Nursing Home Does Not Use Restraints - Should we be worried?

As your father is already accustomed to his own bed with his own full rails (presumably professionally fitted, and with cushioned bumpers?) this should go with him to the NH; and there should be a formal process for the NH to apply for permission to use these "restraints" in the patient's best interest.

The whole bureaucratic can of worms will have a formal, legal label in your state/county. In the UK it is referred to as "Deprivation of Liberty Safeguards," or DoLS for short; but every jurisdiction has its equivalent. Try Googling "legal use of restraints in [name of state] Nursing Homes" and see what you can find out. Then it will be a question of working with the NH to make sure they have this all set up before your father is admitted.

It goes roughly like this:

1. Risk identified and assessed.
2. Solution devised, deprivation of liberty identified.
3. Formal application for "DoL" made to safeguarding authority.
4. Permission granted by authority, with conditions. Or refused, if they don't agree that the proposed solution meets requirements. The solution must be:

- in the person's best interests
- necessary
- proportionate
- kept under review

Just by way of illustration, here is a section from the relevant legislation for Illinois (I picked Illinois at random) -
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 (210 ILCS 45/2-106) (from Ch. 111 1/2, par. 4152-106) 
    Sec. 2-106. (a) For purposes of this Act, (i) a physical restraint is any manual method or physical or mechanical device, material, or equipment attached or adjacent to a resident's body that the resident cannot remove easily and restricts freedom of movement or normal access to one's body. Devices used for positioning, including but not limited to bed rails, gait belts, and cushions, shall not be considered to be restraints for purposes of this Section; (ii) a chemical restraint is any drug used for discipline or convenience and not required to treat medical symptoms. The Department shall by rule, designate certain devices as restraints, including at least all those devices which have been determined to be restraints by the United States Department of Health and Human Services in interpretive guidelines issued for the purposes of administering Titles XVIII and XIX of the Social Security Act. 
    (b) Neither restraints nor confinements shall be employed for the purpose of punishment or for the convenience of any facility personnel. No restraints or confinements shall be employed except as ordered by a physician who documents the need for such restraints or confinements in the resident's clinical record. 
    (c) A restraint may be used only with the informed consent of the resident, the resident's guardian, or other authorized representative. A restraint may be used only for specific periods, if it is the least restrictive means necessary to attain and maintain the resident's highest practicable physical, mental or psychosocial well-being, including brief periods of time to provide necessary life-saving treatment. A restraint may be used only after consultation with appropriate health professionals, such as occupational or physical therapists, and a trial of less restrictive measures has led to the determination that the use of less restrictive measures would not attain or maintain the resident's highest practicable physical, mental or psychosocial well-being. However, if the resident needs emergency care, restraints may be used for brief periods to permit medical treatment to proceed unless the facility has notice that the resident has previously made a valid refusal of the treatment in question.
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What you'd need to find out next is how the NH goes about the correct procedure 😕

Perhaps you can get a lift to get your dad out of bed and into the chair and care for him at home longer? One of my neighbors has one, he fell off a ladder and has no use of his legs.. My neighbors are in their 70's... My Grandparents were here til the end and on hospice. GP had lots of equipment. If I recall once on hospice they took care of providing the equipment.

Ask the facility if they have a Posey bed. It kind of looks like a playpen over the bed. Zippers and flaps on outside of bed. He can't unzipped. He is enclosed but not restrained. He can't crawl out.

While restraints are usually not acceptable, if a doctor determines that they are needed, there maybe a roundabout to their use at the facility. While I do not know how each state rules on these matters, I know that here there is a work around if necessary to prevent injury and to reduce legal action against ALF for such issues. Check with his primary care doctor and seek legal advice to protect your dad.