May 18 2026
OASIS Answers
Categories: HOPE

Making Sense of the SFV, HUV, and HUV Assessment Timeframes

by Kerry Termine, DPT, HCS-D, COS-C, CHS-C

HOPE Guidance References

Current CMS HOPE guidance from the HOPE Guidance Manual (v1.02) Section 1.3.3. Symptom Follow-up Visit (SFV) states:

The SFV is an in-person visit expected within two calendar days as a follow-up for any pain or non-pain symptom impact rated as moderate or severe on J2051 – Symptom Impact.
The SFV must be a separate visit from the Admission or HUV.
Depending upon timing and responses to J2051 – Symptom Impact at Admission, or either of the two HUV timepoints, the SFV could stretch beyond the applicable assessment timeframe.

In reference to the HUV assessment timeframes, the HOPE Guidance Manual (v1.02) Section 1.3.2. HUV Timepoints states:

HUV1 should be conducted on or between days six and 15, but not within the first five days after the date of admission (A0220 – Admission Date).
HUV2 should be conducted on or between days 16 and 30.
The date of the hospice election would be considered “Day 0.”
Additionally, there is an Item-Specific Instruction for Z0350 – Date Assessment was Completed that specifically states that “In situations where there is an SFV, this date may extend beyond the HUV assessment timeframes.”

SFV Scenario

So how would an SFV extend beyond the assessment timeframe for an HUV timepoint? Look at this example:

On April 1, 2026 (Day 0), a RN completes a HOPE Admission
- A0220 – Admission Date = 04/01/2206
On April 16, 2026 (Day 15) a hospice RN begins a HUV assessment.
- J2051 – Symptom Impact indicates the patient is being severely impacted by their pain (J2051A – Symptom Impact; Pain = 3 – Severe)
On April 17, 2026 (Day 16) an LPN from the hospice conducts an in-person SFV
- J2052 – Symptom Follow-up Visit (SFV) and J2053 – SFV Symptom Impact are both assessed and shared with the RN per the hospice’s policies for completing an SFV at a HUV1 timepoint.
On April 17, 2026 (Day 16) the RN, who saw the patient on April 16, 2026, documents and completes the HUV assessment.
- Z0350 – Date Assessment was Completed = April 17, 2026

Interpretation of Guidance for this Scenario

An SFV should be conducted within two calendar days as a follow-up for any moderate or severe pain or non-pain symptom impact identified during an Admission or HUV timepoint. Based on the timing of the HUV1 (on or between days 6 and 15) and the results for J2051 – Symptom Impact, the date of the SFV could stretch beyond the assessment timeframe. In this situation, Z0350 – Date Assessment was Completed for this HUV1 would be when the SFV was conducted, which was two days after the HUV2 timeframe.

For more information on HOPE Guidance, the HOPE in Action Training for Hospice providers focuses on the essential elements that drive HOPE accuracy, compliance, and confidence.

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