Who this guide is for
This is written for the person who has to put a specification on paper and defend it: hospital procurement officers, care-home and hospice buyers, group purchasing teams, laundry managers, and hospitality groups that run institutional-grade laundering rather than a domestic wash.
It assumes you already know roughly what you need. What it gives you is the vocabulary and the decision order, so that the quotes you receive back are comparable and the bedding survives the wash house.
What "hospital bedding" actually means in a purchasing spec
When a buyer says hospital bedding they usually mean one of two very different things, and the confusion causes most of the mistakes in this category.
The first meaning is the bed itself — frames, mattress platforms, pressure-relief surfaces, side rails. That is medical equipment, sold by equipment distributors, and it is not what a textile supplier quotes on. The second meaning is what sits on the bed: the textile set that is changed, washed and replaced on a cycle.
This guide is entirely about the second meaning. If you are sourcing equipment, close this page. If you are sourcing the textile set, the useful structure is a fixed list of six items — and almost every institutional bedding quotation follows some subset of those six.
The six items in a care-bed set
Write your specification as a list of items rather than as a description of a bed. Each item is quoted, replaced and laundered separately, so each needs its own line, its own tolerance and its own quantity.
A full institutional set is usually built from these six. In practice most buyers order four or five of them and skip the rest.
- If your laundry runs chlorine bleach, items 1 to 4 must be specified for it before anything else is decided.
- If your beds are profiling (adjustable) beds, item 2 needs a deeper gusset than a flat-bed measurement suggests.
- If your patients are repositioned manually rather than with a hoist, item 3 will be your highest-consumption line — and the one worth over-specifying.
| # | Item | What it does | Typical replacement driver |
|---|---|---|---|
| 1 | Flat sheet (top sheet) | Covers the patient; the layer that takes most abrasion | Hem failure, thinning at the centre |
| 2 | Fitted sheet (bottom sheet) | Anchors to the mattress; corners take the load | Elastic failure, corner tear |
| 3 | Draw sheet / slide sheet | Sits under the patient to allow repositioning without dragging | Highest mechanical stress in the set |
| 4 | Pillowcase | Encloses the pillow; most frequently changed item | Staining, seam failure |
| 5 | Pillow | Support surface | Loss of loft, contamination |
| 6 | Mattress protector / underpad | Fluid barrier between patient and mattress | Coating breakdown, waterproofing loss |
Item 1 — flat sheet: how to write the line
A flat sheet line has five variables. Write all five, or your supplier will choose two of them for you.
Fabric composition. State the fibre blend as a percentage, not as a name. "Cotton-rich" is not a specification; "50% cotton / 50% polyester" is. If you need wicking behaviour, say so, because a poly-cotton blend wicks differently from a 100% cotton sheet even at the same weight.
Fabric weight. Give GSM (grams per square metre), not thread count. In institutional laundering, GSM predicts how many wash cycles a sheet survives far better than thread count does.
Finished dimensions. Always give finished size plus a shrinkage allowance, and state which of the two you are quoting. A sheet quoted at 140 x 220 cm that arrives at 132 x 208 cm is not a defective sheet — it is a quote that silently included the allowance.
Construction. State the hem type, the stitch density and whether the side hems are single or double folded. Hems are where institutional sheets fail first.
Colour and finish. State the shade reference and whether the fabric is optically brightened, because brighteners interact with bleach chemistry.
Item 2 — fitted sheet: the gusset is the whole specification
A fitted sheet is defined by its corner construction, not by its flat measurement. Two suppliers can both quote "fits a 90 x 200 cm mattress" and deliver products that behave completely differently.
Specify the gusset depth as a finished measurement, then state the mattress depth range it must cover. On a profiling bed the mattress compresses and extends as the head section rises, so the gusset needs more depth than a static measurement suggests.
Specify the corner treatment. A simple sewn corner costs least to make and fails first. A boxed or mitred corner with reinforced stitching costs more per piece and typically outlasts the body of the sheet.
Specify the elastic. Fully elasticated (all the way round) holds better on a profiling bed than corner-only elastic. If you use corner elastic, specify the length of each elastic segment, because "corner elastic" alone covers everything from 8 cm to 40 cm.
Where a fitted sheet keeps slipping, the fix is usually gusset depth plus elastic coverage — not heavier fabric. Adding GSM to solve a fit problem spends money on the wrong variable.
Item 3 — draw sheet and slide sheet: specify the one item you will replace most
The draw sheet sits under the patient and is pulled to reposition them. That means it takes shear and tensile load that no other item in the set sees, and it is the item that most often fails first in a set that is otherwise still serviceable.
Specify it as a load-bearing textile, not as a small sheet. Relevant variables: tensile strength in both directions, the reinforcement at the pulling edge, and whether the pulling edge is a folded hem, a taped edge or a bound edge.
