Failure to Ensure Safe and Compatible Bed Rail Installation
Penalty
Summary
Surveyors identified a deficiency in the facility’s failure to ensure that a bed rail and bed were compatible and safely installed for one resident reviewed for accidents. During observation, the resident was seen in bed with a bed rail that was loose and moved side to side approximately 1 to 2 inches along the length of the bed; the rail appeared to be an aftermarket attachment to the bed frame. When the resident reached for the rail to assist with getting up from a lying position, the rail gave way. Review of the resident’s medical record showed no documentation that the bed rail had been inspected for proper installation. In an interview, the ADON confirmed that the bed rail was not sturdy and stated she did not know if the bed rail had been inspected for proper installation. This sequence of events demonstrates that the facility did not perform or document inspection of the bed rail and its attachment to the bed frame, resulting in the presence of a loose, aftermarket bed rail used by the resident for mobility assistance.
We Help Long-Term Care Teams Stay Survey-Ready
We process and analyze inspection reports and plan of correction using AI to extract insights and trends so providers can improve care quality and stay ahead of compliance risks.