In response to a request for clarification from Mass Senior Care to the CMS Survey Development Team in February on F700 Bedrails, Mass Senior Care received the following response:
"Appendix PP defines bedrails as "adjustable metal or rigid plastic bars that attach to the bed. They are available in a variety of types, shapes, and sizes ranging from full to one-half, one-quarter, or one-eighth lengths. Also some bedrails are not designed as part of the bed by the manufacturer and may be installed on or used along the side of a bed.
Examples of bed rails include, but are not limited to:
- Side rails, bed side rails, and safety rails, and
- Grab bars and assist bars
This means that prior to installing rails for use, or using pre-installed rails, facilities will attempt appropriate alternatives, ensure correct installation, use, and maintenance, which includes:
- assessment for entrapment risk;
- following manufacturers' recommendations and specifications for installing, (using) and maintaining bed rails.
- ensuring bed dimensions are appropriate for resident size/weight; and
- reviewing risks and benefits with the resident or representative, and obtain informed consent prior to installation (or use);
The LTC regulations do not require bedrails be removed from beds when not in use. Facilities would not be considered noncompliant for having bed rails on the bed as long as they can safely be lowered or disabled according to manufacturer's specifications, and are not observed in use.
CMS does not specify the use of a specific side rail assessment but does require that the facility assess the resident for the risks of entrapment and possible benefits of bed rails. The required components of the assessment are outlined in Appendix PP which include size and weight. The assessment information should be evidenced in the medical record."