Support

1. Purpose of this Guide

This guide explains how to manage the HOPE Tool inside HospiceWorks, including:

• Completing the HOPE Admission, HUV-1, HUV-2, and Discharge forms

• Managing Symptom Follow-Up Visits (SFV)

• Using the HOPE dashboards (hospice-level and patient-level)

• Validating and exporting XML files

• Uploading HOPE files to IQIES

• Handling validation errors and re-opening records

It is intended for RNs, LVNs/LPNs, QA staff, and billing/admin team members who support HOPE workflows.

2. Key Concepts & Terms

• HOPE Admission Assessment – Initial HOPE assessment at admission.

• HUV-1 – First HOPE Update Visit (HB) assessment (Day 6–15 window).

• HUV-2 – Second HOPE Update Visit (Day 16–30 window).

• SFV (Symptom Follow-Up Visit) – Follow-up visit required within 2 calendar days when certain symptom-impact items are rated moderate (2) or higher.

• HOPE Discharge – Assessment required at discharge (death or live discharge).

• IQIES – CMS electronic portal to upload HOPE XML submission.

• Z0400 – Section on HOPE form identifying the clinician (RN) completing the assessment.

• Z0500 – Section on HOPE form identifying the record completion metadata (name, date) for upload.

Statuses in the HOPE Dashboard:

• Pending – Form started, not yet validated.

• Validated – Passed validation, ready for export.

• Completed – All required HOPE fields (including Z0400 & Z0500) are filled; export may occur even if e-signature not yet done.

• Exported – The XML file has been generated/downloaded and may be uploaded to IQIES.

 Key Upload Workflow Point:
A HOPE record that is fully completed with Z0400 and Z0500 and validated can be downloaded as a single XML file and uploaded to IQIES — even if it hasn’t been e-signed in HospiceWorks. The recommended workflow:

1. Ensure Z0400 & Z0500 are fully completed

2. Run the validation tool & clear errors

3. Download the XML from the validated record

4. Upload that XML to IQIES

3. HOPE Timelines at a Glance

Submission Requirement: HOPE records must be submitted to CMS within 30 days of the admission date.

Timepoint Breakdown:

4. Local Folder Setup for HOPE XML Files

On the workstation used for validation and uploads, create the following folder structure:

• HOPE\Assessment

• HOPE\HUV1

• HOPE\HUV2

• HOPE\Discharge

Save downloaded XML files into the appropriate folders:

• Admission → HOPE\Assessment

• HUV-1 → HOPE\HUV1

• HUV-2 → HOPE\HUV2

• Discharge → HOPE\Discharge

This structure promotes consistency and audit readiness.

5. HOPE Dashboards in HospiceWorks

5.1 Hospice-Level HOPE Dashboard

Navigation: HospiceWorks → Hospice → HOPE Dashboard (just under HIS)

This dashboard displays:

• Total counts of Admissions, HUV-1, HUV-2, Discharges

• Statuses: Pending, Validated, Completed, Overdue

• Filters to view records by status

• Batch export capability — enables exporting multiple records at once for upload

5.2 Patient-Level HOPE Dashboard

Inside the patient record, a HOPE icon (small laptop) appears. From this view you can:

• See status of that patient’s HOPE assessments (Admission, HUV-1, HUV-2, Discharge)

• Open or initiate the HOPE form directly

• Start from a Nurse Visit Note → click the icon → launch HOPE assessment

6. Completing the HOPE Admission Assessment

6.1 Initiating the Admission Assessment

1. Admit the patient in HospiceWorks.

2. Complete the Initial Nursing Assessment (INA).

3. Launch the HOPE Admission form via the HOPE icon or patient HOPE section.

Many administrative fields will auto-populate (from referral, eligibility, INA). Any missing required fields will show “Intervention Required.”

