Certifies a Medicare patient's homebound status and need for skilled home health care and sets out the plan of care (orders, diagnoses, goals) for the certification period.
- Completed by
- Home health agency drafts it; the certifying physician or allowed practitioner (NP, CNS, PA) reviews, signs and dates it
- Issued by
- Centers for Medicare & Medicaid Services (CMS)
- Format
- Language
- English