C0100: Should Brief Interview for Mental Status Be Conducted?

C0100: Should Brief Interview for Mental Status Be Conducted?  

Item Rationale 

Health-related Quality of Life 

• Most residents are able to attempt the Brief Interview for Mental Status (BIMS), a structured cognitive interview.  

• A structured cognitive test is more accurate and reliable than observation alone for observing cognitive performance.  

— Without an attempted structured cognitive interview, a resident might be mislabeled based on their appearance or assumed diagnosis.  

— Structured interviews will efficiently provide insight into the resident’s current condition that will enhance good care.  

Planning for Care 

• Structured cognitive interviews assist in identifying needed supports.  

• The structured cognitive interview is helpful for identifying possible delirium behaviors (C1310). 

Steps for Assessment 

1. Interact with the resident using their preferred language (See A1110). Be sure they can hear you and/or have access to their preferred method for communication. If the resident needs or requires an interpreter, complete the interview with an interpreter. If the resident appears unable to communicate, offer alternatives such as writing, pointing, sign language, or cue cards. 

2. Determine if the resident is rarely/never understood verbally, in writing, or using another method. If rarely/never understood, skip to C0600, Should the Staff Assessment for Mental Status be Conducted?, unless the assessment being completed is a stand-alone Part A PPS Discharge; if that is the case, then skip to C1310. Signs and Symptoms of Delirium.  

Coding Instructions 

• Code 0, no: if the interview should not be conducted because the resident is rarely/never understood; cannot respond verbally, in writing, or using another method; or an interpreter is needed but not available.  

• Code 1, yes: if the interview should be conducted because the resident is at least sometimes understood verbally, in writing, or using another method, and if an interpreter is needed, one is available.  

Coding Tips 

• Attempt to conduct the interview with ALL residents. This interview is conducted during the look-back period of the Assessment Reference Date (ARD) and is not contingent upon item B0700, Makes Self-Understood.  

• If the resident needs an interpreter, including a resident who uses American Sign Language (ASL), every effort should be made to have an interpreter present for the BIMS. If it is not possible for a needed interpreter to participate on the day of the interview, code C0100 = 0 to indicate interview not attempted and complete C0600-C1000, Staff Assessment for Mental Status. 

• If the resident interview was not conducted within the look-back period (preferably the day before or the day of) the ARD, item C0100 must be coded 1, Yes, and the standard “no information” code (a dash “-”) entered in the resident interview items. 

• Do not complete the Staff Assessment for Mental Status items (C0700-C1000) if the resident interview should have been conducted but was not done.  

• Because a PDPM cognitive level is utilized in the speech language pathology (SLP) payment component of PDPM, only in the case of PPS assessments, staff may complete the Staff Assessment for Mental Status for an interviewable resident when the resident is unexpectedly discharged from a Part A stay prior to the completion of the BIMS. In this case, the assessor should enter 0, No in C0100: Should Brief Interview for Mental Status Be Conducted? and proceed to the Staff Assessment for Mental Status.