A bed exit and patient detection system especially adapted for use in the general medical or surgical floor area of a hospital or other healthcare facility as part of a vital signs monitoring and remote warning system includes a plurality of pressure sensors disposed in the patient's bed in a series of rectangular strips or zones that run laterally across the bed in the area of the patient's mid-back, hips and mid-legs, respectively. Each zone contains a plurality of sensors, arranged symmetrically about the centerline of the bed, with the corresponding sensors on opposite sides of the centerline in each zone being connected in parallel. The sensors are connected to a processor with multiple input channels that continuously monitors the sensor states to determine, from the pattern of sensor states observed, whether the patient is in bed, out of bed or is actively attempting to exit the bed at the sides or foot of the bed. At least three different sets of bed exit logic rules are available for user selection to configure the system for high, medium or low sensitivity, or bed exit privileges, for any particular patient. In some embodiments, the system also is capable of detecting when a patient is attempting to assume certain prohibited in-bed positions, such as sitting positions or slumping positions. An alarm in the form of a pre-recorded voice announcement or an alarm over a pre-existing nurse call system is provided when the sensor states are indicative of an out-of-bed or an exiting bed condition, or other prohibited in-bed positions, for a predetermined minimum period of time.