What is HUV? Hospice Update Visit windows explained

HUV1 and HUV2 are the two mid-stay HOPE observation windows CMS requires between the admission and discharge HOPE assessments. They exist so the quality-reporting dataset reflects a hospice course, not just its endpoints.

By Goodwin Hospice Academy Editorial Team· Published February 16, 2026·Last reviewed February 16, 2026· 5 min read

HUV, in one sentence

HUV stands for "HOPE Update Visit." HUV1 is completed between days 6 and 15 of the hospice election; HUV2 is completed between days 16 and 30. Both use a targeted subset of the HOPE item set and were introduced when HOPE replaced HIS.

What HUV items cover

HUV items focus on domains most likely to change over the first month of hospice — pain, dyspnea, symptom-management follow-through, and functional status. The exact item list is defined in the CMS HOPE Guidance Manual.

Who completes HUV

HUV items are typically completed by the case-managing RN during a home visit that falls in the observation window. Your hospice policy should specify which discipline collects each item.

Why HUV matters

Missing an HUV record is a late record; late records drag your HQRP compliance percentage below the annual threshold and can trigger a 4-percentage-point reduction to the Hospice Wage Index for the following fiscal year.

Frequently asked questions

Is HUV completed on every patient?

On every patient who remains on hospice during the corresponding observation window. Patients discharged before day 6 do not require HUV1; patients discharged before day 16 do not require HUV2.

Are HUV items the same as admission HOPE items?

No. HUV items are a targeted subset focused on domains most likely to change over the first month.

What if I miss the window by one day?

The record is late. Submit it anyway; late records still count toward the submission but affect the HQRP compliance-percentage.

Sources & further reading

Educational content only. Not a substitute for your organization’s policies, your medical director’s clinical judgment, or current CMS guidance.

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