HOPE Implementation: From Regulatory Requirement to Strategic Advantage

The upcoming launch of the Hospice Outcomes and Patient Evaluation (HOPE) assessment tool marks a significant shift for hospices—going beyond mere regulatory compliance.  Starting October 1, 2025, HOPE will officially replace HIS, requiring all hospices to submit HOPE Admission, Update, and Discharge records via iQIES. For clinical teams and leadership focused on compliance, operations, and quality, HOPE represents both a regulatory requirement and a strategic opportunity.  

With proper planning and the right technology, HOPE offers more than just compliance with CMS standards. It provides an opportunity to enhance care quality, improve reporting efficiency, and strengthen your agency's position in the era of value-based reimbursement. 

Here’s what leaders should be reviewing right now.

1. Meet with Your EMR Vendor

If you haven’t already scheduled a conversation with your EMR provider, now’s the time. Ask specifically how your system will support: 

• Updated Item Set Mapping: Transitioning from HIS v3.00 to HOPE v1.01 introduces major changes, such as replacing “Gender” with “Sex,” splitting race and ethnicity into separate data elements, and adding new requirements for payer sources, living arrangements, and caregiver availability. 

• HOPE Technical Data Specs: The submission process is XML-based and highly structured. Each HOPE record must map correctly to the Item Subset Codes (HA for admission, HUV for update, HD for discharge). Missing or mismatched data can trigger fatal errors. 

• Guidance Manual Updates: Clarifications in v1.01 include new language for Symptom Follow-Up Visits, adjustments to compliance criteria, and corrected skip patterns. 

The key question: Can your EMR accurately capture, validate, and transmit every HOPE field without manual workarounds?

2. Know What to Look For

Surveyors expect accurate, transparent, and defensible documentation. That means your system should provide: 

• Accurate Data Fields aligned with the full HOPE All Items Form, which now includes expanded sections on symptoms, life-sustaining treatment preferences, and caregiver availability. 

• Real-Time Reporting and Audit Trails that mirror the surveyor’s view so you can proactively address gaps. 

• Change Table Awareness so your team knows exactly what’s different compared to HIS. For example, discharge reason codes were simplified while symptom impact and follow-up visit items were added for the first time. 

Ask your vendor to walk you through a live demo of how each of these requirements are addressed.

3. Understand the Full Scope of the Assessment

The HOPE All Items form is comprehensive, spanning 14 sections that cover everything from administrative identifiers and payer information to spiritual concerns, skin conditions, opioid use, and symptom management. 

For many agencies, the biggest surprise is how much new content has been added compared to HIS. Examples include: 

• Symptom Impact (J2051) which requires assessing how pain, anxiety, and other symptoms affect patients’ daily life. 

• Skin Condition Assessments (M1190, M1195, M1200) which add detailed documentation of ulcers, wounds, and treatments. 

• Neuropathic Pain (J0915) which is now a required element. 

Getting familiar with the structure of HOPE now will help prevent gaps or errors in submissions later. The HOPE Validation Utility Tool (VUT) is now available for vendor testing. CMS will release more updates by email, including training schedules, onboarding timelines, and what to expect next. Keep an eye out for those announcements and make sure your quality and IT leads are subscribed.

4. Assess Your Readiness at Every Step

QAPIplus has created a HOPE Implementation Timeline and Status Tracker to simplify this process. This practical tool breaks down every milestone, from reviewing CMS guidance and adapting workflows to piloting visits and submitting test files, and allows leaders to mark what’s in place, in progress, or pending leadership support. 

This resource ensures nothing slips through the cracks and gives leadership visibility into where additional support is needed. 

Turning HOPE Into Your Plus 

At QAPIplus, we know compliance should not feel like chaos. Our platform is CHAP Verified and ACHC Certified, built by clinicians for home health and hospice, and designed to: 

• Automate quality and compliance workflows so your staff can focus on patients, not paperwork 

• Provide surveyor-ready dashboards that mirror CMS expectations 

• Support HOPE reporting and beyond, with modules for QAPI, Infection Control, Emergency Management, and HR credentialing 

• Offer PSO membership protections, giving legal safeguards for patient safety data and benchmarking across peers 

With QAPIplus, HOPE implementation is not just about passing a survey. It is about creating a culture of continuous improvement where every feature is a plus for your team, your patients, and your bottom line. 

Next Step: If you haven’t yet connected with your EMR vendor or if you need help optimizing your system for HOPE reporting, reach out today. Our team at QAPIplus is here to help you simplify your submission process, protect your compliance, and empower your clinicians.