hospice care · emr
Hospice EMR: Core Features and Compliance Requirements
September 15, 2025
Updated August 2, 2026
15 min read
An educational overview of hospice EMR systems, including essential features for documentation, scheduling, billing, HIPAA compliance, and the mandatory HOPE assessment tool transition effective October 2025.
Hospice agencies face unique clinical and administrative challenges as they provide end-of-life care. Specialized hospice EMR (Electronic Medical Record) systems help streamline documentation, scheduling, billing and compliance, freeing staff to focus on patients. A robust hospice EMR must satisfy industry-specific needs: it must be HIPAA-compliant under the HIPAA Privacy Rule, meet the Medicare hospice Conditions of Participation at 42 CFR Part 418, support detailed electronic charting of patient observations, and handle care-plan management while tracking advanced directives and other end-of-life documents ([1]) ([2]). Leading hospice EMRs also centralize document storage and include features like digital signatures and regulatory compliance tracking ([2]). For example, industry lists frequently cite all-in-one home care platforms (which include hospice modules) such as Alora Home Health and Netsmart myUnity – both of which market cloud-based solutions covering home health and hospice care ([3]) ([4]).
Effective October 1, 2025, CMS replaced the Hospice Item Set (HIS) with the Hospice Outcomes and Patient Evaluation (HOPE) tool. Medicare-certified hospice providers must collect and submit required HOPE records through iQIES. HOPE includes an admission record, up to two in-person Hospice Update Visits (days 6–15 and 16–30 when required by the patient’s length of stay), and a discharge record. When a moderate or severe pain or non-pain symptom impact is identified during an Admission or HUV assessment, an in-person Symptom Follow-up Visit (SFV) should occur within two calendar days. If an SFV is not completed, the hospice should record the applicable reason, such as patient or caregiver decline, patient unavailability, or unsuccessful contact attempts. Hospices must submit at least 90% of HOPE records within the applicable 30-day submission deadline to meet the timeliness requirement for the Annual Payment Update. HOPE records submitted during CY 2026 affect the FY 2028 Annual Payment Update, not the FY 2026 payment update. Separately, CMS finalized a 2.6% payment update for FY 2026 (October 2025–September 2026), with a hospice aggregate cap of $35,361.44. Hospices that do not submit required quality data receive the 2.6% update reduced by four percentage points, resulting in a payment rate 1.4% below the prior-year rate. Agencies should confirm that their system supports the current HOPE guidance and item sets. See the CMS HOPE Guidance Manual, HOPE implementation FAQs, and FY 2026 hospice final-rule fact sheet.
Key features of a hospice EMR typically include:
- HIPAA Security and Privacy Support – The hospice and applicable vendors or business associates must meet their respective HIPAA obligations for ePHI, including appropriate safeguards, access controls, and audit controls. A business associate agreement is required when a vendor creates, receives, maintains, or transmits ePHI on the hospice’s behalf.
- Electronic Charting – Comprehensive digital charting of patient visits, symptoms, and interventions, replacing paper forms ([1]). This includes notes, vitals, medication records, assessments, and bereavement documentation.
- Care Plan Management – Tools to create and update individualized care plans, schedule tasks, and coordinate multidisciplinary teams (nurses, social workers, volunteers). Many EMRs include built-in care plans tailored to hospice protocols ([1]).
- Document Storage & Workflow – A centralized repository for advance directives, POLST forms, consents, and clinician orders. Hospice EMRs enable staff to upload and retrieve documents easily across locations ([2]).
- E-Signature and Compliance Tracking – Digital signing of physician orders and patient documents, along with real-time compliance alerts. This helps meet accreditation requirements from bodies such as CHAP and ACHC, and Medicare's hospice Conditions of Participation. Since October 2025, Medicare-certified hospices must submit required HOPE records through iQIES. When selecting an EMR, agencies should verify whether it supports their desired HOPE data-collection, export, scrubbing, submission, and Symptom Follow-up Visit-tracking workflow.
These features not only improve record-keeping and reporting, but also give hospice teams more time with patients. Research indicates that specialized hospice software “enables more energy and time to be dedicated to patients” by consolidating administrative data ([5]). In practice, high-rated solutions like Alora Home Health (“all-in-one software solution” for home care) and Netsmart myUnity (a “cloud-based, clinical point-of-care system” for home health and hospice) are repeatedly mentioned as popular hospice EMR options ([3]) ([4]).
Hospice EMR Software Examples
Hospice software capabilities, regulatory-support features, pricing, and implementation support change frequently. Rather than relying on a static product ranking, obtain current written documentation and a demonstration from each vendor, then validate the product against your hospice’s workflow, privacy and security requirements, and HOPE reporting process.
