Understanding and Coding MDS 3.0 Item C0300B: BIMS Resident Interview - Able to Report Correct Month

Introduction

Purpose:
The Brief Interview for Mental Status (BIMS) is an essential tool used in long-term care settings to assess a resident’s cognitive function, particularly their orientation to time. MDS 3.0 Item C0300B focuses on the resident’s ability to report the correct month during the BIMS interview. This item helps to evaluate the resident’s temporal orientation, which is crucial for identifying cognitive impairments such as confusion or memory loss. Accurate coding of this item is vital for determining the resident’s cognitive status and implementing appropriate care interventions.

What is MDS Item C0300B?

Explanation:
MDS Item C0300B, "BIMS Resident Interview: Able to Report Correct Month," is part of Section C, which addresses cognitive patterns. This item specifically assesses whether the resident can correctly identify the current month during the BIMS interview. The ability to state the correct month is a key indicator of a resident’s orientation to time, which is an important aspect of cognitive health. This item contributes to the overall BIMS score, which is used to evaluate the resident's cognitive status and determine if further evaluation or intervention is needed.

Guidelines for Coding C0300B

Coding Instructions:
When coding Item C0300B, the interviewer should ask the resident, “What month are we in right now?” The coding is based on the resident’s ability to accurately report the current month.

1. Code 0 - Missed by > 1 month or no answer: The resident’s answer is incorrect by more than one month, or the resident is unable to provide an answer.
2. Code 1 - Missed by 1 month: The resident’s answer is incorrect, but only by one month.
3. Code 2 - Correct: The resident accurately reports the current month.

Example Scenario:
During the BIMS interview, the interviewer asks Mrs. Davis, “What month are we in right now?” Mrs. Davis responds, “November,” when the current month is October. In this case, Mrs. Davis should be coded as "1 - Missed by 1 month" for Item C0300B because her answer was incorrect by just one month.

Best Practices for Accurate Coding

Documentation:
Document the resident’s exact response to the question, noting whether the answer was correct or incorrect. If the answer was incorrect, record the month the resident provided. This documentation helps ensure consistency and accuracy in future assessments.

Communication:
Share the results of the BIMS, including the resident’s ability to correctly report the month, with the interdisciplinary care team. This information is crucial for developing care plans that address any cognitive deficits identified during the assessment.

Training:
Ensure that staff conducting the BIMS are trained to ask questions clearly and to provide a calm, distraction-free environment for the interview. Training should also cover how to handle situations where a resident struggles to answer, ensuring that the resident feels supported and understood.

Conclusion

Summary:
Accurately coding MDS Item C0300B is essential for assessing a resident’s orientation to time as part of the BIMS. This assessment helps identify cognitive impairments that may affect the resident’s ability to engage in daily activities and make decisions about their care. 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-3, for detailed instructions on coding Item C0300B.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item set C0300B: BIMS Resident Interview - Able to Report Correct Month 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.