A patient monitoring and repositioning system includes a mattress, a sheet residing on an upper surface of the mattress, a housing containing a drive mechanism, and a sensor adapted to sense a position of a patient resting on the mattress. The drive mechanism is operable to pull the sheet and thereby pull the patient resting thereon. The housing receives the sheet through a slot. In the event that the patient is in an undesirable position on the mattress as detected by the sensor, a controller directs the drive mechanism to pull the sheet so as to pull the patient thereon from the undesirable position to a desirable, predetermined position. The controller may direct the drive mechanism automatically or indicate the undesirable position to a caregiver so that the caregiver may direct the drive mechanism accordingly.