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Bed Rails in Nursing Homes

LeadingAge NY ProCare recently assisted a nursing home member in response to an Immediate Jeopardy (IJ) citation for F700 (Bed Rails). The resident involved sustained an injury when they became entrapped in the bed rail. When issues of this magnitude are identified, they often result in survey teams focusing more on the issue, to determine if other nursing homes might also not be in compliance with the requirements.

For nursing homes, months of dealing with infection control and pandemic-related issues have, in many cases, diverted attention away from other routine monitoring and quality assurance activities. In this case, the regular checking of bed rails and mattresses for entrapment risk was not performed.

Given the circumstances of the citation, nursing homes should review their current policies and procedures with respect to the use of bed rails to ensure the safety of the residents they care for.

The following is required under the regulations when evaluating the use or installation of bed rails:

  • Assess the resident’s risk from using bed rails.
  • Ensure that the bed’s dimensions are appropriate for the resident.
  • Confirm that the bed rails to be installed are appropriate for the size and weight of the resident using the bed.
  • Install bed rails using the manufacturer’s instructions to ensure a proper fit.
  • Inspect and regularly check the mattress and bed rails for areas of possible entrapment.
  • Regardless of mattress width, length, and/or depth, the bed frame, bed rail, and mattress should leave no gap wide enough to entrap a resident’s head or body. Gaps can be created by movement or compression of the mattress, which may be caused by resident weight, resident movement, or bed position, or by using a specialty mattress, such as an air mattress, mattress pad, or waterbed.
  • Check bed rails regularly to make sure that they are still installed correctly, as rails may shift or loosen over time.
  • Conduct routine preventive maintenance of beds and bed rails to ensure that they meet current safety standards and are not in need of repair.

Contact: Elliott Frost, efrost@leadingageny.org, 518-441-8761