1. Axxess Hospice
Axxess Hospice is a cloud-based platform designed for hospice care. It offers comprehensive electronic charting, scheduling, medication tracking (eMAR), and volunteer management. Axxess emphasizes mobile access – clinicians can document care on tablets or phones during visits. The system includes automated compliance checks (for documentation and billing rules) and integration with agencies' back-office finance systems. For the October 2025 HOPE transition, Axxess updated its platform to support HOPE assessment data collection and iQIES submission, including symptom impact screenings and time-bound follow-up visit tracking ([6]). Recent enhancements also include custom problem statements, goals and interventions for care plans, general inpatient and continuous care level management, and claim voiding for rebilling. Agencies should validate the platform's current feature set, mobile workflow, implementation support, and HOPE functionality directly with the vendor.
2. Netsmart myUnity (Home Care & Hospice)
Netsmart's myUnity Home Care & Hospice (formerly DeVero) is a cloud-based EHR platform serving home health and hospice agencies. It provides point-of-care documentation, eMAR, billing, and analytics in one system. myUnity allows clinicians to chart on mobile devices during patient visits and includes built-in libraries of forms and care plans. According to software directories, myUnity delivers an "intuitive, clinical point-of-care system" for hospice teams ([4]). In April 2025, myUnity achieved CHAP Verification for Hospice Care, with CHAP recognizing the platform's hospice symptom flow sheet, collaboration forms, secure messaging, dashboards, and assessment tools ([7]). Netsmart has also introduced AI-driven innovations including AlphaCoding (near-real-time AI coding recommendations), Smart Referrals (automated referral intake from eFaxes and handwritten forms), and SimpleConnect for Hospice (streamlined HOPE scrubbing and iQIES submission) ([8]). Agencies should validate the product's current clinical, back-office, HOPE, interface, and implementation capabilities against their own documented requirements.
3. MatrixCare Home Health & Hospice
MatrixCare offers a home-based care solution that its current product page describes as supporting hospice workflows, including point-of-care documentation, scheduling, billing, bereavement, and interdisciplinary-group tools. Its public HOPE materials describe the transition requirements, but agencies should obtain current written confirmation of the specific HOPE collection, submission, reporting, deployment, and multi-state billing capabilities they require before purchase.
4. Hospice Tools EMR
Hospice Tools offers hospice-focused EMR software. CHAP lists Hospice Tools eDocs EMR among its CHAP Verified products. This is a product verification, not provider accreditation; CHAP states that verification should not be treated as a product endorsement. Confirm current workflow, mobile, billing, bereavement, and HOPE capabilities directly with the vendor before purchase.
5. FootPrints EMR
FootPrints EMR provides a cloud-based solution aimed at small to mid-sized hospice agencies. For a HIPAA-covered hospice, using the platform requires appropriate safeguards and, if the vendor handles ePHI, a business associate agreement; a product claim alone does not establish compliance. The vendor describes functions that include clinical documentation, care plans, billing and finance, reports, volunteer services, and custom forms. Agencies should verify the product's current hospice reporting, integration, hosting, security, and HOPE-workflow capabilities before purchase.
6. Curantis (Cardinal Health Hospice Suite)
Curantis Hospice Solution is one product option to evaluate. CHAP lists it among its CHAP Verified products. Obtain current written product documentation from the vendor and validate its clinical, billing, reporting, deployment, security, and HOPE-workflow capabilities against the hospice’s requirements.
7. Hummingbird (mumms™ Software)
Hummingbird, by mumms Software, is a hospice-focused software option that the vendor describes as supporting hospice and palliative-care workflows, including documentation, interdisciplinary collaboration, medication management, billing, and HOPE readiness. Obtain current written documentation and a demonstration to verify the specific billing-audit, reporting, security, implementation, and HOPE capabilities required by the hospice.
8. Alora Home Health (with Hospice Module)
Alora Home Health is an all-in-one home care EMR that also serves hospices. It includes clinical charting, electronic drug administration records (eMAR), scheduling, and billing. The platform is fully integrated, so clinical notes flow directly into billing and compliance reports. Features such as outcome-driven care plans and performance dashboards help agencies monitor quality of care. For the HOPE transition, Alora added a Symptom Follow-Up workflow triggered directly from HOPE assessments that automatically identifies patients requiring reassessment visits and tracks their status through completion, with a dashboard widget providing real-time visibility into pending follow-ups ([9]). According to the vendor, "Alora Home Health is an all-in-one software solution that streamlines the management of home health care agencies" ([3]). Agencies should validate its current volunteer, bereavement, billing, implementation, and HOPE capabilities against their own requirements.
9. StoriiCare
StoriiCare is a care-planning and engagement platform to evaluate separately from hospice-specific EMRs. Agencies should obtain current vendor documentation and verify whether its clinical, billing, reporting, interoperability, security, and hospice-workflow capabilities meet their requirements.
10. DayCentra (DayCentre Hospice)
DayCentra (also known as DayCentre) is a software option to evaluate. Agencies should obtain current vendor documentation and verify its jurisdiction-specific regulatory, clinical, billing, deployment, security, reporting, and support capabilities before considering it.
