Bed Rails in an RCFE

This week’s tip is our favorite type of tip to share; it is in response to a question received from a Tuesday Tip subscriber:

“We have a small dementia care community. Can we have half rail beds in this setting or do they have to have quarter rail?” 

The primary concerns with bed rails are resident safety and avoiding the use of the rails as a restraint. RCFE regulation 87608 “Postural Supports” addresses the use of bed rails for all residents, not just those with dementia:

“Under no circumstances shall postural supports include tying, depriving, or limiting the use of a resident’s hands or feet… A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed… Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails.”

So, as you can see, we are limited to using half-rails and they must only be used for assistance with mobility – not as a restraint.

Additionally, regulation 87608 also states that you must have a physician’s order for the use of a postural support, including bed rails.

3 Responses to “Bed Rails in an RCFE”

  1. Assisting finger sticks and insulin shot is allowed?

  2. Hello Del… staff in an RCFE may only assist with fingersticks and insulin. This could include reminding the resident, helping to open the package, and helping to steady the hand. But the resident must draw up, administer, puncture the skin, etc. I hope that helps answer your question.

  3. Hi Josh,
    I have a situation I’m dealing with and need your input on bed rails. It’s my understanding that bed rails cannot be used for the purpose of preventing a resident from falling out of bed. That would be the same as preventing the resident from getting out of bed which is considered restraint. Is that correct?


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