If your care protocol involves hoists, specify a slide sheet with a low-friction panel and state which side faces the mattress. Getting the orientation wrong in the specification produces a slide sheet that behaves like a brake.
Because this item is replaced most often, it is the one where an apparently small unit price difference compounds fastest across a year. Put it on its own line in the quote comparison.
Item 4 — pillowcase: the housekeeping variable
Pillowcases are changed more often than sheets in most facilities, so the annual volume is higher even though the unit price is lower. That makes two specification details disproportionately important.
Closure type. An open-end pillowcase is fastest to change and lets the pillow escape. A flap (housewife) closure holds the pillow without hardware. A tuck-in closure on an oxford-style case is the most secure and the slowest to change. Choose based on your housekeeping time budget, not on price.
Seam construction. The side seam on a pillowcase sees repeated tension each time a pillow is inserted. Specify a double-stitched or flat-felled seam if you want the case to outlast the sheet it matches.
If your facility uses pillow protectors under the case, say so — it changes the required case dimensions by a centimetre or two, and a case that is one size too small will split at the seam within a few months.
Item 5 — pillow: the item buyers under-specify most
Pillows are usually bought on price and replaced on complaint. Specifying them properly is mostly about three numbers and one construction choice.
Fill weight, not just fill type. "Hollowfibre" describes a material family, not a firmness. Give the fill weight in grams and the finished loft height in centimetres.
Cover fabric. Specify the ticking weight and whether it is down-proof. A pillow cover that allows the fill to migrate will lose loft from the inside out, long before the ticking looks worn.
Construction. Stitched-edge, piped-edge and double-stitched-edge pillows behave differently after 50 wash cycles. If the pillow will be laundered rather than replaced when soiled, specify the construction and the wash temperature it must survive.
Barrier option. Where infection-control protocol requires a wipeable surface, specify an encased pillow with a coated cover, and state the coating type rather than a performance claim.
Item 6 — mattress protector and underpad: the item where cheap fails visibly
A mattress protector is a barrier product. Its whole job is to stop fluid reaching the mattress, and its failure mode is invisible until the mattress is already contaminated.
Specify the barrier as a coated fabric with a stated coating weight, or as a laminated membrane with a stated hydrostatic resistance. "Waterproof" on its own is a marketing word, not a specification.
Specify the skirt. A fitted skirt holds on a profiling bed; a flat protector slides. If the mattress is profiled, specify skirt depth against the maximum mattress depth, not the resting depth.
Specify the wash and temperature limit in cycles, not just in degrees. A protector rated for a temperature but not for a cycle count will be quoted by one supplier at 50 cycles and by another at 150, and you will not see the difference until year two.
Underpads (the absorbent layer used on top) are a consumable and should be on a separate line with a separate annual quantity, because they are replaced far more often than the protector itself.
Fibre choice: why poly-cotton dominates institutional bedding
In domestic bedding, 100% cotton is the premium choice. In institutional bedding, the calculus is different, and the reason is the wash house rather than the patient.
Three fibre routes are common, and they behave differently across a laundering life.
Poly-cotton blends (most often 50/50 or 65/35 polyester/cotton) hold their dimensions better through repeated hot washing, dry faster, and resist the mechanical abrasion of a tunnel washer better than 100% cotton at the same weight. They feel less soft when new and stay closer to their original feel over time.
100% cotton is more comfortable against skin when new and handles higher temperatures without losing strength. It also shrinks more and pills more under industrial abrasion, which means a larger shrinkage allowance and a shorter replacement cycle in high-turnover facilities.
100% polyester is the most dimensionally stable and the lowest-cost to replace, and it is the least comfortable against skin. It is widely used where the bedding is a barrier rather than a comfort surface.
| Route | Dimensional stability | Drying time | Abrasion life | Skin feel when new |
|---|---|---|---|---|
| 50/50 poly-cotton | High | Short | High | Moderate |
| 100% cotton | Moderate (needs allowance) | Long | Moderate | High |
| 100% polyester | Very high | Shortest | Highest | Low |
GSM, thread count and what actually predicts survival
Thread count is a marketing number in this category. It can be inflated by counting multi-ply yarns individually, and it says nothing about how a sheet behaves in a tunnel washer.
GSM is the more useful number because it correlates with the mass of fibre available to resist abrasion. As a working reference, institutional flat sheets commonly sit in the 110–150 GSM range for poly-cotton, with higher weights used where the wash cycle is aggressive or the replacement budget is tight.
There is a second number that matters more than either and is almost never quoted: yarn count or yarn linear density. Two 130 GSM sheets can be built from very different yarns, and the finer-yarn version at the same weight will feel better and abrade faster.
