Health calculators

BIMS Calculator

Updated Nov 11, 2026 By Infinity Calculator Formulas Sources Medical disclaimer
Rate
Current Score (live)
0 / 15
Questions Answered
0 of 7

Part I – Repetition of Three Words

Immediate recall — maximum 3 points
“I am going to say three words for you to remember. Please repeat the words after I have said all three. The words are: sock, blue, and bed.” “Now please tell me the three words.” [Score the number of words repeated on the first attempt only. After that attempt, say the three words again, each with its category cue listed under Part III. If the resident repeated fewer than three, ask for the words again, up to three attempts in all.]
Part I – A: How many words did the resident repeat on the first attempt? (maximum 3 points)

Part II – Temporal Orientation

Orientation to year, month, and day — maximum 6 points
“Please tell me what year it is right now.” “What month are we in right now?” “What day of the week is it today?” [Ask each question separately. Allow up to 30 seconds for each answer and do not give clues. For the month, count today as day 1 when deciding whether the answer is within 5 days.]
Part II – A: What year is it? (maximum 3 points) Correct answer: —
Part II – B: What month is it? (maximum 2 points) Correct answer: —
Part II – C: What day of the week is it? (maximum 1 point) Correct answer: —

Part III – Recall

Delayed recall of the three words — maximum 6 points
“Let’s go back to an earlier question. What were those three words that I asked you to repeat?” [Allow up to 5 seconds for each word. For any word not recalled, give the cue listed below for that word, then allow up to 5 seconds more.]
  • Cue for “sock”: “something to wear”
  • Cue for “blue”: “a color”
  • Cue for “bed”: “a piece of furniture”
Part III – A: Did the resident recall “sock”? (maximum 2 points)
Part III – B: Did the resident recall “blue”? (maximum 2 points)
Part III – C: Did the resident recall “bed”? (maximum 2 points)

Introduction

The Brief Interview for Mental Status (BIMS) is a quick test used to check how well a person can think and remember. It is part of the Minimum Data Set (MDS 3.0) assessment used in nursing homes and long-term care settings. Doctors, nurses, and care staff use the BIMS to screen for cognitive impairment, which means problems with memory, thinking, or orientation to time. Other tools, such as the Barthel Index, measure a resident's ability to carry out daily activities.

The BIMS test has three parts. First, the resident is asked to repeat three words: sock, blue, and bed. Second, the resident is asked what year, month, and day of the week it is. Third, the resident is asked to recall the three words from earlier. Each part earns points, and the total score ranges from 0 to 15.

A score of 13 to 15 means the person is cognitively intact with little or no impairment.2 A score of 8 to 12 suggests moderate cognitive impairment.2 A score of 0 to 7 points to severe cognitive impairment.2 A higher score is better. In the national validation study, a score of 12 or below identified any impairment with sensitivity 0.83 and specificity 0.91, and 7 or below identified severe impairment with sensitivity 0.83 and specificity 0.92.1

Use this BIMS calculator to enter the resident's responses, get an instant total score, and see a clear breakdown of results. The tool also shows a step-by-step solution and a chart so you can understand exactly how the score was reached.

How to Use Our BIMS Calculator

Enter the results from each part of the Brief Interview for Mental Status (BIMS) below. The calculator will add up the scores and tell you if the resident's cognitive status is intact, moderate, or severe.

Part I – A: Words Repeated. Say the three words (sock, blue, bed) to the resident. Select how many words they repeated back on the first try. This is worth up to 3 points.

Part II – A: Year. Ask the resident what year it is. Select how close their answer was to the correct year. This is worth up to 3 points.

Part II – B: Month. Ask the resident what month it is. Select how close their answer was to the correct month. This is worth up to 2 points.

Part II – C: Day of the Week. Ask the resident what day of the week it is. Select whether they answered correctly or not. This is worth up to 1 point.

Part III – A: Recall "Sock." Ask the resident to recall the word "sock." If they cannot after 5 seconds, give the cue "something to wear." Select whether they recalled it on their own, with the cue, or not at all. This is worth up to 2 points.

Part III – B: Recall "Blue." Ask the resident to recall the word "blue." If they cannot after 5 seconds, give the cue "a color." Select whether they recalled it on their own, with the cue, or not at all. This is worth up to 2 points.

