RTLS vs. WanderGuard: What Hospital Decision-Makers Need to Know

By Mike Maurer, President, MGM Solutions | 35+ Years in RTLS

If you’re evaluating patient wander management systems, you’ve almost certainly encountered WanderGuard — the legacy exit-alarm system that’s been installed in nursing homes and hospitals since the 1980s. It’s familiar, it’s affordable, and it’s what most facilities default to when “we need something at the doors.”

But here’s the question that doesn’t get asked often enough: is preventing a patient from exiting a door the same as knowing where every at-risk patient is, right now?

The answer matters more than most facility managers realize, and it’s the fundamental difference between WanderGuard-style exit alarms and modern Real-Time Locating Systems (RTLS). After 35+ years deploying both categories of technology in hospitals, VA medical centers, and corrections facilities, we’ve seen the consequences of each approach firsthand.

How WanderGuard Works

WanderGuard and similar systems (Code Alert, Tab-Sensor, AccuNurse) use a simple model:

A low-frequency tag is attached to the patient (usually as a wristband or ankle band)
Receivers are installed at exit doors
When a tagged patient approaches an exit, the system triggers an alarm and optionally locks the door

This model has been the standard of care in memory care units for decades. It’s straightforward, relatively inexpensive ($5,000-$15,000 per exit), and requires minimal staff training.

But it has a fundamental limitation: WanderGuard is blind between the exits. It cannot tell you where a patient is inside the building. It cannot alert you when a dementia patient leaves their unit. It cannot track movement patterns that predict elopement attempts.

How RTLS Changes the Equation

A true RTLS — like SecurTRAK’s wander and elopement management system — operates on a completely different principle. Instead of monitoring exits, it monitors patients.

Capability	WanderGuard	SecurTRAK RTLS
Exit door alerts	✔	✔
Real-time patient location	✘	✔
Zone-based alerts (patient leaves unit)	✘	✔
Works through walls and floors	N/A	✔ (433 MHz)
Campus-wide outdoor tracking	✘	✔
Historical location data	✘	✔
Staff duress integration	✘	✔
Asset tracking capability	✘	✔
Elevator integration	✘	✔
CCTV integration	✘	✔

The Scenario That Changes Minds

Consider this real-world scenario: A 78-year-old patient with moderate dementia is admitted to a 400-bed hospital. She’s on the 3rd floor medical/surgical unit. At 2:00 AM, she becomes confused and leaves her room.

With WanderGuard: Nothing happens. No alert is generated until she reaches an exit door — if she reaches one. She could wander through corridors, enter supply rooms, fall down stairs, or end up in the basement before anyone notices she’s missing. Staff discovers her bed empty during routine rounds at 3:00 AM. Search begins.

With RTLS: The moment she leaves the 3rd floor medical/surgical zone, the charge nurse’s phone receives an alert: “Patient Jane Doe has left Zone 3-West. Current location: 3rd floor elevator lobby.” Staff intercepts her within 60 seconds. No search. No incident. No documentation nightmare.

That’s not a hypothetical. We’ve seen this exact scenario play out hundreds of times across our installed base.

When WanderGuard Is (and Isn’t) Enough

We’re not here to tell you WanderGuard is useless — it’s not. For small memory care units with a single controlled exit, a door alarm system may be perfectly adequate. If your entire at-risk population is on one locked unit with one exit, you may not need campus-wide RTLS.

But WanderGuard becomes inadequate when:

At-risk patients are on open units (medical/surgical floors, rehab, etc.)
Your facility has multiple exits including emergency exits, loading docks, and roof access
You need to track patients across buildings on a multi-building campus
You want to combine elopement prevention with staff duress and asset tracking on one platform
Regulatory surveyors have cited your facility for inadequate elopement prevention

The Cost Comparison

WanderGuard is less expensive per door — typically $5,000-$15,000 per monitored exit. But when you calculate the total cost of protection for a mid-size hospital with 20+ exits, multiple buildings, and patients on open units, the math changes:

WanderGuard for 20 exits: $100,000-$300,000 (exit-only protection, no location tracking)
RTLS for full campus: $200,000-$500,000 (complete location tracking, zone alerts, exit alerts, staff duress, asset tracking)

The RTLS system costs more upfront but delivers 5-10x more capability. And when you factor in the litigation cost of a single preventable elopement incident ($1-5 million), the investment calculus is clear.

FAQ

Can RTLS and WanderGuard work together?

Yes, some facilities use WanderGuard at exits as a backup layer alongside RTLS for campus-wide tracking. However, most hospitals that deploy RTLS find that the door-locking and alert capabilities built into the RTLS platform make the separate WanderGuard system redundant. SecurTRAK integrates directly with door controllers and elevator systems.

Is WanderGuard still the standard of care?

WanderGuard was the standard of care for decades, but regulatory expectations have evolved. The Joint Commission and CMS surveyors increasingly expect facilities to demonstrate proactive patient monitoring — not just exit alarms. RTLS-based systems that provide continuous location tracking are becoming the new standard, particularly in acute care settings.

See the Difference RTLS Makes

MGM Solutions has been deploying wander and elopement management systems since 1987. We can show you exactly how SecurTRAK compares to your current door-alarm system — and what full campus visibility looks like.

Request a side-by-side demo: