Different ER beds



I was wondering if someone can explain the different scenarios where a patient is put in a Board Bed, Holding bed and an Overflow bed in ER. My understanding is that Overflow bed would be used in case ER is running to full capacity.

Board/Hold bed I guess would be used when physician decides to Admit patient and there is no MedSurg/ICU bed available. Is Board bed and Holding bed for the same purpose or there is some sort of a different between the two?

Also, are all of these beds licensed? As in, if Hospital says they are "250" bed hospital, then beds like Triage, Hold, Overflow etc.. counted?

Thanks for your input in advance.

psu_213, BSN, RN

Specializes in Emergency, Telemetry, Transplant. Has 6 years experience. 3,869 Posts

Different EDs probably give different names to hold beds, observation beds, overflow beds, etc. I'm not sure exactly how is works from a licensing perspective, but, in my experience, if a hospital is listed as having 250 beds, there are no ED beds included in that number--Even if some of the ED beds are used to hold overflow patients.

Someone with more regulatory experience may be able to provide more detailed information.


Specializes in Medical-Surgical/Float Pool/Stepdown. Has 6+ years experience. 1,224 Posts

It is my understanding that there are licensed beds and unlicensed beds. Licensed beds are already the predetermined amount for the hospital. Anything over the licensed bed count becomes unlicensed aka overflow beds.

If your hospital's census is fairly consistently above the licensed beds requiring the need to open unlicensed beds then your hospital can go in front of some governing agent - unsure of whom - and ask for more licensed beds but I think a hospital can only get so many beds at a time like 10 or so I believe each year.

You may want to briefly read up on hospital "designations" like critical access which I think can be no more than 25 beds, etc. It's kinda cool. Like I work at a designated Level I Trauma, Level III NICU, Teaching hospital, non-profit etc, etc. We take all types of patients from all over the state and a few surrounding states because of our trauma, stroke, MI etc designations, and our robust specialty services...especially from critical access hospitals.

AND we are not in the big city of Chicago to boot but we really do a lot of cool stuff, like partnering with area crital access hospitals so their doors can stay open and patients can be treated in their hometowns without having to drive hours to us when they're having stable health issues.