Harmony Healthcare Blog

Siderails/Bedrails F700: State Operation Manual Appendix PP

Posted by The Harmony Team on Tue, Aug 07, 2018

Edited by Kris Mastrangelo


Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency

Ill senior woman and nurse using talcum powder-1The State Operation Manual Appendix PP specifically addresses siderails in F700. 

The SOM states: 

“After a facility has attempted alternatives to bedrails and determined that these alternatives do not meet the resident’s needs, the facility must assess the residents for the risk of entrapment and possible benefits of bedrails.” 

The components of the assessment (resident) should be considered including: 

  • Medical diagnoses, conditions, symptoms and/or behavioral symptoms
  • Size and Weight
  • Sleep Habits
  • Medication(s)
  • Acute Medical or Surgical Interventions
  • Underlying Medical Conditions
  • Existence of Delirium
  • Ability to Toilet Self Safely
  • Cognition
  • Communication
  • Mobility (in and out of bed)
  • Risk of Falling 

The assessment must include the alternatives to the use of a bedrail that were attempted and how these alternatives failed to meet the resident’s assessed needs. 

The facility must also assess the resident’s risk from using bedrails: 

  • Accident Hazards
  • Barrier to residents from Safety Getting out of Bed
  • Physical Restraint
  • Potential Negative Outcomes
  • Potential Negative Psychosocial Outcomes 

HHI Site Visit

After the rails are set up, the facility must obtain an informed consent from the resident or resident representative. Information that the facility must provide the resident or resident representative include: 

  • What assessed medical needs would be addressed by the use of bed rails?
  • The resident’s risks from the use of bed rails and how those risks will be mitigated.
  • The resident’s benefits from the use of bedrails and the likelihood of those benefits.
  • Alternatives attempted that failed to meet the resident’s needs and alternatives considered. 

The Care Plan should define: 

  • How the medical needs are met.
  • How often the rail is applied.
  • How monitoring is provided.
  • Resident’s functional ability.
  • Interventions to address only potential complications.
  • Interventions to minimize the use of bedrails.
  • Who monitors the implementation of bed rails and determines the ongoing need for the rails.

The Harmony Healthcare International (HHI) site visit process is an intensive, detailed review of the medical record content to identify compliance risk areas, revenue and coding opportunities, systematic refinements with the overarching goal to improve medical record accuracy and minimize compliance concerns. 

To learn more about our site visit process, click here.

Harmony Healthcare International (HHI) is available to assist with any questions or concerns that you may have.  You can contact us by clicking here.  Looking to train your staff?  Join us in person at one of our our upcoming Competency/Certification Courses.  Click here to see the dates and locations. 

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Tags: physical restraints

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