08/15/2018

NEW Tip of the Week: Bed Rails

The Centers for Medicare & Medicaid Services (CMS) provided additional guidance related to the use of bed rails within the Requirements of Participation. CMS also updated the Long Term Care Survey Frequently Asked Questions with additional clarifications regarding bed rail use. CMS provided clarification on what is considered appropriate alternatives. 

CMS provided the following response: CMS would encourage facilities to refer to published information from recognized authorities such as the FDA, which has identified the following alternatives: ‘Alternatives include: roll guards, foam bumpers, lowering the bed and using concave mattresses that can help reduce rolling off the bed.’  

Additionally, the alternative that is attempted should be appropriate for the intended use of the bed rail. For example, a low bed, or concave mattress would not be an appropriate alternative to an enabler for a resident receiving therapy for hip-replacement.  

If there is no appropriate alternative that would be suitable for the intended use of the bed rail, the medical record would have to include evidence of the following:

 

• purpose of the bed rail and notation that no suitable alternative exists;

• assessment of the resident, the bed and rail for entrapment risk (which would include ensuring bed dimensions are appropriate for resident size/weight), and

• risks versus benefits were reviewed with the resident and/or representative, and informed consent given.

 

The updated LTC Survey FAQ document can be found on the CMS nursing home webpage. 

LeadingAge Ohio continues to share tips each week to assist members during the survey process. Any questions may be directed to Stephanie DeWees at sdewees@leadingageohio.org.  

Please join us for the monthly In The Know Long Term Care Survey Process call which occurs on the 2nd Wednesday of every month at 1:00pm.