>Users:   login   |  register       > email     > people    

Sample Guideline: Bottom Bunk Requests
By Jeffrey E. Keller MD
Published: 12/10/2018

Bunk bed This clinical guideline is intended to be used as a template to help clinicians and administrators create their own policies. This sample guideline must be modified to make it applicable to each unique correctional facility. This guideline is not intended to apply to all patients. Practitioners should use their clinical judgement for individual patients.

Introduction. Occasionally, inmates who have been assigned the top bunk of a bunk bed state that they have a medical condition that requires them to be given the bottom bunk instead. Since medical providers must be fair and consistent, it is important to differentiate medical need for a low bunk from requests made for non-medical reasons such as a desire for convenience or as a sign of increased status.

Medical need. Medical need for a low bunk generally falls into one of two categories: Patients who are unable to safely climb onto the top bunk because of physical limitations and patients who have a medical condition that might lead them to fall off of the top bunk and injure themselves. Patients who are unable to safely climb onto the top bunk because of physical limitations include:
  • Obesity (BMI >30)
  • Advanced age and/or infirmity
  • Late term pregnancy.
  • Permanent physical disabilities, such as amputations, paralysis, or previous strokes.
  • Temporary physical disabilities such as a broken bone or recent surgery.
Patients who have a medical condition that might lead them to fall off of the top bunk include:
  • Seizure disorders which are current and ongoing.
  • Conditions causing vertigo or dizziness, such as Meniere’s disease.
  • Conditions which impair coordination such as cerebral palsy.
Chronic pain syndromes independent of other conditions such as those listed above generally do not constitute a medical need for a bottom bunk assignment.

Patients who have been successfully using a top bunk generally do not have a medical need for a bottom bunk reassignment unless their medical condition has acutely changed, such as with a traumatic injury. Example. A patient has been using a top bunk for three weeks. Now he comes to medical stating that there are several bottom bunks available in his pod. He would like medical to approve a bunk reassignment for him because of an old leg injury. The fact that he has been using a top bunk for three weeks indicates that this patient does not have a legitimate medical need for a bottom bunk.

Nursing Personnel may address routine patient requests for low bed assignments based on this guideline. If nursing personnel are unsure or have questions, they may refer the patient to a medical practitioner.

Documentation. Security personnel assign bunks, not medical personnel. Medical personnel are being asked if a patient has a medical need for a low bunk assignment. Therefore, medical personnel should document the answer to this question only.

Incorrect: “Bottom bunk request is not approved.”
Correct: “This patient does not have a medical need for a bottom bunk assignment.”
Incorrect: “Bottom bunk is approved for medical reasons.” (Security staff may elect to place the patient on a single bed, a cot, or a floor “boat” instead of a bottom bunk.)
Correct: “This patient should not be assigned a top bunk for medical reasons.”

If a patient does have a legitimate medical need for a low bunk assignment, consideration should also be paid to the patient’s other housing needs. For example, a low bunk may not actually meet the patient’s needs; the patient may need a hospital bed. Patients who have a medical need for a low bunk assignment may need to be restricted to a bottom tier so that they will not have to climb stairs. Patients who are inmate workers may need work restrictions. If the medical need for a low bunk assignment is temporary (such as a broken arm), the bottom bunk memo should have a time limit.

Sample guidelines can be found under the “Guidelines” tab (above) as they are published. I view these sample guidelines as a group effort! If you have a suggestion, critique or simply a better way to phrase some concept, say so in comments!

Corrections.com author, Jeffrey E. Keller is a Board Certified Emergency Physician with 25 years of practice experience before moving full time into the practice of Correctional Medicine. He is the Chief Medical Officer of Centurion. He is also the author of the "Jail Medicine" blog

Other articles by Keller


  1. hamiltonlindley on 03/18/2020:

    Hamilton loves his family of five and badminton. His favorite sports ball team is the McGregor Dodgeballers. He has worked as a foreman on a chain gang, and later in life he was an architect of skyscrapers and tunnels. He was forced to give up his career because he was terrible at math. Hamilton has a keen attention to detail. He enjoyed watching bowling on TV and spent most every weekend on the couch falling asleep. He was a demon at croquet. He also enjoyed war movies and baking shows. Hamilton Lindley is constantly helping others less fortunate and lending a helping hand for relatives and friends in need of encouraging words. He coaches different sports and provided guidance for people who needed it, and a few who didn’t want it.