Part III – C: Recall "Bed." Ask the resident to recall the word "bed." If they cannot after 5 seconds, give the cue "a piece of furniture." Select whether they recalled it on their own, with the cue, or not at all. This is worth up to 2 points.

Click Calculate to see the total BIMS score out of 15, a step-by-step breakdown, and the cognitive impairment level. A score of 13–15 means intact cognition, 8–12 means moderate impairment, and 0–7 means severe impairment.

What Is the Brief Interview for Mental Status (BIMS)?

The Brief Interview for Mental Status (BIMS) is a short test used to check how well a person's brain is working. It measures cognitive function, which means things like memory, thinking, and knowing what day it is. Doctors, nurses, and care staff use it most often with older adults in nursing homes and long-term care settings. The BIMS does not assess every aspect of cognitive impairment, and dementia should only be diagnosed after a careful check for other reasons for a low score.2

The BIMS is part of the Minimum Data Set (MDS 3.0), which is a standard assessment required in U.S. nursing facilities. In the MDS 3.0 evaluation it was completed in 90% of a feasibility sample of 3,258 residents, and its scores correlated at 0.906 with the Modified Mini-Mental State.1 It takes only a few minutes to give and is done by talking directly to the resident.

How Does the BIMS Work?

The test has three parts and a total score of 15 points:

  • Part I – Repetition (0–3 points): The person is asked to repeat three words right away. This tests attention and immediate recall.
  • Part II – Orientation (0–6 points): The person is asked what year, month, and day of the week it is. This tests whether they are oriented to time.
  • Part III – Recall (0–6 points): The person is asked to remember the three words from Part I. If they cannot, a hint is given. This tests short-term memory.

What Do the Scores Mean?

A higher BIMS score means better cognitive function. The scores break down into three levels:

  • 13–15: Cognitively intact (little to no impairment)
  • 8–12: Moderate cognitive impairment
  • 0–7: Severe cognitive impairment

These levels apply when the BIMS is carefully given to a resident who can hear all the questions and is not delirious.2 The resident's doctor or a mental health specialist makes the final call on the level of impairment.2

Scores can be compared over time. A recent drop in cognitive function may indicate delirium, which may be reversible if it is found and treated in time.2 Delirium may be a symptom of an acute, treatable illness, such as an infection or a reaction to medicines.2 If the score worsens, an assessment for delirium, depression or both should be considered.2

Why Is the BIMS Important?

The BIMS helps care teams spot cognitive decline early. Early detection means faster treatment and better care planning. It is also used to track changes over time, so staff can see if a person's thinking skills are getting better or worse. Because it is quick and simple, it can be repeated regularly without putting stress on the resident.

Formulas used

Part II – Temporal Orientation Score
\text{Part II} = \text{Year} + \text{Month} + \text{Day}
Part III – Recall Score
\text{Part III} = \text{Recall}_{\text{sock}} + \text{Recall}_{\text{blue}} + \text{Recall}_{\text{bed}}
Total BIMS Score
\text{Total} = \text{Part I} + \text{Part II} + \text{Part III}
Interpretation Thresholds
\text{Classification} = \begin{cases} \text{Severe} & \text{if Total} \le 7 \\ \text{Moderate} & \text{if } 8 \le \text{Total} \le 12 \\ \text{Intact} & \text{if } 13 \le \text{Total} \le 15 \end{cases}

Frequently asked questions

What is a good BIMS score?

A good BIMS score is 13 to 15. This means the person is cognitively intact with little or no impairment. Their memory, thinking, and sense of time are working well.

How long does it take to give the BIMS test?

The BIMS test usually takes about 3 to 5 minutes. It is a short interview done by talking directly to the resident. No special equipment is needed. A resident with hearing loss should use their usual hearing devices, and headphones or a hearing amplifier can help if hearing is in doubt.2

Can the BIMS diagnose dementia?

No. The BIMS is a screening tool, not a diagnostic test. It can show signs of cognitive problems, but a doctor must do more tests to diagnose dementia or other conditions.

How often should the BIMS be given?

In U.S. nursing homes, the BIMS is given at admission, quarterly, annually, and whenever there is a significant change in the resident's condition. It is part of the required MDS 3.0 assessment schedule.

What if the resident cannot speak or refuses to answer?

