You Asked: Are bed and chair alarms allowed in nursing homes?
We Answered: Yes. Bed and chair alarms (position change alarms) are allowed under the federal regulations. However, CMS expects facilities to use them cautiously, based on an individualized assessment and care plan, and not as the primary or sole intervention for fall prevention.
Surveyors evaluate alarms under several F-tags. Under F584 (Safe/Clean/Comfortable and Homelike Environment), surveyors consider whether the widespread or long-term use of audible alarms creates an institutional rather than homelike environment. Under F604 (Right to be Free from Physical Restraints), an audible alarm may be considered a restraint if it inhibits a resident's movement because they are fearful of triggering the alarm. Surveyors also assess whether the alarm has resulted in negative outcomes such as decreased mobility, sleep disturbances, anxiety, or loss of dignity.
Under F689 (Free of Accident Hazards/Supervision/Devices), CMS emphasizes that alarms should never replace adequate supervision or staffing. In the State Operations Manual Appendix PP, CMS notes that research has not demonstrated that alarms effectively prevent falls, and they may contribute to alarm fatigue or simply alert staff after a fall has already occurred. If an alarm is used, the facility should demonstrate that it is part of a comprehensive, resident-centered fall prevention plan, based on an individualized assessment, monitored for effectiveness, and supplemented with interventions that address the resident's specific fall risks and routines.