Understanding and Coding MDS 3.0 Item C0500: BIMS Resident Interview - Summary Score

Understanding and Coding MDS 3.0 Item C0500: BIMS Resident Interview - Summary Score

Introduction

Purpose:
The Brief Interview for Mental Status (BIMS) is a standardized tool used to assess cognitive function in residents of long-term care facilities. MDS 3.0 Item C0500 calculates the summary score for the BIMS, which is derived from the resident’s responses to specific questions about memory and orientation. The BIMS summary score is crucial in determining the resident’s cognitive status, which directly influences care planning and interventions aimed at improving or maintaining cognitive health.

What is MDS Item C0500?

Explanation:
MDS Item C0500, "BIMS Resident Interview: Summary Score," is part of Section C, which addresses cognitive patterns. This item provides a cumulative score based on the resident's performance in the BIMS, which includes items such as repeating words (C0200), recalling words (C0400A, C0400B, C0400C), and orientation questions (C0300A, C0300B, C0300C). The BIMS score ranges from 00 to 15, with higher scores indicating better cognitive function.

The BIMS summary score is used to categorize the resident’s cognitive status:

• 13-15: Cognitively intact
• 08-12: Moderately impaired
• 00-07: Severe cognitive impairment

This score helps in identifying residents who may require further cognitive evaluation or specific interventions to manage cognitive decline.

Guidelines for Calculating and Coding C0500

Scoring Instructions:
The BIMS summary score (C0500) is calculated by summing the scores from the following items:

• C0200 (Repetition of three words): Each correct repetition scores 1 point.
• C0300A (Correct year), C0300B (Correct month), and C0300C (Correct day of the week): Each correct answer scores up to 3 points.
• C0400A (Recall "sock"), C0400B (Recall "blue"), and C0400C (Recall "bed"): Each correct recall without cue scores 2 points, and recall with cue scores 1 point.

The total score is calculated by adding the points from these responses, leading to a score between 00 and 15.

Example Scenario:
Consider Mrs. Taylor, a resident who scored as follows:

• C0200: Repeated all three words correctly (3 points).
• C0300A: Correct year (3 points).
• C0300B: Incorrect month by one month (1 point).
• C0300C: Correct day of the week (1 point).
• C0400A: Recalled "sock" without cue (2 points).
• C0400B: Recalled "blue" with a cue (1 point).
• C0400C: Unable to recall "bed" (0 points).

Her total BIMS summary score would be 11, indicating moderate cognitive impairment.

Best Practices for Accurate Coding

Documentation:
Ensure that all responses used to calculate the BIMS summary score are accurately documented. This includes the resident’s answers to each BIMS item and any cues provided. Proper documentation supports accurate scoring and helps track changes in cognitive function over time.

Communication:
Share the BIMS summary score and its implications with the interdisciplinary care team. This score should be integrated into the resident’s overall care plan, guiding interventions to address cognitive impairments and maintain cognitive health.

Training:
Staff should be trained to conduct the BIMS interview consistently and accurately. Training should emphasize the importance of scoring each item correctly and summing the scores to arrive at the BIMS summary score. Staff should also be trained to understand the implications of different BIMS score ranges and how they inform care planning.

Conclusion

Summary:
Accurately calculating and coding MDS Item C0500 is crucial for assessing a resident’s cognitive status using the BIMS. This summary score provides valuable insights into the resident’s cognitive function, helping to guide care planning and interventions. By following the scoring guidelines and best practices, healthcare professionals can ensure that cognitive assessments are conducted accurately, leading to better care outcomes for residents.

Click here to see a detailed Step-by-Step to how to complete this item set.

Reference

Please refer to CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024, specifically Chapter 3, Page C-6, for detailed instructions on coding Item C0500.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item set C0500: BIMS Resident Interview - Summary Score was originally based on the CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024. Every effort will be made to update it to the most current version. The MDS 3.0 Manual is typically updated every October. If there are no changes to the Item Set, there will be no changes to this guide. This guidance is intended to assist healthcare professionals, particularly new nurses or MDS coordinators, in understanding and applying the correct coding procedures for this specific item within MDS 3.0. The guide is not a substitute for professional judgment or the facility’s policies. It is crucial to stay updated with any changes or updates in the MDS 3.0 manual or relevant CMS regulations. The guide does not cover all potential scenarios and should not be used as a sole resource for MDS 3.0 coding. Additionally, this guide refrains from handling personal patient data and does not provide medical or legal advice. Users are responsible for ensuring compliance with all applicable laws and regulations in their respective practices.