BIMS Calculator

The Brief Interview for Mental Status (BIMS) is a 7-item, performance-based cognitive screening interview in Section C of the CMS Minimum Data Set 3.0. It checks attention, temporal orientation, and the ability to register and recall new information, and produces a summary score from 0 to 15.

For a carefully conducted interview, CMS guidance suggests these distributions: 13 to 15, cognitively intact; 8 to 12, moderately impaired; 0 to 7, severely impaired. These are screening ranges, not diagnoses.

No. The BIMS is a brief screening tool that helps detect possible cognitive impairment. A diagnosis of dementia should only be made after a careful assessment for other causes of poor performance, and the final determination is made by the resident's physician or mental health specialist.

A score of 0 is a valid, completed BIMS result in the severe-impairment range; it does not mean the interview was incomplete. A score of 99 means the interview could not be completed, for example when the resident attempted fewer than four items with relevant answers, and the Staff Assessment for Mental Status should be done instead.

CMS coding instructions say to record the maximum number of words repeated correctly on the first attempt, from 0 to 3. Repeating the words again with category cues helps the resident learn them for the later recall section, but those repeats are not scored.

Temporal orientation is scored by closeness. Year: 3 points for the correct year, 2 for missing by one year, 1 for missing by two to five years, 0 for missing by more than five years or not answering. Month uses similar closeness tiers measured in days (2, 1, 0), and day of week is scored 1 for correct or 0 for incorrect.

Sock (something to wear), blue (a color), and bed (a piece of furniture). In the recall section each word scores 2 points if remembered spontaneously, 1 point if remembered after its category cue, and 0 if it cannot be recalled even with the cue.

The interview is stopped after the day-of-the-week question if every response so far has been nonsensical, or there has been no verbal or written response to any question, or a combination of the two. The recall items are then dashed, the summary score is coded 99, and staff complete the Staff Assessment for Mental Status.

The BIMS is a direct interview with the resident. The Staff Assessment (items C0700 to C1000) is completed only when the BIMS could not be done, and it relies on observation across shifts plus input from direct-care staff, family members, and the medical record.

Yes. The summary score lets staff compare current performance with past and future results. An abrupt change in cognitive status may indicate delirium, which can signal a potentially life-threatening illness, so a sudden decline needs prompt medical evaluation.