HOPE Guidance Manual v1.02, Item F2000

Timepoint(s) Item Completed

Admission (ADM)

Item-Specific Instructions

• Item completion should be based on what is included in the clinical record.

• Review the clinical record for information regarding discussion of patient preference for

cardiopulmonary resuscitation (CPR).

• Consider care processes and discussions documented in the clinical record that took place during preadmission or educational visits, as well as those during the admission assessment.

• Review all response choices before making a selection.

• Use the date on which the discussion first occurred.

A. Was the patient/responsible party asked about preference regarding the use of CPR?

• Code 0, No, if there is no documentation that the hospice discussed (or attempted to discuss)

preference regarding the use of CPR with the patient or responsible party. Skip to Item F2100, Other

Life-Sustaining Treatment Preferences.

o This applies to situations where there is no documentation that a discussion occurred or was

attempted with the patient or responsible party. This could happen if the patient was unable to

discuss and/or the responsible party was unavailable.

• Code 1, Yes, and discussion occurred, if there is documentation that the hospice discussed

preference regarding the use of CPR with the patient or responsible party.

o This applies to situations where there is documentation that the hospice brought up the topic of CPR

use, engaged, and/or had a conversation with the patient, the responsible party, or both. The

conversation does not have to result in the patient stating a preference for or against the use of CPR.

• Code 2, Yes, but the patient/responsible party refused to discuss, if there is documentation

that the hospice asked about preference regarding the use of CPR, but the patient or responsible party

refused to discuss or was unable to discuss. The hospice was not successful in engaging the patient

and/or responsible party in a discussion.

o This applies to situations where there is documentation that the hospice attempted to have a

conversation with the patient and responsible party, but both the patient and responsible party

explicitly refused to discuss the topic with the hospice (e.g., “I don’t want to talk about this”) or the

patient was unable to discuss because of their clinical status and the responsible party explicitly

refused to discuss.

B. Date the patient/responsible party was first asked about preference regarding the use of

CPR.

• Enter the date the hospice first discussed (or attempted to discuss) patient preference regarding the use

of CPR.

• Multiple discussions regarding the use of CPR may be documented in the clinical record.

• Completion of this item is based on the first dated discussion about preference regarding the use of CPR

that appears in the clinical record.

Coding Tips

• Documented evidence of a discussion or attempted discussion may be located in the clinical record or

via a Do Not Resuscitate (DNR) order, POLST order, or the equivalent.

• A newly completed order or form that is completed after the admission to hospice or during a

preadmission visit is sufficient provided there is evidence of involvement from the patient/responsible

party (e.g., signature of the patient/ responsible party, or documentation that DNR preference was

confirmed with patient/responsible party).

• Orders alone or short statements in the clinical record, such as “DNR/DNI” or “full code,” without

evidence of discussion or involvement from the patient/responsible party, are not sufficient to code

“Yes” for F2000A.

• For pre-existing orders or forms signed in a prior care setting, the hospice should re-affirm the patient’s

preferences and document them in the clinical record.

Examples

1. Patient admitted on 11-05-2025. Clinical note dated 11-05-2025 shows, “talked with the patient about

preference for CPR; patient states they are not sure. Requests time to think and wants to discuss later.”

Clinical note dated 11-10-2025 shows, “discussed patient’s preference for CPR; patient stated

preference for DNR. DNR order signed and in the clinical record.”

Coding: F2000A, Was the patient/responsible party asked about preference regarding the use of

cardiopulmonary resuscitation (CPR)? would be coded 1, Yes, and discussion occurred. F2000B, Date

the patient/responsible party was first asked about preference regarding the use of CPR, would be coded

“11-05-2025.”

Rationale: Although the patient later stated a preference regarding DNR, coding should be completed

based on the first dated discussion. Although a clear preference was not expressed, a discussion did

occur.

2. Patient admitted 11-01-2025. The clinical record for the patient includes a DNR order, signed in the

prior care setting, which is dated 10-15-2025. There is no discussion documented in the clinical record

on this topic.

Coding: F2000A, Was the patient/responsible party asked about preference regarding the use of

cardiopulmonary resuscitation (CPR)? would be coded 0, No” Skip to Item F2100, Other Life-Sustaining Treatment Preferences.

Rationale: Although the patient has a recently dated DNR order, it was signed in a prior care setting.

There is no documentation in the clinical record to indicate that the hospice re-confirmed the patient’s

preferences. If a statement such as “DNR order confirmed with the responsible party, patient’s daughter”

was included, that would be sufficient to code 1, Yes, and discussion occurred.