A mattress with a rotating and waste elimination system comprises a mattress with a recessed area for receiving a rotation and waste elimination system. The rotation and waste elimination system comprises a (i) frame with a rectangular base and two side walls, forming a “U” shape; (ii) platform (with a central cut out for a waste elimination bag) suspended over the base by two pairs of sliding posts; (iii) optional four chains attached to the platform and side walls; and (iv) programmable electronic gear to operate the sliding posts to simultaneously raise one end and lower the opposite end of the platform to gently turn the patient. Alternately, the gear operates a cable/pulley system (involving two independent systems positioned outside the frame) by attaching one cable end to the midpoint of the platform's shorter side and the other cable end to the gear to rotate and counter-rotate the platform.