The Brief Interview of Mental Status (BIMS) was developed to screen for the presence or absence of a cognitive impairment. The three parts of the assessment look at attention, orientation and ability to recall information. A score of 0-7 indicates severe impairment, 8-12 indicates moderate impairment, and 13-15 indicates intact cognitive response.  

So, who should be responsible for conducting this assessment in the skilled nursing facility?   

In some facilities, social workers are responsible for administering the BIMS, however, SLP’s are specially trained in providing prevention, screening, assessment, diagnosis, treatment, intervention, management, counseling, and follow-up for disorders of cognitive aspects of communication (e.g., attention, memory, problem solving, executive functions) according to the American Speech and Hearing Association.  

 SLP’s regularly complete patient interviews to determine the need for skilled speech, language, swallowing, voice and cognitive communication treatment. Recommendations and outcomes are documented within the EMR. The outcome of the BIMS, presence of acute neurological diagnosis, SLP comorbidity and section K (presence of swallowing disorder and mechanically altered diet) is utilized to determine the SLP payment component of PDPM.  

Given that cognitive communication treatment is well within the scope of the SLP’s roles and responsibilities, speech therapists are equipped to administer the BIMS accurately and efficiently to ensure maximum reimbursement and to determine which patients will require additional standardized assessment to further assess cognitive skills. SLP’s can prevent instances in which cognitive impairment is incorrectly diagnosed or missed which may result in patients missing out on appropriate communication strategies and necessary services to improve overall safety and independence on the unit and in activities of daily living.  

Utilizing the expertise of SLP’s in your skilled nursing facility can ultimately result in more accurate and reliable detection of patients with cognitive impairment and delirium, generating appropriate reimbursement, enhanced care and identifying needed support and treatment.