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Evolving Guidelines For Bed Rail Use In Nursing Homes Help To Prevent Accidents

This week I was delivering my “Senior Living Myths Unmasked,” presentation to a group of business owners. The discussion on nursing home safety always stirs a lot of emotion and discussion. This week’s presentation wasn’t exempt from a lively discussion regarding the use of bed rails in long term care communities.

I shared a story with the group about a nursing home that had a reputation for terrible care. I had been hired by a client to move his wife from that particular nursing home to one of better quality. In the process of my research, I found that they had incurred 42 deficiencies during their inspection from the Illinois Department of Health (the average number of deficiencies in Illinois is 7), which is a feat that is next to impossible. Upon further investigation, I found that the home had a death in the records with regard to using a bed rail that was unsafe. The details of the death outlined the fact that a resident had a history of constantly climbing out of his bed. He required a bed rail that was waist high to assure his safe entry and departure from the bed. The nursing home maintenance department didn’t have the materials to install a railing at the right height. Some railings can cost as much as $200. Instead of a waist high railing, they installed an eye high railing. When the resident tried to climb out of the bed, he hit his forehead on the rail. His neck became compressed between the rail and the bed. He fell between the mattress, suffocated and died. Unfortunately, a resident may not be able to inhale or scream. At the end of my story, a member of the audience put his hand up and said, “Yes, but my parents were recently in a nursing home in Ohio, and there were no bed rails there. Instead, the home’s staff placed my parents’ mattresses close to the floor.”

Note that the story I shared with the audience occurred a number of years ago and I assured the individual that guidelines for bed rails had changed. The accident that I shared with them is one of the most common tragedies that occurred with the misuse of bed rails. Since the accident, some guidelines for the use of bed rails have been established. Hospitals and nursing homes do not allow the use of four bed rails at once, which is considered to be a restraint. Bed rails may be used with an order from a physician. What you may see are 2 rails used near the head of the bed that can assist the patient or resident with his/her mobility. The Center For Medicare and Medicaid Services does not allow the use of restraints and will no longer pay for treatment of falls if it was caused by an accident with a bed rail.

As a senior living advisor, I always review the inspections from the Illinois Department of Public Health to determine whether the nursing homes that I am presenting as options to my clients have not been cited for issues involving accidents such as the story I shared with my audience. Please contact Andrea Donovan Senior living Advisors for help with all of your senior living options.