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Wider beds in long-term care

September 13, 2010
by Lisa Cini
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This is really not an issue until we consider that an existing door is typically 36", which leaves us with approximately 34" of clear space for the opening. There are some larger beds being produced at 35" wide, and these won't fit through a typical door width unless the rails are taken off.

The obvious answer to this issue is to start specifying wider doors. However, in existing conditions this is very difficult.

My concern is that as long-term care interior designers, we rely on manufacturers to design furniture for the typical long-term care environment. What they are doing (rightly so) is designing for patient need and caregiver observations. We need to follow their lead and stop designing to code and plopping and dropping outdated unit sizes and layouts.

The British Healthcare Trades Association has highlighted the next generation of beds that moves a resident from laying to seating, assisting them to a walking position. (Click here for more details.)

If this can be done with a bed maybe we need to address the issue of doors and the fact they really haven’t changed in hundreds of years.

Lisa Cini

President and CEO


Cini is president and CEO of Mosaic...



This may sound strange but if there were a science-fiction thriller written which happens to occur on a long-term care facility in the future. Hollywood would figure out what the nursing home of the future looks like.


I am a designer at Joerns Healthcare and I understand, first hand, the challenges you mention. We need to balance the environmental and clinical needs of the residents. I've had a lot of great success with our UltraCare XT bed. We specify it with the UltraWide extension kit that takes a 35"W bed to 39" or 42" — without tools! Our solution was to allow for a wider bed option, without limiting its ability to get through a door or not fit in a smaller room through no-tools removable width extension kits. We can also add a residential style wood trim kit to the bed frame, immediately providing a more homelike feel to the care environment.

Craig and Kathleen, I agree with both of your comments. Unless a facility is going from multi-bed units down to privates it becomes extremely difficult to widen doors and maintain the required side access needed for ADA. I was hoping in my dream of dreams that manufacturers would see this issue and develop more of a convertible option for beds so that current door widths would not be an issue and patient comfort and safely were met.

Lisa, I can sympathize with your position, especially when it comes to designing to outdated codes. However, the fact remains that the vast majority of facilities were built 40-45 years ago with little upgrades. The current economic conditions, specifically reimbursement, preclude most providers from undertaking substantial structural upgrades of their facilities.

Given the age of the current facility portfolio, it is a matter of time before substantial physical plant changes will need to occur. But, the issue of funding for such changes becomes a central concern. Until then, it becomes quite difficult to practically design equipment and supplies without having to deal with outdated codes.