In the last week of April, a new version of the Guidance Manual for completing the HOPE tool was released, along with an updated version of the HOPE itself. That manual includes several updates, a few of which we are sharing with you today. These updates come as HOPE is scheduled to take effect on October 1, 2025, making it essential to stay informed and prepared for the upcoming changes.
One important update is the revision of an item on the HOPE. The item previously labeled A0800, “Gender,” has been changed to A0810, now labeled “Sex.” The value entered must align with the Social Security record of the patient. This adjustment was made to ensure consistency with documentation used in other post-acute care settings.
Another update provided clarification on the transition process, specifically regarding which type of assessment should be completed and when—depending on the patient’s admission, discharge, or death—especially when these events occur around the transition period into October 1.
The guidance states that if a patient is discharged on or before September 30, only the HIS documents need to be completed. If the patient is admitted prior to October 1, but discharged after October 1 then there will be a combination of HIS and HOPE. For example, if a patient is admitted on September 15, the admission would be documented using the HIS. However, if the patient is not discharged or does not pass away until after October, the discharge would be documented using the HOPE. With the HOPE, unlike the HIS, there are update or follow-up visits that take place within the first 30 days of care. However, these follow-up visits do not apply if the patient was admitted using the HIS. As in this example, no update or symptom follow-up visits are necessary. Patients admitted on or after October 1 will be fully managed under the HOPE.
With the HOPE, unlike the HIS, there are update or follow-up visits that take place within the first 30 days of care. However, these follow-up visits do not apply if the patient was admitted using the HIS. If a patient is admitted before October 1, a HIS admission document will be completed, and if that patient is discharged after October 1, a HOPE discharge will be required. In this case, no update or symptom follow-up visits are necessary. Patients admitted on or after October 1 will be fully managed under the HOPE.
The guidance manual includes numerous updates to the wording of instructions for completing specific items. It also offers new examples that were not previously included and provides more detailed information on symptom follow-up visits. It’s important to ensure that any training you have given or plan to give to your staff is based on the most current version of the manual released in April 2025.
Additionally, there are a few concerns being echoed nationwide—one of the main ones being the required transition from the current QIES system to iQIES before the HOPE implementation on October 1. As of now, no detailed guidance has been provided on how this transition to iQIES will take place.
In addition, specific software is required within your EMR system to extract the HOPE Detail Report for transmission to iQIES. That supplemental application has not yet been finalized, which is causing some concern. It’s important to note that, for Hospice Quality Reporting Program compliance, at least 90% of HOPE documents for the fourth quarter—covering October 1 through December 31—must be submitted on time, which means within 30 days of completion.
What’s really being discussed now is that many are requesting a delay in the implementation of HOPE. While it’s unlikely that the actual implementation date will be postponed, there is hope that CMS might delay applying the HOPE results to the Hospice Quality Reporting Program for compliance purposes—specifically in determining whether providers will face a 4% penalty in future reimbursement.
At this time, the fourth quarter is still set to be included in the Hospice Quality Reporting Program. However, if you are invited to engage in any advocacy efforts, be aware that these efforts may be focused on seeking a delay in the integration of HOPE into the Hospice Quality Reporting Program.
Our HPS Alliance two-day Hospice Workshop is scheduled for June 17-18, and two of the sessions at our workshop will focus specifically on completing the HOPE and reviewing the updates introduced in the April manual. To register for our 2-Day HPS Alliance Hospice Workshop, click here.
Healthcare Provider Solutions stands ready to support you with any of your HOPE-related needs. Please don’t hesitate to reach out to us.
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