How many items with the FIM
FIM was developed to...
provide a uniform measurement of disability and rehabilitation
When do you perform FIM?
in the 1st 72 hrs of admission
72 hrs before discharge
Total FIM range is...
FIM is usuable by?
any trained healthcare professional reguardless of discipline
FIM is designed to measure level of independence in:
Purposes of the FIM:
-determine rehabilitation outcome
-internally improve quality of programs
-externally by 3rd party payers for reimbursement
-plan rehabilitation interventions
-determine effectivenss of treatment
-maintain continuity of care develop and improve treatment resources
The FIM instrument is based on measuring the....
Burden of Care
Burden of care refers to...
the type and amount of assistance required for an to perform basic life activites
FIM has a maximum rating of
0 refers to activities
that did not happen or patient could not perform
FIM self-care includes:
-dressing upper and lower body
FIM sphincter control includes:
FIM tranfers includes:
FIM locomotion includes:
No helper levels in FIM
7 and 6
Helper level in FIM
Complete Dependence level in FIM
Can use Code 0 in FIM for:
Cannot Code 0 in FIM for:
If a FIM item does not occur at the time of discharge, rate the item level
If supervision or setup is required...
2 or more helpers automatic level
If the patient manages all w/c parts w/o help and does not use the arm rests during the transfer
If patient required raising of the head of bed or used bed rails
If patient requires setup, cueing, coaxing, or supervision
If patient requires contact guard assistance, or requires helper to lift only one leg onto or off the bed
If patient requires lifting assistance for part of the transfer, or helper must lift both legs onto or off the bed
If patient requires assistance for both lifting and lowering
If patient requires total assistance
When do you record locomotion FIM?
addmission and discharge
If both modes (walk and w/c) are the same record...
True/False score same mode of locomotion on addmission and discharge.
locomotion 150' or greater
locomotion less than 50'
locomotion did not occur
Complete independence, walks minimum of 150'
Modified independence, minimum of 150' with a device or w/ safety concerns
Household Exception: 50' independently w/ or w/o an assistive device
150' with supervision
150' minimal assistance
150' moderate assistance
50-149' Level of assistance irrelevant
less than 50' LOA irrelevant
2 aspects to consider when measuring stairs FIM?
-number of stairs
-LOA and use of devices
12-14 stairs independently
12-14 stairs with device
4-6 stairs independently
Level 5 House hold rule
12-14 stairs with supervision
12-14 stairs with minimal assistance
12-14 stairs with moderate assistance
4-11 stairs LOA irrelevant
Less than 4 stairs LOA irrelevant
Importance of accurate FIM
Consequences of Inaccurate FIM
-LOS too short to meet patient needs
-CMS does not get an accurate picture of severity of patient population
-Patient doesn't have the opportunity to reach full potential
-denial of rehab access
Center for Medicare Services