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Hospice Outcome & Patient Evaluation Tool

Hospices will begin completing the Hospice Outcome & Patient Evaluation (HOPE) on October 1, 2025.  The final HOPE item sets and HOPE guidance manual were released on September 16, 2024.  The HOPE data collection tool replaces the Hospice Item Set (HIS) but includes many of the same items.  Medicare-certified hospices will complete HOPE records for…

Hospices will begin completing the Hospice Outcome & Patient Evaluation (HOPE) on October 1, 2025.  The final HOPE item sets and HOPE guidance manual were released on September 16, 2024.  The HOPE data collection tool replaces the Hospice Item Set (HIS) but includes many of the same items.  Medicare-certified hospices will complete HOPE records for all patient admissions regardless of payer source, patient age, location of patient, or length of stay. As stated by CMS, the primary objectives of HOPE are to provide quality data for HQRP requirements through standardized data collection.  This data will help support survey and certification processes and affect future quality improvement and payment updates.

  The HOPE data is expected to help improve care quality; however, it is important to remember it is a data tool, not an assessment. The HOPE data tool can be incorporated into the comprehensive assessment as many providers currently do with the HIS but is not a requirement.  Electronic submissions are expected with up to four records for each patient admitted beginning October 1, 2025, including a minimum of a HOPE-Admission record, a HOPE-Discharge record, and up to two HOPE Update Visits (HUVs). Each timepoint will not require completion of all items and the intention is not to replace a thorough and ongoing assessment of each patient.  Acceptable sources of documentation include in-person clinical assessments, real-time data collection, as well as other information obtained from the clinical record. The HUV1 should be completed between day 6 and 15.  HUV2 should be completed between days 16 and 30.  The hospice date of election is considered “Day 0”.  CMS does not specify which member of the hospice interdisciplinary group member must complete the updates, however since the data collection includes clinical components requiring a skilled nursing assessment, the general expectation is that the RN would be completing these visits.

The HOPE includes required data collection on pain and non-pain symptoms upon the admission and update visit timepoints and if the impact is scored as moderate or severe at either of these timepoints, a Symptom Follow-up Visit (SFV) is expected within 2 calendar days.  The SFV requires an in person visit and must be a separate visit from the Admission or HUV. The SFV evaluates symptom impact rather than the rating of experienced pain or non-pain symptoms.  For clarity, the SFV is not an assessment of the intensity, severity, frequency, or other factors of the symptom but what impact these symptoms have on the patient.

There is much to be done within the hospice industry to ensure the successful implementation of HOPE.  For questions or ways in which MAC Legacy can help you walk through this transition, please reach out to info@mac-legacy.com.  Please see this website for further information HOPE.  HOPE | CMS