Understanding and Coding MDS Item C0400B: BIMS Resident Interview - Able to Recall "Blue"

Understanding and Coding MDS 3.0 Item C0400B: BIMS Resident Interview - Able to Recall "Blue"

Introduction

Purpose:
The Brief Interview for Mental Status (BIMS) is an essential cognitive assessment tool used in long-term care facilities. MDS 3.0 Item C0400B assesses a resident’s ability to recall the word "blue" during the BIMS interview. This task evaluates short-term memory, which is crucial for understanding the resident’s cognitive function. Accurate coding of this item helps healthcare professionals identify memory impairments, enabling the development of personalized care plans and interventions to support the resident’s cognitive health.

What is MDS Item C0400B?

Explanation:
MDS Item C0400B, "BIMS Resident Interview: Able to Recall 'Blue'," is part of Section C, which focuses on cognitive patterns. This item specifically evaluates whether the resident can recall the word "blue" after a brief delay, following the initial word repetition task in the BIMS interview. The ability to remember this word provides insight into the resident’s short-term memory, a key aspect of cognitive function.

During the BIMS, residents are first asked to repeat three words—"sock," "blue," and "bed." Later, they are asked to recall these words without prompts. Item C0400B measures the resident’s ability to recall "blue," contributing to the overall BIMS score and offering valuable information about the resident’s cognitive status.

Guidelines for Coding C0400B

Coding Instructions:
When coding Item C0400B, the interviewer should ask the resident to recall the three words ("sock," "blue," "bed") that were mentioned earlier in the interview. The coding for C0400B specifically reflects whether the resident can correctly recall the word "blue."

1. Code 0 - No: The resident is unable to recall the word "blue."
2. Code 1 - Yes, after cueing ("a color"): The resident recalls the word "blue" only after being provided with a cue or prompt, such as "a color."
3. Code 2 - Yes, no cue required: The resident recalls the word "blue" without any cues or prompts.

Example Scenario:
During the BIMS interview, the interviewer asks Mrs. Clark, “What were the three words I asked you to remember?” Mrs. Clark recalls "sock" and "bed" but struggles with "blue" until the interviewer prompts her with the cue "a color." Mrs. Clark then correctly recalls "blue." In this case, Mrs. Clark should be coded as "1 - Yes, after cueing" for Item C0400B because she needed a prompt to remember the word.

Best Practices for Accurate Coding

Documentation:
Record the resident’s response, including whether they remembered the word "blue" independently or needed a cue. This documentation is vital for tracking changes in the resident’s memory over time and ensuring accurate and consistent assessments.

Communication:
Share the results of the BIMS, including the resident’s ability to recall "blue," with the interdisciplinary care team. This information is critical for developing care plans that address memory impairments and support the resident’s cognitive health.

Training:
Ensure that staff conducting the BIMS are trained to administer the recall task clearly and to allow sufficient time for the resident to respond. Training should also include how to appropriately provide cues if the resident struggles to recall the word, ensuring the resident feels supported during the interview.

Conclusion

Summary:
Accurately coding MDS Item C0400B is essential for assessing a resident’s short-term memory as part of the BIMS. This assessment helps identify cognitive impairments that may affect the resident’s daily functioning and decision-making. 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.

Click here to see a detailed Step-by-Step on 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-5, for detailed instructions on coding Item C0400B.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item set C0400B: BIMS Resident Interview - Able to Recall "Blue" 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.