Notable mention: WellSky Hospice & Palliative – Evaluate WellSky alongside other current options by requesting current written documentation and a demonstration of the specific clinical, billing, security, and HOPE workflows your hospice requires.
Choosing the Right Hospice EMR: Actionable Insights
Selecting an EMR for hospice requires balancing features, cost, and organizational needs. Here are some actionable tips:
- Assess Your Agency’s Workflows and Size: Define the hospice’s census, charting load, locations, interfaces, and staffing model. Ask each vendor to demonstrate how its current product handles those documented requirements.
- Evaluate Core Functionality: Make sure any system you consider includes clinical charting, care plan management, electronic medication administration (eMAR), scheduling, and billing integration. Check for hospice-specific modules (advance directives, volunteer/bereavement tracking, hospice quality metrics).
- Check Regulatory and Billing Support: Medicare-certified hospices must meet HOPE and other applicable reporting requirements. Verify that the product supports the hospice’s HOPE assessment, coding, XML-file, and iQIES-submission workflow, including any desired follow-up tracking. CMS applies the HQRP reporting requirement and associated Annual Payment Update reduction to the hospice provider, not to every EMR product. If the hospice bills multiple payers, verify that the product supports the applicable billing workflows and that the vendor maintains regulatory updates.
- Consider Deployment and Mobility: Decide between cloud-based vs. on-premise. Cloud (SaaS) hospice EMRs are popular since they require no local servers and can be accessed from anywhere. Ensure staff can easily use mobile devices (tablets/smartphones) for point-of-care documentation.
- Integration and Interoperability: If you use pharmacy, portal, analytics, or other systems, verify the specific interfaces, export formats, security controls, implementation responsibilities, and ongoing costs. Ask whether the product supports any required FHIR (Fast Healthcare Interoperability Resources) use cases; do not assume FHIR availability or interoperability from a general product claim.
- Vendor Reputation and Support: Review independent feedback cautiously, ask for references from similar-sized hospices, and evaluate the vendor’s training and implementation support. Confirm which claims are documented contractually, including service levels, responsibilities, product updates, and data-export terms.
- Budget and Total Cost: Compare pricing models (subscription, per-patient or per-seat, etc.) and total cost of ownership. Consider implementation fees, training, and ongoing support costs. A higher upfront cost may be justified only when the documented capabilities, implementation needs, and total cost of ownership fit the hospice’s requirements.
- Pilot and Trial: Whenever possible, request a demo or trial of the software using your own forms/data. Involve clinical users and IT staff in the trial to ensure the system meets real-world needs.
By carefully evaluating these factors, hospice administrators can narrow the list to a solution that fits their clinical processes, improves patient care, and supports compliance. The products listed above are examples to compare alongside other current options.
Key Takeaways
- Specialized hospice EMRs replace paper records with digital charting, scheduling, and billing tailored to end-of-life care. These systems can centralize documentation and reduce manual workflow steps. For example, dedicated hospice software supports centralized storage of advance directives and automates compliance tasks (advantages over paper-based systems) ([1]) ([2]).
- Hospice EMR vendors (such as Axxess, Netsmart/myUnity, MatrixCare, and Hospice Tools) offer products with clinical, administrative, and financial features. A hospice should verify the vendor’s current capabilities and ensure its own HIPAA obligations, including safeguards and any required business associate agreement, are addressed. Industry guides frequently cite vendors like Alora and myUnity as “all-in-one” platforms supporting hospice operations ([3]) ([4]).
- Selection tips: Before choosing, map your key requirements (HOPE assessment support, charting, hospice regulations, and mobile use), and compare demo systems. OASIS is relevant only if the organization also operates home-health services; HOPE is the CMS assessment tool that replaced HIS for hospice quality reporting. Engage staff in testing interfaces. Verify that the vendor stays current with hospice regulations—particularly HOPE requirements—and provides training.
- Long-term benefits: A well-chosen hospice EMR can streamline documentation and coordination workflows. Evaluate automation, digital signatures, coding tools, and optional HOPE follow-up tracking against the hospice’s needs, and retain clinical oversight of all documentation and reporting.
Implementing the right hospice EMR is a significant investment in quality and efficiency. By leveraging a specialized system with the features outlined above, hospice providers can enhance patient care coordination and meet regulatory demands more effectively. The products listed here are examples of hospice software options; agencies should evaluate several current products to find the best fit for their needs.
Sources: Industry analyst sites and user reviews highlight these hospice EMR solutions and their features ([3]) ([4]) ([1]) ([2]). (Providers should consult each vendor’s documentation and trials for detailed capabilities.)
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I'm Adrien Laurent, Founder & CEO of IntuitionLabs. With 25+ years of experience in enterprise software development, I specialize in creating custom AI solutions for the pharmaceutical and life science industries.
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