If you can only put three fabric numbers in your specification, use GSM, composition percentage, and either yarn count or tensile strength. Those three predict service life far better than thread count.
Sizes: the standard dimensions and the allowance rule
Care-bed mattress sizes vary by country and by facility, so there is no single correct dimension — but there is a correct way to state whichever dimension you choose.
The rule is: state the finished dimension, and state the shrinkage allowance separately. A supplier cannot be held to a finished size that was never given, and you cannot compare quotes that treat the allowance differently.
A practical allowance guide for woven cotton and poly-cotton bedding, to be confirmed against the supplier's own test data for the specific fabric:
For the mattress itself, most care beds fall into a small number of standard footprints, and the fitted sheet dimensions follow from the footprint plus mattress depth plus allowance. Measure the actual mattress fleet rather than the purchase order — mattress depth in particular drifts over a fleet's life as toppers are added.
| Item | What to state | Typical allowance direction |
|---|---|---|
| Flat sheet | Finished width x finished length | Length allowance larger than width |
| Fitted sheet | Finished width x length x gusset depth | Gusset depth for max mattress depth, not resting |
| Pillowcase | Finished width x length + closure type | Small, but confirm against pillow + protector |
| Draw sheet | Finished width x length + pulling-edge construction | Width allowance for tuck-in |
The bleach problem: chlorine versus oxygen, and why it decides your colour
If your laundry uses chlorine bleach, most of your colour decisions have already been made for you. Chlorine attacks dyed cotton and will progressively strip almost any shade back toward white, unevenly and unpredictably.
The practical consequence is that facilities running chlorine bleach standardise on white bedding and treat every coloured item as a consumable with a short life. Facilities running oxygen-based bleach systems have far more shade freedom, but oxygen systems typically need higher temperatures and longer dwell times.
Write the bleach chemistry into the specification. Not as a preference but as a constraint: "must withstand X cycles of [chemistry] at [temperature]". A supplier who knows the chemistry can select dye class accordingly. A supplier who does not will quote a standard shade and you will discover the problem at cycle 20.
There is also a colour-management point that is easy to miss. Where a facility uses colour to distinguish wards or departments, specify the shade by a reference the supplier can match, and specify the tolerance. Two deliveries of "blue" from the same supplier can be visibly different, and mismatched bedding across one ward is a visible failure even when every item is within its own specification.
Specifying for laundering cycles: the number that should lead your RFQ
The most useful single number you can put in a hospital bedding specification is the expected number of industrial wash cycles the item must survive before replacement. Everything else — fibre, GSM, seam construction, coating — is selected to meet that number.
A specification written this way changes the supplier conversation completely. Instead of comparing fabric descriptions, you are comparing three suppliers' answers to the same service-life question, and you can ask each of them what their answer is based on.
Two practical notes. First, ask for the number as a range with the conditions attached (temperature, chemistry, load size), because a cycle count without conditions is not comparable. Second, separate the items: a draw sheet and a pillowcase in the same set will not have the same target, and forcing one number across the whole set over-specifies the cheap items and under-specifies the expensive ones.
Finishing, stitching and the details that decide service life
Fabric is the visible half of a bedding specification. Construction is the half that decides whether the item fails at the hem or at the seam, and it is where the largest differences between apparently similar quotes sit.
Hems. Specify the hem width and whether it is a single or double fold. A wider double-folded hem takes longer to fail at the same abrasion level.
Stitch density. Specify stitches per unit length rather than just "double stitched". Very high stitch density in the wrong fabric perforates it and creates a tear line; the correct density depends on the fabric.
Bar-tacks at stress points. On fitted sheets these belong at the corner joins; on draw sheets, at the pulling edge. Their absence is the most common cause of a "premature" corner failure.
Thread. Specify the thread type and colour-match rule. Cotton thread in a poly-cotton product shrinks differently and can create a pucker line that becomes the failure point.
Labelling and traceability
Institutional bedding is tracked. Whether you need item-level traceability depends on your asset-management approach, but the labelling decision needs to be made before production, not after.
The available routes are a woven or printed care label, a printed barcode, a QR code, or an RFID tag. Each has a different cost and a different position in the product, and each has a different survival profile through laundering.
If you intend to track individual items through their service life, specify the tag type, the position (and make sure the position avoids the highest-abrasion zone) and the laundering conditions the tag must survive. A traceability programme that loses its tags at cycle 40 delivers no data.
Where you only need batch-level traceability, a printed care label with a production reference is usually sufficient and costs nothing extra. Decide which of the two you actually need before you ask for quotes.
How to compare three supplier quotes like for like
Most hospital bedding procurement goes wrong at the comparison stage rather than at the selection stage. Three quotes arrive, each is priced on slightly different terms, and the lowest-priced one wins on a difference that was never real.