6.2 Symptom Impact & SFV Trigger Logic

In the Symptom Impact section:

• 0 = None

• 1 = Slight

• 2 = Moderate

• 3 = Severe

• 4 = Very Severe

If any symptom impact item is scored 2 (moderate), 3 (severe), or 4 (very severe) →
a Symptom Follow-Up Visit (SFV) must be scheduled and completed within 2 calendar days of the assessment.

6.3 SFV Workflow

1. Schedule a Nurse Visit in the Calendar within 2 days of triggering assessment.

2. In the visit, mark “Is this a Symptom Follow-Up Visit?” → Yes.

3. Complete the SFV section during the visit note (must be separate from the assessment visit).

4. Upon signing, the SFV data will automatically flow back into the HOPE assessment form.

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6.4 Completing Z0400 & Z0500

At the bottom of the HOPE Admission form:

• Z0400 (Clinician) – Must be completed by the RN/practitioner.

• Z0500 (Record Completion) – Person (Administrative/Office) completing the record & date.

  • The record completion date must be on or after any SFV date (if an SFV was required).

• Once Z0400 & Z0500 are completed and validation is passed, the record is eligible for export/upload.

7. HUV-1 (Day 6–15)

1. If the patient remains on service Day 6–15: open HUV-1 via the HOPE icon.

2. Form structure is essentially the same as the Admission HOPE (Symptom Impact logic, SFV trigger applies).

3. Complete Z0400 & Z0500.

4. Validate and download XML for upload.

8. HUV-2 (Day 16–30)

1. If the patient remains on service Day 16–30: open HUV-2.

2. Same form logic applies (including SFV triggers).

3. Complete Z0400 & Z0500, validate, download XML for upload.

9. HOPE Discharge

1. At time of discharge (expired, revoked benefit, transferred, etc.): open HOPE Discharge.

2. The Discharge form is shorter; collects reason for discharge and minimal additional items.

3. Complete required items, validate, download XML, upload to IQIES.

10. Validation & XML Export

10.1 Validating a HOPE Record

From within any HOPE form:

1. Ensure Z0400 & Z0500 completed.

2. Use the Validation HOPE Assessment Tool section → click Validate HOPE Assessment.

3. Download XML file and save it in the appropriate folder.

4. Use the external validation tool (via HospiceWorks link) to upload and confirm:

   • “Record Accepted” → proceed

   • “Record Rejected” → correct fatal errors before upload

10.2 Status Workflow: Pending → Validated → Completed → Exported

• Pending – form still in progress

• After validation and Z-sections complete → mark Validated

• The record is functionally completed for upload (even without e-signature)

• Download/Export XML → status becomes Exported

11. Uploading to IQIES

1. Log into IQIES portal.

2. Navigate to HOPE file upload section.

3. Browse to your local folder and select appropriate XML files.

4. Upload; IQIES returns status – accepted or rejected.

5. It is best practice to upload at least weekly or twice per month once workflow is stable, ensuring you stay within the 30-day submission window.

12. Error Handling & Re-Opened Records

12.1 Fatal Errors vs Warnings

• Fatal Errors (record rejected) — must be corrected.

• Warnings — acceptable but may highlight quality/timeliness issues.

12.2 Correction Workflow

If a record is signed and submitted but you need to correct:

• Use the URL link of that HOPE document to request it be reopened.

• Once reopened, correct, re-validate, re-export, and re-upload.

13. Early Discharges & Special Situations

According to CMS guidance:

• “An Admission and Discharge record must be completed for each hospice admission. … Depending on the patient’s length of stay (LOS), up to two HUV records may be required for every hospice admission.”

• “HUV1 is required … if the patient remains on service between days 6 and 15. HUV2 is required … if the patient remains on service between days 16 and 30.”

In practical terms:
If a patient is admitted and discharged early (for example Day 7):

• HUV-1 may not yet be due (patient discharged before Day 15)

• HUV-2 will not apply (patient discharged before Day 30)

• A HOPE Discharge record is still required

• Not all in-month HOPE forms (HUV-1/HUV-2) will be present when discharge occurs before their windows apply