Cognitive screening
Brief Interview for Mental Status (BIMS)
The BIMS is a resident interview tool used in CMS Minimum Data Set (MDS) assessments. It evaluates orientation and recall to categorize cognitive function (score range 0–15).
Recall the current year
Recall the current month
Recall the current day of week
Repeat and recall the word “sock” (after delay)
Repeat and recall the word “blue” (after delay)
Repeat and recall the word “bed” (after delay)
Total BIMS score
9
Moderate impairmentBIMS 8–12 suggests moderate cognitive impairment. Evaluate reversible causes and tailor care plans.
How to Use This Calculator
Perform the standardized interview
Ask orientation questions first (year, month, day), then repeat and recall words after a brief delay.
Assign scores based on accuracy
Score partial correctness for orientation items per CMS guidelines. Recall items are scored 0 or 1.
Use total score to guide care
Scores 0–7 = severe impairment, 8–12 = moderate, 13–15 = cognitively intact for care planning and MDS coding.
Formula
Total BIMS score = Orientation total + Recall total
- Orientation: year (0–3) + month (0–2) + day of week (0–1)
- Recall: three words (sock, blue, bed), each 0–1
Maximum score = 15. Interpret 13–15 (intact), 8–12 (moderate impairment), 0–7 (severe impairment).
Full Description
The BIMS is a structured interview designed for nursing home residents. It replaces proxy assessments when patients can respond reliably. BIMS aligns with MDS Section C requirements and correlates with cognitive performance scale scores. Use consistent administration and clarify responses gently.
Scores inform care plans, therapy goals, and monitoring for delirium or dementia progression. Combine BIMS with mood and behavior assessments for comprehensive care planning.
Frequently Asked Questions
What if the resident cannot complete the interview?
Document inability to complete and use the Staff Assessment for Mental Status (MDS Section C0700) instead.
Can I cue or prompt the resident?
Minimal clarification is allowed, but do not coach or provide the answer. Follow CMS scripted wording.
How often should BIMS be repeated?
At admission, quarterly, annually, and with significant change in status per MDS scheduling guidelines.
Does BIMS replace comprehensive cognitive testing?
No. Use BIMS as a screening tool. Refer for neuropsychological evaluation when detailed assessment is needed.