quality Help Desk – direct contact
- Question: HOPE applies to all levels of care, correct? So, if an HUV is due during a GIP stay, it needs to be completed, correct?
Answer: That is correct.
Source: The Hospice Quality Help Desk – direct contact
- Question: Will the QTSO manual for HOPE be ready before 10/1/2025?
Answer: There are several video tutorials available for providers on the iQIES YouTube channel. You can find the topics and links to these tutorials on the QIES Technical Support Office (QTSO) website. Please refer to the resources slides. https://qtso.cms.gov/training-materials/iqies-training-videos. CMS will provide detailed iQIES onboarding instructions during the summer of 2025. As always, information about HOPE will be posted on the CMS HQRP website on the Announcement and Spotlight page and announced during the Hospice, Home Health, DME Open Door Forums
Source: The Hospice Quality Help Desk – direct contact
- Question: Will CMS have any period where both HOPE and HIS records are acceptable, or is it just a hard cutover on 10/1/25?
Answer: While there will be some transition time to allow for HIS record corrections, only HOPE records will be accepted for all patients admitted or discharged on or after October 1, 2025.
Source: Help Desk Questions and Answers: Quarter 3, 2024
Topic: HIS to HOPE Transition
Question: Will CMS have any period where both HOPE and HIS records are acceptable, or is it just a hard cutover on 10/1/25?
Answer: While there will be some transition time to allow for HIS record corrections, only HOPE records will be accepted for all patients admitted or discharged on or after October 1, 2025.
Source: Help Desk Questions and Answers: Quarter 3, 2024
HOPE Assessment Tool Utilization
Topic: Leading Zeroes on Hospice Outcomes and Patient Evaluation (HOPE)
- Question: Data Elements When reviewing the HOPE item sets, we noticed that unlike the Hospice Item Set (HIS), the response codes for some data elements no longer have leading zeroes (two digits) in the new HOPE tool (e.g., A0250. Reason for Record, A2115. Reason for Discharge). Was this intentional or an error?
Answer: HQRP Q&A-Q3, 2024 Posted: November 2024 Intentional changes have been made to some HIS items retained for the HOPE tool to streamline and align with other items within the new tool, including changes made to A0250 and A2115. The current HOPE Guidance Manual v1.00, item sets, and change table are currently posted on CMS’ HOPE webpage.
Source: Help Desk Questions and Answers: Quarter 3, 2024
Topic: HOPE and Hope Update Visit (HUV) data collection
- Question: For patients admitted just before 10/1/25 using the HIS, will providers have to submit the HUV timepoint, or is that only for new patients admitted on or after 10/1/25?
Answer: The HUV data collection time points will only apply to new patients admitted on or after October 1, 2025, using the HOPE tool.
Source: Help Desk Questions and Answers: Quarter 3, 2024
- Question: What happens if an HUV is completed late (outside of the prescribed timeframes)?
Answer: This is covered in the updated manual posted on 4/22- Section 1.3.2: “If an HUV is missed or late for any reason (e.g., HUV1 conducted on day 17 or HUV2 conducted on day 33), conduct the visit as appropriate and submit the record once completed, including any SFV if applicable. “ Hospice Outcomes and Patient Evaluation (HOPE) Guidance Manual
Source: The Hospice Quality Help Desk – direct contact
Topic: Symptom Follow-Up Visit
- Question: From the FY2025 proposed rule to the publication of the FY2025 final rule (FR), we noticed a change in the name of the visits from the Symptom Re-assessment visit (SRA) to the Symptom Follow-up Visit (SFV). Can you please confirm the name change?
Answer: HQRP Q&A-Q3, 2024 Posted: November 2024 in the FY2025 Hospice Final Rule, the name change was confirmed from the SRA to SFV to accommodate allowing LPN/LVNs to complete this follow-up visit for both moderate or severe symptoms.
Source: Help Desk Questions and Answers: Quarter 3, 2024
- Question: Will CMS provide any additional information about the SFV related to determining impact?
Answer:
- While there are some examples in the HOPE Guidance Manual (CMS just posted the final v1.01 on 4/22/25), CMS does anticipate some scoring variation as the coding for Symptom Impact is based on the individual clinician’s observation and judgment after their clinical assessment of the patient, including interviews with the patient and caregivers. This was done to avoid these symptom impact items being based solely on a patient report since many hospice patients may not be able to verbalize.
- Information re: future trainings for HOPE implementation will be forthcoming. Please monitor the HQRP Announcements and Listservs: https://www.cms.gov/medicare/quality/hospice/hospice-qrp-announcements-spotlight
Source: The Hospice Quality Help Desk – direct contact
Additional Resources on the HOPE Assessment Tool
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