As regulatory changes reshape hospice care, understanding how to adapt is essential.
Laura Barnett, Vice President of External Affairs at Axxess, moderated a webinar focused on the upcoming implementation of the Hospice Outcomes and Patient Evaluation (HOPE) assessment tool and its implications for hospice professionals.
Amy Rose, Senior Product Director, and Karen Chamberlain, Product Manager, both at Axxess, discussed strategies to help organizations stay compliant, efficient and centered on compassionate care.
Understanding HOPE
Set to take effect on October 1, 2025, HOPE will introduce new regulatory expectations for hospice organizations, including symptom impact screenings and time-bound follow-up visits.
These changes are designed to enhance quality and standardization, but they also bring new clinical and administrative challenges.
“They [organizations] will be capturing information in the assessment that looks very similar to the Hospice Item Set (HIS), with the addition of about seven to nine new questions,” Rose said.
If a patient reports moderate or severe symptoms, clinicians are now required to conduct an in-person follow-up within 48 hours, even if their prior assessment may have suggested a longer wait was acceptable.
Leverage Technology to Streamline Compliance
To manage the complexity of HOPE requirements, both speakers emphasized the role of technology and centralized visibility.
“One of the most practical ways to streamline operations is to have a centralized location where staff can see the entire census, patient assessments and their HOPE records,” Chamberlain said.
Rose added that digital tools should be intuitive and built around clinicians’ workflows. She introduced the concept of “forced functions,” which guide staff through required steps without pulling them away from patient care.
Align Quality With Compassionate Care
HOPE isn’t just about compliance. It’s about improving patient outcomes and making care more consistent.
Rose encouraged organizations to track internal measures like the frequency of daily visits in the final days of life, even if they’re not required by the Centers for Medicare and Medicaid Services (CMS).
“This is just good quality care,” Rose said. “This is something that I’m hoping every hospice nurse is already doing.”
Chamberlain emphasized that integrating HOPE questions into standardized processes can eliminate gaps and improve the experience for both patients and families.
“When HOPE questions are built into standardized processes, every clinician is capturing the same critical data, and patients experience fewer gaps in care,” Chamberlain explained.
Use of Nursing Staff
A key concern discussed was staffing and role optimization.
Although licensed practical nurses (LPNs) and licensed vocational nurses (LVNs) cannot perform HOPE Update Visits (HUVs), they can play a critical role in conducting symptom follow-ups.
“Really being able to counter-leverage those LPNs in unique ways, being aware of their limitations, but also their value is essential,” Rose expressed.
Prepare for HOPE
Rose and Chamberlain encouraged organizations to do the following as they prepare for HOPE:
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Conduct an internal assessment of current practices.
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Align workflows with the 30-day quality data reporting window.
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Ensure teams are trained and equipped for early and frequent assessments.
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Use automation, centralized dashboards, and electronic medical record (EMR) integration to minimize risk and ensure compliance.
HOPE gives organizations the opportunity to improve quality, increase visibility, and provide more consistent care throughout the hospice continuum.
To learn more about how your organization can prepare for HOPE, visit our HOPE resource page here.
