OT FIM

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1

FIM

Functional Independent Measure

2

When is the FIM given

-Admission data must be collected within 72 hours after admission.
-Discharge data must be collected within 72 hours before discharge.
-Follow-up data are collected 80 to 180 days after discharge

3

FIM follow up

80 to 180 days after discharge

4

FIM discharge

collected within 72 hours before.

5

FIM Admission

collected within 72 hours

6

FIM scores reflect

what the person usually does

7

# of items on FIM

18

8

Lowest FIM score

1

9

Highest FIM Score

7

10

Total score ranges

18 -126

11

FIM score is recorded

offical coding sheet

12

If FIM scores are different

always record the lowest

13

FIM - set up is automatically

5

14

If the subject would be put at risk for injury if tested

= level 1 - Total Assistance.

15

If the subject does not perform the activity,

= level 1 - Total Assistance.

16

Level 1 total Assitance example

= subject who requires a bed bath is scored 1 for Transfers: Tub or Shower.

17

When two helpers are required for the subject to perform the activities described in an
item,

= score level 1 - Total Assistance.

18

Do not leave any FIM item

blank.

19

Do not enter ___ for any FIM item.

“N/A”

20

If the subject requires supervision,

he/she is not independent.

21

7 Complete Independence 100%-

All of ax tasks are performed safely, without modification, assistive devices, or aids, and within a reasonable amount of time.

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6 Modified Independence— mod I

1 or ^ of the following may be true: ax requires an assistive device; ax takes more than reasonable time; or safety (risk) considerations

23

Independent is a score of

7 0r 6

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DEPENDENT is a score of

5-1

25

A score of 1-5 means client

requires another person for either supervision or physical assistance in order for the ax to be performed, or it is not performed

26

Dependent means

requires helper

27

Mod assist

Cl expends half (50%) or ^ on effort

28

5 Supervision or Setup

• requires no more help than standby, cueing or coaxing, without physical contact,
o helper sets up needed items or applies orthoses or assistive/adaptive devices

29

5 Supervision or Setup

• requires no more help than standby, cueing or coaxing, without physical contact,

30

5 Supervision or Setup

o helper sets up needed items or applies orthoses or assistive/adaptive devices

31

Supervision or Setup

5

32

4 Minimal Contact Assistance,

expends 75% ^
• requires no more help than touching, &
• expends 75% or more of the effort.

33

4 Minimal Contact Assistance

expends 75% ^
• requires no more help than touching, &

34

4 Minimal Contact Assistance

expends 75% ^

35

4 Minimal Contact Assistance

• requires no more help than touching, &

36

3 Moderate Assistance

^ 50% less than 74%
• requires more help than touching, or
• OR expends half on effort

37

3 Moderate Assistance

• requires more help than touching,

38

3 Moderate Assistance

• OR expends half on effort

39

Complete Dependence

expends less than half (less than 50%) of effort.

40

2 Maximal or total assistance

required, or the ax is not performed.

41

2 Maximal Assistance—

expends less than 49% of the effort, but at least 25%.

42

1 Total Assistance -

expends less than 25% of the effort.

43

Complete dependence scores

1-2

44

7 FIM

100%= I w/ circle around it

45

6 FIM

mod I w/ circle around it

46

5 FIM

S/U or sup

47

4 FIM

min A (w/circle around it)

48

3 FIM

mod A (w/circle around it)

49

2 FIM

max A (w/circle around it)

50

1 FIM

D or total A (both w/circle around it)

51

A two person assist score

1 total assist

52

Client doesn't do task at all score

1 total assist

53

Independent

Another person is NOT required for ax.

54

No helper is a score of

7-6


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