ArticleJournal of the American Medical Directors Association2026
Applying the Brief Interview for Mental Status in a Diverse Home Health Patient Population.
Article in Journal of the American Medical Directors Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesIn 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.
designCross-sectional study. SETTING AND
participantsWe examined 2023 to 2024 OASIS clinical assessments for 42,745 older (65+) patients at a large, urban HH agency.
methodsBIMS 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).
resultsBased 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). CONCLUSIONS AND IMPLICATIONS: 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.
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