US · guidance

HOPE All Items v1.01, Item A1005

Ethnicity

activein force · 2025-10-01 – presentcompiled-edition

A1005. Ethnicity

Are you of Hispanic, Latino/a, or Spanish origin?

↓ Check all that apply

A. No, not of Hispanic, Latino/a, or Spanish origin

B. Yes, Mexican, Mexican American, Chicano/a

C. Yes, Puerto Rican

D. Yes, Cuban

E. Yes, Another Hispanic, Latino, or Spanish origin

X. Patient unable to respond

Y . Patient declines to respond

History

HOPE All Items v1.01, effective October 1, 2025 (OMB control number 0938-1153).

Provenance

Source: cms.gov
Retrieved: 2026-09-17
Edition: hope-v1.02
Content hash: 998cc35f7b819d954d48ca9905933f035ee334210625402bdfd860e1b3cc6b85

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