HOPE Guidance Manual v1.02, § 1.5

For all current patients with discharges occurring through September 30, 2025, completion and submission of both

the HIS Admission and Discharge is required.

For patients admitted through September 30, 2025, but discharged on or after October 1, 2025, providers will:

• Complete and submit the HIS Admission.

• Not be required to administer the HUV assessment(s).

• Complete and submit a HOPE Discharge assessment.

For all patients admitted on or after October 1, 2025, only HOPE records will be accepted by CMS. These include

the HOPE-Admission, HOPE Update Visit(s), if applicable, and HOPE-Discharge records.

Completion of HOPE records (formerly HIS) applies to all patient admissions to a Medicare-certified hospice

program regardless of the following:

• Payer source (Medicare, Medicaid, or private payer).

• Patient age.

• Where the patient receives hospice services, such as a private home, nursing home, assisted living, or

hospice inpatient facility.

• Hospice LOS.

1.5.1. Special Circumstances Affecting HOPE

Patient transfers from one hospice provider to another provider with a different CMS Certification Number

(CCN):

• Hospice quality reporting is at the CCN level.

• If a hospice patient’s care transfers or changes from one hospice to another, and the two hospices have

different CCNs, each hospice should complete a HOPE-Admission, HOPE Update Visit records (as

applicable), and a HOPE-Discharge record for the care provided to the patient by their organization.

• When the transferring hospice completes its HOPE-Discharge, response 05, “transferred to another

hospice,” should be selected for Item A2115—Reason for Discharge.

In some circumstances, a hospice’s policy may be to discharge a patient administratively and re-admit them.

Such circumstances might include the following:

• Change in patient’s payer source: a private pay patient becomes eligible for Medicare during the hospice

stay; the hospice completes an “administrative” discharge and re-admits the patient for billing purposes.

• Hospice fails to meet the face-to-face requirement: if a hospice fails to meet the face-to-face

requirement, the hospice must “administratively” discharge the patient, but the patient remains on

service. This means that Medicare would expect the hospice to discharge the patient from the Medicare

hospice benefit, but to continue to care for the patient at its own expense until the required (face-to-face)

encounter occurs, enabling the hospice to re-establish Medicare eligibility.

• In general, if the patient remains under hospice care with no interruption in hospice service, completion

of a HOPE discharge record is not required. In both situations listed above, the patient remained under

the hospice’s care without interruption in service. The hospice would not be required to submit a HOPE-Discharge. Hospices should submit a HOPE-Discharge record once the patient is no longer receiving

hospice services or there is an interruption in care related to one of the reasons for discharge listed in

Item A2115.

Traveling Patients

Hospice patients may, on occasion, travel outside of their “home hospice’s” service area. In these

circumstances, when the patient is outside of the home hospice’s service area, the patient may receive services

from a “host hospice.” Per CMS regulations at 418.26, a hospice may discharge a patient if the patient moves

out of the service area or transfers to another hospice. However, per the hospice regulations, a hospice may also

enter into a written arrangement with another Medicare-certified hospice program to provide core services to

supplement hospice employees/staff to meet the needs of patients. Circumstances under which a hospice may

enter into a written arrangement to provide core services include a patient temporarily traveling outside of the

hospice’s service area.

In the case of a traveling patient, whether a hospice should submit a HOPE-Discharge record and new HOPE-Admission record depends on whether the home hospice discharged the patient and if the host hospice admitted

the patient to hospice care and filed a notice of election (NOE) within the claims processing system. If there is

no discharge by the home hospice, then the home hospice is not required to submit a HOPE-Discharge record

when the patient travels out of the home hospice’s service area. Relatedly, the host hospice would not need to

submit a HOPE-Admission or HOPE-Discharge record for a traveling patient for whom they are providing

services under a written agreement with the home hospice.

In rare circumstances where a newly admitted hospice patient travels during the first month of hospice service,

the home hospice may request the host hospice to conduct and provide the documentation for HUV1 and/or

HUV2.