Applying the Brief Interview for Mental Status in a Diverse Home Health Patient Population.

Authors

Julia G Burgdorf, Yolanda Barrón, Emmanuelle Bélanger

Published in

Journal of the American Medical Directors Association. Volume 27. Issue 9. Pages 106375. Jul 09, 2026. Epub Jul 09, 2026.

Abstract

In 2023, the Brief Interview for Mental Status (BIMS) was added to the Medicare-funded home health (HH) standard patient assessment (Outcomes and Assessment Information Set [OASIS]). This is the first validated cognitive screening tool in the OASIS, but no existing work reports on BIMS implementation in real-world HH clinical practice, overlap between BIMS and clinician-reported cognitive symptoms in the OASIS, or patient characteristics associated with lower BIMS scores.
Cross-sectional study.
We examined 2023 to 2024 OASIS clinical assessments for 42,745 older (65+) patients at a large, urban HH agency.
BIMS scores range from 0 (severe impairment) to 15 (cognitively intact). We describe BIMS score distribution, report overlap between BIMS scores and other OASIS items describing patient cognition, and fit a multivariable model predicting a BIMS score indicating cognitive impairment (score <13).
Based on the BIMS score, 78% of patients were cognitively intact, 15% moderately impaired, and 7% severely impaired. Over half (59%) received the maximum possible score of 15, indicating no impairment. Even among those with probable dementia, reported memory deficits, or reported impaired decision-making, one-quarter scored as cognitively intact (25%, 25%, and 22%, respectively). Patients were more likely to score as cognitively impaired if they primarily spoke Spanish (adjusted odds ratio [aOR], 1.58; 95% CI, 1.42-1.76) or another language (aOR, 1.54; 95% CI, 1.41-1.67) compared with English, were non-Hispanic Black (aOR, 1.44; 95% CI, 1.34-1.54), Hispanic (aOR, 1.38; 95% CI, 1.25-1.53), Asian (aOR, 1.34; 95% CI, 1.20-1.48), or other race/ethnicity (aOR, 1.51; 95% CI, 1.35-1.70) compared with non-Hispanic White, or paid for HH using Medicaid compared with traditional Medicare (aOR, 1.34; 1.24-1.44).
Findings suggest value in combining BIMS scores with other data elements to inform care planning and indicate a need for additional resources and training to ensure BIMS is implemented as intended across subgroups.

PMID:
42424691
Bibliographic data and abstract were imported from PubMed on 10 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.