US · guidance

HOPE All Items v1.01, Item A1010

Race

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

A1010. Race

What is your race?

↓ Check all that apply

A. White

B. Black or African American

C. American Indian or Alaska Native

D. Asian Indian

E. Chinese

F. Filipino

G. Japanese

H. Korean

I. Vietnamese

J. Other Asian

K. Native Hawaiian

L. Guamanian or Chamorro

M. Samoan

N. Other Pacific Islander

X. Patient unable to respond

Y . Patient declines to respond

Z. None of the above

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: 00bd456ca246db3055768845804eab40cc76ab8d63532c1563e1b856157d479f

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