FIM Scoring

Question 1

Level 7 (Basic)

Answer 1

Independent (100%)

Question 2

Level 6 (Basic)

Answer 2

Modified Independent (100%)

Question 3

Level 5 (Basic)

Answer 3

Supervision/Set up (>90%)

Question 4

Level 4 (Basic)

Answer 4

Min Assist or CGA (>75%)

Question 5

Level 3 (Basic)

Answer 5

Moderate Assist (50-74%)

Question 6

Level 2 (Basic)

Answer 6

Max Assist (25-49%)

Question 7

Level 1 (Basic)

Answer 7

Total Assist (ex. 2 clinicians, W/C follow, or Hoyer/Mechanical Lift) (<25%)

Question 8

Level 0 (Basic)

Answer 8

Activity Does not occur

Question 9

Level 3 (Distance Walked/Navigated WC)

Answer 9

150 feet or greater

Question 10

Level 2 (Distance Walked/Navigated WC)

Answer 10

50 to 149 feet

Question 11

Level 1 (Distance Walked/Navigated WC)

Answer 11

Less than 50 feet

Question 12

Level 0 (Distance Walked/Navigated WC)

Answer 12

If activity does not occur

Question 13

Level 7 - Ambulation

Answer 13

Complete Independence (at least 150 feet)

Question 14

Level 6 - Ambulation/WC Navigation

Answer 14

Modified Independent, with a device or safety concerns (at least 150 feet)

Question 15

Level 5 - Ambulation/ WC Navigation

Answer 15

Supervision/SBA (At least 150 feet)

Question 16

Level 4 - Ambulation/WC Navigation

Answer 16

Min Assist/CGA (At least 150 feet)

Question 17

Level 3 - Ambulation/WC Navigation

Answer 17

Moderate Assist (at least 150 feet)

Question 18

Level 2 - Ambulation/WC Navigation

Answer 18

Max Assist (or less than 150 feet)

Question 19

Level 1 - Ambulation/WC Navigation

Answer 19

Total Assist, Two clinicians, or W/C follow (or less than 50 feet)

Question 20

Level 4 (Sit to Supine)

Answer 20

Helping with one leg back onto bed/helping minimally with trunk

Question 21

Level 3 (Sit to Supine)

Answer 21

Helping with both legs back onto bed/Helping trunk moderately

Question 22

Level 2 (Sit to Supine)

Answer 22

Helping with both legs back onto bed and the Trunk

Question 23

Level 1 (Sit to Supine)

Answer 23

Two therapist assist; Using Mechanical lift device back to bed; Could be one therapist with both legs and trunk, but person doing less that 25% of the work