Crossroad Legal

Are Nursing Homes Allowed to Use Bed Rails and Fall Alarms?

If you have a loved one in an Illinois nursing home, and that loved one has recently suffered injuries from a fall, then you need to keep reading. At Crossroad Legal, LLC, we have a proven track record of achieving maximum compensation for injured nursing home residents. We offer free consultations, and we never take a fee on nursing home negligence cases unless we can obtain compensation for you and your family. You cal call us day or night at (618) 515-5555 to find out if you have a case against the nursing home.


If you are like many people in this situation, and your loved one has fallen at a nursing home, you were probably told that the nursing home “can’t use bed rails, because they are an unlawful restraint.” But this is a complete mischaracterization of state and federal guidelines. In fact, if we look directly to the source – the U.S. Centers for Medicare and Medicaid Services (CMS) – we see a very different picture. According to CMS and the Department of Health and Human Services, in a recent policy statement:

CMS neither prohibits nor requires the use of alarms (even on a trial basis) as part of an individualized fall prevention program.

So, when a nurse or administrator tells you they “can’t” use personal alarms as part of their fall prevention measures, at least now you know that this is simply not true. But the policy statement does discuss some of the adverse problems that may be caused by such alarms, such as increased confusion, disturbance, mobility limitations due to fear of embarrassment, and so forth. But these are all reasons why a competent physician needs to supervise such decisions. Here’s how the medical determination to use an alarm should take place. 


In general, both state and federal law do not prohibit bed or chair alarms from being used for nursing home residents. Instead, they simply state that if the resident’s physician believes that an alarm is indicated for resident safety, one can be used with consent of the resident or the resident’s power of attorney. So, the real issue comes down to consent and medical necessity. Nursing homes should not be slapping bed alarms on every resident, as this would indeed make residents nervous and likely lead to some adverse issues. However, when the dangers of falling outweigh the risk of some agitation or discomfort with the alarm, then a medical provider should make the decision to use an alarm. Here are some instances where bed or chair alarms may be appropriate:

  • Dementia and Limited Mobility. Resident has dementia and may not be aware of his or her mobility limitations, causing them to get out of bed and try to ambulate without assistance. In this case, an alarm may provide an early warning to staff that the person is attempting to get up. If the facility is properly staffed and workers are properly trained, this should create urgency for staff to get to the resident. It should go without saying that yes, there may be times they cannot get to a resident in time. But in many situations, they will. 
  • History of Falls.  If the resident has a long history of falling and perhaps even a history of injury from falls, then an alarm may alert staff that the resident is moving around. Movement at night especially can be a sign that the resident needs to use the restroom. By alerting staff, nurses can be there to assist, rather than coming into the room in the morning to find a resident laying in the bathroom with a broken hip.


Some nursing home administrators and nurses will tell residents and their families that even bed rails are considered “restraints.” And yes, this too is case-by-case dependent. If a rail is used to keep a resident from moving around on their own, then yes, it is likely an unlawful restraint that can cause negative outcomes. But if the resident is capable of consenting and understands that the rails are up at night to keep them safe, and they or their power of attorney agree to it for the sake of preventing injuries, then there is nothing about this practice that would be improper. 

One potential issue with bed rails, however, is the staffing of the facility. If staff do not timely respond to call lights, then residents may end up waiting for hours for assistance getting to the restroom or getting out of bed. This can indeed be a restraint. So, in many situations, the issue is less about the bed rail itself, and far more about the fact that no one responds to assist the resident when needed. 


If your loved one is falling at a nursing home or has suffered any form of injury from falls, you need to contact an attorney familiar with these complex regulations and policies. Not all personal injury attorneys in southern Illinois truly understand how to handle a complex nursing home abuse or neglect case. At Crossroad Legal, LLC, attorney Jaye R. Lindsay has been fighting for the rights of injured nursing home residents for more than a decade. From our downstate office, we frequently help families throughout Illinois secure significant cash compensation for injuries. To find out more or to schedule a free consultation with the attorney, call (618) 515-5555 or email us directly at [email protected].