[Expert Solution]: What supporting documentation is required…

What supporting documentation is required to support the Brief Interview for Mental Status (BIMS) in section C of the MDS per the RAI User’s Manual? The interview responses must be documented in the medical record verbatim to support the MDS coding. The interview information is documented directly on the MDS form. It is not necessary to document the resident’s responses elsewhere in the chart unless stricter state requirements exist. The care plan should match the BIMS information. Resident interview and documentation from all disciplines that come in contact with the resident should be used to code the BIMS.