BIMS Form – Fill Out and Use This PDF

BIMS Form PDF Details

The BIMS form is the Brief Interview for Mental Status, the cognitive screening interview in Section C (Cognitive Patterns) of the MDS 3.0 Nursing Home Comprehensive assessment, here Version 1.20.1, effective 10/01/2025. Item C0100 asks whether the interview should be conducted: staff attempt it with all residents, and a resident who is rarely or never understood gets the Staff Assessment for Mental Status instead. C0200 asks the resident to repeat three words, sock, blue and bed, and staff may repeat them with cues up to two more times. C0300 checks temporal orientation: the year, the month and the day of the week. C0400 asks the resident to recall the three words, with or without a cue. C0500 is the BIMS summary score, the sum of C0200 to C0400 from 00 to 15, or 99 if the resident was unable to complete the interview.