HOPE Guidance Manual v1.02, Item A1010

Timepoint(s) Item Completed

Admission (ADM)

Item-Specific Instructions

• Ask the patient to select the category or categories that most closely correspond to the patient’s race

from the list in A1010.

• Respondents should be offered the option of selecting one or more categories.

• If a patient is unable to respond, the assessor may ask a caregiver and/or responsible party.

• Only use medical record documentation to code A1010, Race if the patient is unable to respond and no

caregiver and/or responsible party provides a response for this item.

• If the patient declines to respond, code Y, Patient declines to respond, and do not code based on

responses from a caregiver and/or responsible party or medical record documentation.

• If the patient can provide a response, check the box(es) indicating the race category or categories

identified by the patient.

• Complete as close to the time of admission as possible.

• Code X, Patient unable to respond, if the patient is unable to respond.

o In the cases where the patient is unable to respond, and the response is from a caregiver and/or

responsible party, check all boxes that apply, including “X, Patient unable to respond.”

o If the patient is unable to respond and no other resources (a caregiver and/or responsible party or

medical record documentation) provided the necessary information, code “X, Patient” unable to

respond.

• Code Y, Patient declines to respond, if the patient declines to respond.

o When the patient declines to respond, code only “Y, Patient declines to respond.”

o When the patient declines to respond do not code based on responses from a caregiver and/or

responsible party or medical record documentation.

• Code Z, None of the above, if the patient reports or it is determined from a caregiver and/or

responsible party, or medical record documentation that none of the listed races apply.

Coding Tips

• Standardizing self-reported data collection for race allows for the comparison of data within and across

multiple healthcare settings and is an important step in improving quality of care and health outcomes.

• These categories are NOT used to determine eligibility for participation in any Federal program.

Examples

1. The patient has severe dementia with agitation. During the admission assessment they are unable to

provide their race. Their family member informs the nurse that the patient is Korean and African

American.

Coding: A1010 would be coded as “B, Black or African American,” “H, Korean,” and

“X, Patient unable to respond.”

Rationale: If a patient is unable to respond but a caregiver and/or responsible party provides the

response, code both the response from the caregiver and/or responsible party and “X, Patient unable to

respond.”

2. The patient declines to provide their race during the admission assessment stating, “I’d rather not

answer.”

Coding: A1010, Race would be coded as “Y, Patient declines to respond.”

Rationale: If a patient declines to respond to this item, then code only “Y, Patient declines to respond.”

Do not make attempts to code A1010 when a patient declines to respond based on responses from a

caregiver and/or responsible party or medical record documentation.