Run Low Bed and Floor Mat Placement Verification — Free

Inspection Setup

Inspection date and shift recorded

Unit, hallway, or resident area identified

Residents included in this verification identified

Select the residents or rooms reviewed during this shift verification.

Low Bed Position Verification

Low bed is in the lowest position critical (required)

Verify the bed is lowered to the lowest available position for the resident.

Yes No N/A

Photo evidence (optional)

Bed controls or adjustment mechanism are functioning critical (required)

Confirm the bed can be lowered and raised normally and is not obstructed or damaged.

Yes No N/A

Bed is positioned to support safe resident transfer and egress

Verify the bed placement does not create an additional fall hazard and allows safe access for care.

Yes No N/A

No clutter or equipment blocks access to the bed critical (required)

Check that walkers, chairs, cords, or other items do not obstruct the resident's path or staff access.

Yes No N/A

Floor Mat Placement Verification

Floor mat is in place for residents with a high fall risk intervention critical (required)

Confirm the floor mat is present for residents whose care plan includes this fall-prevention intervention.

Yes No N/A

Photo evidence (optional)

Floor mat is positioned adjacent to the correct side of the bed critical (required)

Verify the mat is placed where it will reduce injury risk if the resident exits or falls from bed.

Yes No N/A

Floor mat is flat, secure, and not creating a trip hazard critical (required)

Check that the mat does not curl, buckle, overlap, or shift into a walkway.

Yes No N/A

Floor mat surface is clean and in good condition

Inspect for tears, wear, contamination, or damage that could reduce effectiveness or create a hazard.

Yes No N/A

Care Plan and Documentation Verification

High fall risk status supports use of low bed and floor mat intervention critical (required)

Verify the resident's fall risk status and care plan support the environmental intervention being used.

Yes No N/A

Low bed and floor mat intervention is documented in the care plan critical (required)

Confirm the intervention is listed in the resident care plan and matches current practice.

Yes No N/A

Any deficiency was communicated to the responsible nurse or supervisor

Document whether issues were escalated for immediate correction and follow-up.

Yes No N/A

Note (optional)

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Run: Low Bed and Floor Mat Placement Verification

Inspection Setup

Low Bed Position Verification

Floor Mat Placement Verification

Care Plan and Documentation Verification

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