Hospice providers are entering a pivotal stage of preparation with the October 1, 2025, implementation date of the Hospice Outcomes and Patient Evaluation (HOPE) tool quickly approaching. Many organizations have made considerable progress – training is underway, timelines are mapped out, and internal team champions are leading the charge. Despite these important steps, the real…
Hospice providers are entering a pivotal stage of preparation with the October 1, 2025, implementation date of the Hospice Outcomes and Patient Evaluation (HOPE) tool quickly approaching. Many organizations have made considerable progress – training is underway, timelines are mapped out, and internal team champions are leading the charge. Despite these important steps, the real measure of success lies not in planning but in execution.
The shift to HOPE represents more than a new documentation requirement. It redefines how hospices assess, communicate, and respond to patient needs across the full spectrum of care. It requires a fundamental shift in practice that demands confidence and consistency from every team member regardless of their role or assignment. Real-world readiness means ensuring that staff don’t just know what HOPE is but are fully equipped to implement it effectively when it matters most.
For many organizations, the groundwork has been accomplished: foundational education has been completed and a core group of nurses may be piloting the assessments. But these early efforts can give a false sense of security. Readiness is not achieved until all team members including new hires, on-call staff, and PRN personnel can complete HOPE assessments correctly and confidently in routine and high-pressure situations alike. If the process breaks down, that’s not a minor gap. It’s an operational risk.
Equally important is the ability to apply HOPE across the full continuum of care. Training must extend beyond standard sessions, and teams need opportunities to practice assessments in varied scenarios (admissions after hours, symptom exacerbations, rapid declines, and complex hand-offs). These are the moments where preparation is tested and where real readiness is revealed.
Leadership engagement is another critical factor that can make or break implementation. Clinical and administrative leaders must be aligned in approving the training plan as well as in understanding its operational implications. HOPE may impact visit structures, staff workflows, productivity metrics, and after-hours coverage. Leaders must be ready to support frontline staff with real-time solutions, particularly during the go-live period when unexpected challenges will arise.
Equally important is the seamless integration of HOPE workflows into the electronic medical record (EMR) system. If the assessment cannot be efficiently documented in the EMR or if key alerts and timepoints are not functioning as expected, then documentation will fall behind, and compliance could be jeopardized. Testing HOPE processes within the actual EMR, under real staffing conditions, is essential to avoid disruptions.
The compliance and financial implications are significant too. HOPE will become central to the Hospice Quality Reporting Program (HQRP), and compliance will require timely, complete, and accurate submission of admission, update, and discharge data for every patient. At least 90% of all HOPE records must be accepted within 30 days of assessment to meet compliance standards. Failure to do so will result in a 4% reduction in annual Medicare payments. That is a loss few organizations can afford.
In this final stretch before October 1st, the focus must shift from preparation to execution. There is still time to identify weaknesses, adjust workflows, and build confidence across the team. But that time is limited. The most successful organizations will be those that use these remaining weeks not just to train, but to test, refine, and adapt. Once HOPE goes live, the margin for error disappears and only teams that are truly operationally ready will thrive.