  2. RicardoOrnello on 05/05/2019:

    This article states a lot of essential parts of the process. But you can describe it better with the help of http://essaylab.co.uk/, if you want more people to see your information. Will it be useful for you?

  3. RicardoOrnello on 05/05/2019:

    This article states a lot of essential parts of the process. But you can describe it better with the help of http://essaylab.co.uk/ , if you want more people to see your information. Will it be useful for you?

  4. lewis on 01/14/2019:

    Burger King has started an online customer satisfaction survey using their official website. This article provides you with the complete guide for taking part in the ‘Mybkexperience’ survey. mybkexperience | www.mybkexperience.com | mybkexperience.com

  5. siko11 on 12/21/2018:

    http://awalsh.com/78828 http://www.short4free.us/81044 http://tans.me/60259 https://atho.me/3TeA http://www.xn--277c.com/20038 http://ralive.de/26478 http://www.vkvi.net/57499 https://aaa.moda/20284 https://arill.us/52500 http://freest.at/65141 https://arill.us/42921 http://go.fireontherim.com/52454 http://999.sh/24740 http://perkele.ovh/62926 https://aaa.moda/70623 https://aaa.moda/89654 http://www.vkvi.net/69989 http://awalsh.com/50586 http://awalsh.com/82992 http://valeriemace.co.uk/89358 http://perkele.ovh/48025 http://www.short4free.us/72357 http://www.abcagency.se/28400 http://tans.me/94601 http://wntdco.mx/43847 https://atho.me/3Thu https://lil.ink/41105 http://www.vkvi.net/84169 http://freest.at/50166 http://go.fireontherim.com/12079 https://e13.co/36852 https://atho.me/3Tfz http://tropaadet.dk/28028 https://e13.co/66252 https://arill.us/55267 http://rih.co/17978 http://tans.me/87373 http://www.short4free.us/40929 http://corta.co/13569 http://wntdco.mx/14862 http://webhop.se/79451 https://tinyurl.com/y8tjf7tm http://freest.at/17081 https://xxs.yt/57504 http://wntdco.mx/70905 http://valeriemace.co.uk/22747 http://freest.at/29230 http://tans.me/31710 http://freest.at/40059 https://tinyurl.com/yczs4j2e http://tropaadet.dk/80599 http://www.vkvi.net/63530 http://perkele.ovh/51830 https://aaa.moda/53318 https://lil.ink/61494 http://www.short4free.us/27575 http://perkele.ovh/25980 http://www.lookweb.it/34075 http://goto.iamaws.com/54390 https://lil.ink/23179 http://tans.me/11707 https://aaa.moda/73651 http://perkele.ovh/77512 https://aaa.moda/80865 http://www.short4free.us/89473 http://wntdco.mx/58797 http://www.vkvi.net/64134 http://jnl.io/58292 http://tropaadet.dk/52936 http://goto.iamaws.com/63360 http://ralive.de/56216 http://ralive.de/22036 http://ralive.de/46687 http://freest.at/99440 http://www.abcagency.se/47170 http://ralive.de/86606 https://e13.co/95127 https://arill.us/42024 http://corta.co/52306 https://aaa.moda/15691 https://xxs.yt/20911 http://rih.co/54003 http://rih.co/26646 http://awalsh.com/57878 http://freest.at/44754 http://ralive.de/47743 http://valeriemace.co.uk/38543 http://www.short4free.us/79056 http://www.vkvi.net/95515 http://perkele.ovh/95931 http://tans.me/23858 https://arill.us/83425 http://www.short4free.us/63980 http://www.xn--277c.com/83982 http://ralive.de/29035 http://go.fireontherim.com/62497 http://www.abcagency.se/87565 https://atho.me/3SPc http://webhop.se/57724 http://jnl.io/60556

  6. enable on 12/13/2018:

    I prefer typically the present. It is terrific to realize a man or woman verbalize from your very own cardiovascular system in addition to good utilizing this fundamental topic may well be readily perceived. Offer Financing to Customers

Login to let us know what you think

User Name:   


Forgot password?

correctsource logo

Use of this web site constitutes acceptance of The Corrections Connection User Agreement
The Corrections Connection ©. Copyright 1996 - 2022 © . All Rights Reserved | 15 Mill Wharf Plaza Scituate Mass. 02066 (617) 471 4445 Fax: (617) 608 9015