HOPE Guidance Manual v1.02, § 3.3

The HOPE tool contains several data elements calling for dates. There are also recommended completion and

required submission dates. Table 10 below defines the various dates associated with HOPE.

Table 10: Timing Definitions

Title / Date Name Definition

Admission Date (A0220) The date on which the hospice becomes responsible for the care of the

patient. For Medicare patients, it is the same as the effective date of the

hospice benefit election (or re-election), which may be the first day of

hospice care or a later date but may be no earlier than the date of the

election statement.4

Discharge Date (Item A0270) The date a patient leaves the hospice. If the patient has expired, it is

the date of death. For live discharges, it is the date the patient revoked

the hospice benefit or the date the hospice discharged the patient.5

Date Assessment Completed

(Z0350)

This is the date that the clinician enters once they have conducted their

assessment visit, gathered information/responses for the HOPE Update

Visit (HUV) as well as any SFV data if applicable.

Record Completion Date

(Z0500B)

The actual date on which the hospice verifies the information to be

submitted in the HOPE record is complete. Defined as the date all

required information has been collected and documented, and staff

have signed and dated that the record is complete.

Completion Goal The latest possible date that a provider is encouraged to complete a

HOPE record.

The completion goal for the Admission record is no later than the

Admission Date + 14 calendar days.

The completion goal for HUV records is no later than Z0350. Date

Assessment was Completed + 14 calendar days.

The completion goal for the Discharge record is no later than the

Discharge Date + 7 calendar days.

Submission Date The submission date is defined as the date on which the completed

record was submitted to CMS. The submission date should be no later

than the submission deadline.

Submission Deadline The submission deadline is defined as the latest possible date on which

the HOPE record should be submitted to and accepted by CMS.

The submission deadline for the Admission record is no later than the

Admission date + 30 calendar days.

The submission deadline for HUV records is no later than Z0350. Date

Assessment was Completed + 30 calendar days.

The submission deadline for the Discharge record is no later than the

Discharge Date + 30 calendar days.

4 “Hospice Care.” 42 CFR 418.24 (2011).

5 Centers for Medicare & Medicaid Services. Medicare Claims Processing Manual.

3.3.1. Completion Timing

Clinician in-person visits for HOPE timepoints should be completed within the assessment timeframes outlined

in Chapter 1 (Table 1).

The following completion goals are the latest possible dates that providers are encouraged to complete HOPE

records. Note that the Completion Date (Z0500B., the actual date on which the hospice completed the record)

may occur later than the date the patient was assessed by the clinician (Z0350) because some HOPE data

elements can be extracted from the patient record after the assessment date but prior to submission:

• For Admission records (A0250 = 1), the Completion Goal is no later than Admission Date + 14 calendar

days. Therefore, Z0500B (Completion Date) minus A0220 (Admission Date) is recommended to be less

than or equal to 14 days.

• For HOPE Update Visit (HUV) records (A0250 = 2 or 3), the Completion Goal is no later than Z0350.

Date Assessment was Completed + 14 calendar days. Therefore, Z0500B (Completion Date) minus

Z0350 is recommended to be less than or equal to 14 days.

• For Discharge records (A0250 = 9), the Completion Goal is no later than the Discharge Date + seven

calendar days. Therefore, Z0500B (Completion Date) minus A0270 (Discharge Date) is recommended

to be less than or equal to seven days.

The completion goals outlined above are CMS guidance only. Compliance with completion goals is not

considered in APU determinations. Although it is at the discretion of the hospice to develop internal policies for

completing HOPE records, CMS continues to recommend that providers complete and attempt to submit HOPE

records early, prior to the submission deadline of 30 days. This allows ample time to address any technical

issues encountered in the submission process, such as correcting fatal errors. Although a hospice may complete

and submit a HOPE record prior to the completion goal/deadline, the data reported in HOPE must accurately

reflect the patient’s status at the time the data was collected during the clinician’s visit.

Completion timing policies above do not outline the timing of care processes captured by HOPE for quality

measure calculation purposes. For more information on timing for quality measure calculation purposes, please

see the HQRP QM User Manual, available in the Downloads section on the Current Measures page of the CMS

HQRP website.

3.3.2. Submission Timing

All HOPE records should be submitted and accepted electronically within 30 days of completion as specified:

• For Admission records (A0250 = 1), the submission date may be no later than 30 days from the

Admission Date (A0220). Therefore, the submission date minus the Admission Date (A0220) should be

less than or equal to 30 days.

• For HOPE Update Visit (HUV) records (A0250 = 2 or 3), the submission date may be no later than 30

days from the Date Assessment was Completed (Z0350). Therefore, the submission date minus the

Date Assessment was Completed (Z0350) should be less than or equal to 30 days.

• For Discharge records (A0250 = 9), the submission date may be no later than 30 days from the

Discharge Date (A0270). Therefore, the submission date minus the Discharge Date (A0270) should be

less than or equal to 30 days.

• See Figure 9 for a summary of submission deadlines.

Figure 9: Submission Deadlines

The table below outlines one patient example with an Admission Date of November 11 and Discharge Date of

December 22, 2025. Each assessment timeframe, record completion goal, and record submission deadline is

depicted. See Table 11 below.

Table 11: HOPE Completion and Submission Timing Example

HOPE

Timepoint

Date Assessment

Timeframe

Record

Completion

Goal

(Recommended)

Record

Submission

Deadline

Admission Admission Date

(A0220) =

11/11/2025

No later than

11/16/2025 (within

five days of

Admission Date)

No later than

11/25/2025 (within

14 days of

Admission Date)

No later than

12/11/2025 (within

30 days of

Admission Date)

HOPE Update HUV1 Date On or between day No later than No later than

Visit 1 (HUV1) Assessment was

Completed

(Z0350) =

11/24/2025

six and day 15

(should not occur

within the first five

days after the date

of hospice

election)

12/08/2025 (within

14 days of HUV1

Date)

12/24/2025 (within

30 days of the Date

Assessment was

Completed

(Z0350) for

HUV1)

HUV2 HUV2 Date

Assessment was

Completed

(Z0350) =

12/10/2025

On or between day

16 and day 30

No later than

12/24/2025 (within

14 days of HUV2

Date)

No later than

01/09/2026 (within

30 days of the Date

Assessment was

Completed

(Z0350) for

HUV2)

Discharge

Assessment

Discharge Date

(A0270) =

12/22/2025

Completed at the

time of discharge

No later than

12/29/2025 (within

seven days of

Discharge Date)

No later than

01/21/2026 (within

30 days of

Discharge Date)

3.3.3. Submission Sequence

The submission system will issue a warning on the FVR when a HOPE record is submitted out of sequence.

Examples include the following:

• Submission of an Admission record where the prior record submitted was also an Admission record and

there was no Discharge record submitted in between.

• An Admission record submitted for a patient after the submission of a Discharge record indicating that

the patient has expired (A2115 = 1).

• Submission of a HUV record before an Admission record.

• Submission of HUV2 before HUV1.

• A Discharge record where the Discharge Date (A0270) minus Admisison Date (A0220) indicates that an

HUV1 or HUV2 record should be the prior record.

Admission and Discharge records may be completed and submitted on the same day when situations arise that

warrant this; for example, when a patient is admitted and discharged or dies on the same day.