Understanding and Coding MDS 3.0 Item C0200: BIMS Resident Interview - Repetition of Three Words

Understanding and Coding MDS 3.0 Item C0200: BIMS Resident Interview - Repetition of Three Words

Introduction

Purpose:
The Brief Interview for Mental Status (BIMS) is a key component of cognitive assessment in long-term care facilities. MDS 3.0 Item C0200 focuses on the resident’s ability to repeat three words as part of the BIMS. This task assesses short-term memory and cognitive function, which are crucial in identifying potential cognitive impairments such as dementia. Accurate coding of this item helps healthcare providers to develop appropriate care plans and interventions based on the resident’s cognitive abilities.

What is MDS Item C0200?

Explanation:
MDS Item C0200, "BIMS Resident Interview: Repetition of Three Words," is part of Section C, which addresses cognitive patterns. This item specifically measures the resident’s ability to repeat three words immediately after they are spoken by the interviewer. The words are usually simple and commonly used, such as "sock," "blue," and "bed." The resident’s ability to correctly repeat these words is an important indicator of their immediate recall ability, which is a key component of cognitive function.

This item is the second step in the BIMS process, and it provides an objective measure of the resident's short-term memory. The performance on this item, combined with others in the BIMS, helps determine the resident's overall cognitive status.

Guidelines for Coding C0200

Coding Instructions:
When coding Item C0200, the interviewer should clearly state the three words and allow the resident to repeat them. The coding is based on how accurately the resident repeats the words immediately after they are spoken.

1. Code 0 - None: The resident was unable to repeat any of the words.
2. Code 1 - One: The resident was able to repeat only one of the three words.
3. Code 2 - Two: The resident was able to repeat two of the three words.
4. Code 3 - Three: The resident was able to repeat all three words correctly.

Example Scenario:
During the BIMS, the interviewer says, "sock, blue, bed," and asks Mrs. Smith to repeat the words. Mrs. Smith successfully repeats "sock" and "bed," but cannot recall "blue." In this case, Mrs. Smith should be coded as "2 - Two" because she correctly repeated two out of the three words.

Best Practices for Accurate Coding

Documentation:
Document the exact words used in the interview and the resident’s responses. This ensures transparency and allows for consistent reevaluation if needed. Note any factors that might have influenced the resident’s performance, such as distractions or hearing impairments.

Communication:
Share the results of the BIMS, including the resident's ability to repeat the three words, with the interdisciplinary care team. This helps in the development of a comprehensive care plan that addresses the resident's cognitive needs.

Training:
Ensure that staff conducting the BIMS are trained to deliver the instructions clearly and at an appropriate pace. Training should also cover techniques for minimizing environmental distractions and ensuring that residents are comfortable during the interview.

Conclusion

Summary:
Accurately coding MDS Item C0200 is essential for assessing a resident’s short-term memory as part of the BIMS. This assessment is crucial for identifying cognitive impairments and planning appropriate interventions. By following the coding guidelines and best practices, healthcare professionals can ensure that the cognitive assessment is conducted accurately, leading to better care outcomes for residents.

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-2, for detailed instructions on coding Item C0200.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item set C0200: BIMS Resident Interview - Repetition of Three Words 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.