If the resident has trouble speaking, the interviewer first offers other ways to answer, such as writing, pointing, sign language or cue cards, and uses an interpreter if one is needed.2 The BIMS is skipped only if the resident is rarely or never understood by any method, or a needed interpreter is not available. Staff then complete the Staff Assessment for Mental Status instead.2

A question the resident chooses not to answer is scored 0 and still counts in the total. The interview is treated as incomplete only if the resident will not take part at all, or refuses or gives nonsensical answers to four or more items. Staff then complete the Staff Assessment for Mental Status instead.2

Why are the three words always sock, blue, and bed?

These words are standardized in the MDS 3.0 manual. Using the same words every time makes the test consistent and reliable. Each word comes from a different category: clothing, color, and furniture. Each category is also used as a cue that helps the resident learn the word and recall it later.2

What is the difference between recall with a cue and recall without a cue?

Recall without a cue means the person remembered the word on their own. This earns 2 points. Recall with a cue means the person needed a hint (like "a color" for blue) to remember. This earns 1 point. Not recalling at all earns 0 points.

What should I do if the BIMS score drops by 1 or 2 points?

Compare it with the resident's earlier scores and share the results with their doctor, who makes the final call on the level of impairment.2 A recent drop may indicate delirium, which can be a symptom of an infection or a reaction to medicines and may be reversible if it is found and treated in time.2 A worse score should prompt the care team to consider an assessment for delirium, depression or both.2

Is a BIMS score of 0 possible?

Yes. A score of 0 means the person could not repeat any words, could not answer any orientation questions correctly, and could not recall any words. This falls in the severe cognitive impairment range. A score of 0 still counts as a completed interview, unless the resident refused or gave nonsensical answers to four or more items.2

Does the BIMS test measure physical ability?

No. The BIMS only measures cognitive function like memory and orientation. It does not test physical ability. Physical function is measured by other tools like the Barthel Index.

Can medications affect BIMS scores?

Yes. Some medicines can contribute to delirium, which can lower a BIMS score. They include new medicines or higher doses, medicines with anticholinergic effects, opioids, benzodiazepines and other pain medicines.2 Stopping a benzodiazepine suddenly can also contribute.2 If a low score seems unexpected, the care team can review the resident's medicines, and a pharmacist may need to check for interactions.2

Is the BIMS the same as the MMSE?

No. The BIMS and the Mini-Mental State Examination (MMSE) are different tests. The BIMS is shorter and built into the MDS 3.0. The MMSE is sold by its publisher and tests more areas of cognition, such as naming, reading, writing and drawing. Both screen for cognitive impairment, but they are not interchangeable.

Can the BIMS be given in a language other than English?

The BIMS should be given in the resident's preferred language. If the resident needs an interpreter, the interview is done with one, and the interpreter uses equivalent words and similar cues.2 If a needed interpreter cannot be there on the day of the interview, the BIMS is not given and staff complete the Staff Assessment for Mental Status instead.2

Sources

  1. Saliba D, Buchanan J, Edelen MO, Streim J, Ouslander J, Berlowitz D, Chodosh J. MDS 3.0: brief interview for mental status. Journal of the American Medical Directors Association. 2012;13(7):611-617. doi:10.1016/j.jamda.2012.06.004. Accessed September 4, 2026.
  2. Long-Term Care Facility Resident Assessment Instrument 3.0 User's Manual, Version 1.20.11. Centers for Medicare & Medicaid Services. 2026;Chapter 3, Section C, pp. C-1 to C-20 (BIMS, C0100 to C0600) and p. C-29 (C1310, delirium), and Appendix C, Delirium CAA, p. C-7. Accessed October 7, 2026.

Related Health calculators

All Health calculators
Health

Corrected Sodium Calculator

Calculate corrected sodium for hyperglycemia with Katz 1.6 and Hillier 2.4 factors. Enter glucose in mg/dL or mmol/L, see step-by-step math and a chart.

Open Health

GCS Calculator

Calculate GCS from eye, verbal, and motor responses. Get the 3 to 15 total, mild/moderate/severe rating, NT flags for intubated or sedated cases.

Open Health

ICH Volume Calculator

Estimate intracerebral hemorrhage volume with ABC/2 or ABC/3. Enter length, width, and craniocaudal depth or derive C from slice count and thickness.

Open