US · guidance
HOPE Guidance Manual v1.02, Item J2050
Symptom Impact Screening
Timepoint(s) Item Completed
Admission (ADM)
HOPE Update Visit 1 (HUV1)
HOPE Update Visit 2 (HUV2)
Item-Specific Instructions
• Review all response choices before making a selection.
• Item completion should be based on what is determined during the
assessment visit and/or included in the clinical record. Do not use
sources external to the clinical record.
A. Was a symptom impact screening completed?
• Code 0, No, if the patient was not screened for symptom impact
and Skip to Item M1190, Skin Conditions.
• Code 1, Yes, if the patient was screened for symptom impact.
B. Date of symptom impact screening
• Enter the date of the symptom impact screening was performed.
DEFINITION
SYMPTOM IMPACT
The effect of
symptom(s) on the
patient. Symptoms may
impact a patient in
multiple ways, (e.g.,
sleep, concentration,
day to day activities).
History
HOPE Guidance Manual v1.02, effective October 1, 2025 (OMB control number 0938-1153).
Provenance
- Source
- cms.gov
- Retrieved
- 2026-09-17
- Edition
- hope-v1.02
- Content hash
96748c085b7d630b39b231039101f6ed99d3975b347883e8ee9530f58c4fecfe
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