CMS-485 Form (02-94)
Home Health Certification and Plan of Care
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| CMS-485 Fillable PDF | $59.95 |
CMS-485 serves as a plan of care. The completed form provides all the information required to
deliver relevant treatment and medical care to a patient, outside of a specialized institution.
Patients must be evaluated and the Nurses supervised and orders rewritten at least every sixty days. All Therapies and
medications listed become Doctors Orders once signed. All other documents (i.e., Medication Administration Record) in the
home chart should follow the orders listed on the 485, except interim orders written/signed after the date of the 485.
The 485 should be the “Go To” document when unsure, or verification of Rx/Tx's is needed.
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