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Three HOPE record types and when each is required
The three HOPE assessment types: Admission completed within 5 days of start of care, Update Visits (HUV1 on days 6–15 and HUV2 on days 16–30), and Discharge at end of the benefit period, each with its own submission window and item set.
These are the three record types in the HOPE assessment: the HOPE Admission captures the patient at start of care, the HOPE Update Visits (HUVs) capture the patient at fixed points during the first 30 days, and the HOPE Discharge captures the patient at end of the hospice episode (HOPE Guidance Manual v1.02)[1]. The Update Visit is the structural change from HIS, which had no mid-stay timepoint.
The HOPE Admission must be completed within 5 days of the hospice admission date and establishes the baseline clinical picture (HOPE Guidance Manual v1.02)[1]. HUV1 is completed between days 6 and 15 and cannot be done within the first 5 days; HUV2 is completed between days 16 and 30 (CMS HOPE page)[2]. Whether a HUV is required depends on how long the patient remains on service: a patient discharged before the HUV window opens does not generate that HUV record. The HOPE Discharge is completed when the patient dies or is discharged. Each timepoint carries its own item requirements, and not every HOPE item is collected at every timepoint (HOPE Guidance Manual v1.02)[1]. Across any timepoint, a symptom rated moderate or severe triggers a Symptom Follow-Up Visit within 2 calendar days (CMS HOPE page)[2]. Findings at admission, at an HUV, or at an SFV commonly drive Plan of Care Update Triggers, since a new or worsening symptom identified on a HOPE assessment should be reflected in the interdisciplinary plan of care.
The distinction matters because each record type has a different completion deadline and a different failure mode. The HUVs are the highest operational risk: they require a real, timed visit inside a narrow day range that many agencies never scheduled under HIS. Missing an HUV window is not recoverable after the fact; the compliance mechanism requires day 6 and day 16 to be tracked for every active patient, not just at admission and discharge. The day-6-to-15 and day-16-to-30 windows are the records most likely to slip past the timeliness threshold, because they require scheduling a real visit inside a narrow day range that most agencies did not track under HIS.
The Admission is a one-time baseline completed within 5 days of start of care, while an Update Visit is a timed reassessment completed at days 6–15 (HUV1) or days 16–30 (HUV2) to capture changes during the first month on service (CMS HOPE page)[2].
No. The number of HUVs depends on length of stay; a patient discharged before a given HUV window opens does not generate that record (HOPE Guidance Manual v1.02)[1].
No. HUV1 must fall between days 6 and 15 and cannot be completed within the first 5 days after admission (CMS HOPE page)[2].
A symptom or change identified on a HOPE Admission, HUV, or Symptom Follow-Up Visit should feed the interdisciplinary plan of care, which is why HOPE timepoints are common Plan of Care Update Triggers.
Vitalis Care is the end-of-life care app that helps hospices deliver compassionate care — while staying on top of schedules, field operations, documentation, compliance, and reimbursement.
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