Normalise the quotes on these axes before you compare any number. If a supplier cannot answer one of them, that is itself information.
Only after all seven axes are filled in for all three quotes does a price comparison mean anything. In practice, doing this exercise usually changes which quote is lowest.
- Composition stated as percentages, not names
- GSM stated for every fabric component
- Finished dimensions stated, with the shrinkage allowance stated separately
- Construction stated: hem type, stitch density, bar-tack positions
- Target wash cycles stated with the conditions attached
- Packing stated: pieces per pack, packs per carton, carton dimensions and gross weight
- Lead time stated from order confirmation or from artwork approval — these are different dates and often differ by weeks
Order quantities and lead-time planning
Institutional bedding is made to order, so the order quantity interacts with both the unit price and the delivery schedule in ways that a domestic purchase does not.
Volume and cost. Unit price falls with quantity, but the more important effect is on colour and construction consistency. A single larger run produces more consistent shade and construction than several smaller runs across the same period.
The minimum order is usually expressed per style and per colour, not per order. That means a facility wanting four colours across two sizes may hit four separate minimums, and this is worth resolving before the RFQ goes out rather than after the quote comes back.
Lead time. Plan backwards from your changeover date and include three separate periods: production, transit, and inbound handling at your end. Buying against a fixed changeover date without a buffer is the most common cause of an emergency top-up order, and emergency orders are the most expensive way to buy bedding.
What to check in a sample before you commit to bulk
A sample has a different job from production. Its job is to let you test the specification, not to show you the best possible version of the product.
Ask for the pre-production sample to be made from the same fabric lot and the same construction as the bulk order, and say so explicitly. Otherwise you are evaluating a prototype, not the product.
Then test it against the specification rather than against your impression of it. Measure it, wash it, measure it again. A sample that looks right and measures 4% short has told you something a photograph never will.
Where a barrier coating, a finish or a traceability tag is part of the specification, the sample needs to include it. Testing a sample without the coating tells you nothing about the coated product.
A sample-first workflow, followed by photographs of the bulk production before shipment, removes almost all of the uncertainty in this category. Both steps are standard practice and neither should cost you anything beyond the sample itself.
- Measure finished dimensions before washing, and again after the first wash at your laundry conditions
- Check every hem for fold width and stitch type
- Check bar-tacks at the positions named in the specification
- Confirm the shade against the reference under daylight, not under office lighting
- Where a coating or tag is specified, confirm both are present and positioned correctly
What to check in the bulk shipment
By the time the bulk order ships, the specification has already been tested. The remaining risk is consistency — that the bulk matches the approved sample.
Ask for pre-shipment photographs showing finished items, the packed cartons and the shipping marks. This is a low-cost check that catches labelling and packing errors before they cross a border.
On receipt, check three things before the shipment is distributed: carton count and carton condition, the finished dimensions of a sample of items against the approved sample, and the shade of a sample against the reference.
Discrepancies found at this stage are resolvable. The same discrepancy found after the bedding has been distributed across twelve wards is not.
Six specification mistakes that cost the most
These are the errors that show up repeatedly in institutional bedding procurement, in roughly descending order of cost.
- Giving a cut size instead of a finished size. Produces a product that is described correctly and behaves wrongly, and the dispute is unwinnable.
- Specifying thread count instead of GSM. Pays for a marketing number and tells you nothing about service life.
- Leaving bleach chemistry out of the specification. Guarantees a shade failure at some point in the first year and makes it look like a manufacturing defect.
- Specifying "corner elastic" without a segment length. Two suppliers deliver two different products under the same words.
- Under-specifying the draw sheet. It is the highest-stress item in the set and usually the lowest-cost line in the quote.
- Comparing quotes on unit price alone. The lowest unit price frequently belongs to the quote with the shortest target service life.
Writing the RFQ: the order that works
If you send one thing to suppliers, send this structure. It produces comparable quotes and it also tests the supplier, because a supplier who cannot answer these questions in writing is telling you something useful.
State the facility context first, the items second, the performance requirement third, and the commercial terms last. Suppliers who receive the performance requirement before the fabric description tend to quote the fabric they already stock; suppliers who receive it in this order tend to quote to the requirement.
- Facility type and bed count, plus the bed sizes and maximum mattress depth
- Laundry conditions: maximum temperature, bleach chemistry, expected cycles between replacement
- Item list with quantities per item, per year
- For each item: composition in percentages, GSM, finished dimensions, construction details
- Colour: shade reference and tolerance, or "white only"
- Labelling and traceability requirement, or "none"
- Packing requirement and shipping terms
- Required delivery date and the date the order will be placed
- Sample requirement: pre-production sample from production fabric, yes or no
