HOPE Guidance Manual v1.02, § 1.6

1. To accurately and fully complete HOPE data, hospice staff should understand what information each

item requires and complete the item based only on what is being requested. Responses to items in

HOPE can be selected by the assessing clinician as part of the routine assessment during a patient

visit or, for select items, can be based on information documented in the clinical record and

abstracted on or before the Completion Date (Item Z0500B).

2. HOPE records should be submitted even if the patient revokes the hospice benefit or is discharged

from hospice before all HOPE-related care processes are complete.

3. If a patient is discharged (for whatever reason) before a hospice care process takes place, hospices

should answer “no” to any of the HOPE gateway questions and follow the skip patterns as indicated

on the individual data elements. Hospices should not leave any items blank unless directed to do so

by skip patterns.

4. HOPE includes several “date” items. All date items should be completed as follows:

• Use the format Month-Day-Year: MM-DD-YYYY.

• Do not leave any spaces blank.

• If the month and/or day contains only a single digit, enter “0” in the first box of the month and/or

day.

• For example, November 1, 2025, would be entered as 11-01-2025.

• The day begins at 12:00 a.m. and ends at 11:59 p.m.

5. All completed HOPE records must be electronically submitted to CMS.

6. HOPE record submission should follow the sequence outlined in Chapter 3, Section 3.3. Timing and

Sequence Policies.

7. Policies outlined in Chapter 3 describe how to correct errors in a HOPE record that CMS has already

accepted.

1.6.1. Who May Complete HOPE

H

OPE contains a combination of existing HIS items and new items. Some of the data elements are to be

collected during routine clinical assessment visits, while other data may be extracted from the clinical record by

hospice staff, including volunteers, contractors, and affiliates. For example, staff could collect data from the

quality division of the health system to which a hospice belongs. HOPE may be completed by any appropriate

hospice staff member, based on the data being collected, such as the registered nurse (RN) for HOPE items

requiring a skilled nursing assessment. The hospice is responsible for the accuracy and completeness of

information in HOPE. Per the hospice CoPs, (See 418.114 Conditions of Participation), it is at the discretion of

the hospice to determine who can accurately complete HOPE. Each person completing any portion of HOPE

should provide a signature in Section Z, Record Administration, per the instructions provided in Section Z of

Chapter 2.

1.6.2. Acceptable Sources of Documentation

The primary sources of information for completing HOPE include the following:

• Data collected through in-person visits and clinical care processes as they are conducted.

• Documentation in the hospice clinical record from which the responses to HOPE data elements can be

obtained.

This means that, in general, sources external to the clinical record should not be used when completing the

hospice data set.

• In some instances, a provider may consult sources other than the hospice clinical record to complete

HOPE. For example, completion of Section A (Administrative Information) items may require review of

claims or billing records, while Section F (Preferences) items may require review of physician orders for

life-sustaining treatment (POLST) forms or other equivalent forms.

• If a particular HOPE care process is not documented in the hospice clinical record, the care process is

considered not to have occurred. Complete each HOPE data element accordingly, following skip

patterns outlined in the tool.