The short answer
Bed rails are allowed only under conditions. Before installing them, a nursing home must try appropriate alternatives, assess the resident for the risk of entrapment, review the risks and benefits with the resident or representative and get informed consent, and make sure the bed and rails fit and are maintained. Rails that keep a resident from getting out of bed can also count as a restraint.
The dangers
Residents can become trapped between the rail and the mattress, between split rails, or between the rail and the headboard, which can cause suffocation, strangulation and death. Residents also climb over rails and fall from a greater height.
What the facility must do
- Try alternatives first, such as a low bed, floor mats, a concave or bolstered mattress, or more frequent checks
- Assess the resident's entrapment risk
- Explain risks and benefits and obtain informed consent
- Make sure the rails, mattress and bed frame are compatible and properly installed, and inspect them regularly
What to look for
- Gaps between the mattress and the rail large enough for an arm, head or chest
- A mattress that is too small for the frame, or an air mattress that compresses at the edge
- A resident who tries to climb over the rails
If you see an entrapment risk, report it to the nurse in writing immediately.
The rules behind this
- 42 C.F.R. § 483.25(n) (bed rails)
Related questions
This guide provides general information, not medical or legal advice. Rules change; confirm current requirements with the facility, the New York State Department of Health or a professional. Attorney Advertising.