Falls are common in older adults, but they should never be shrugged off as “expected” in a nursing home. Residents in facilities experience falls far more often than people living independently, and the consequences can be life changing. National public health data shows that falls are the leading cause of injury for adults 65 and older and that more than one in four older adults reports a fall each year.
That is why every incident in a facility deserves careful review to determine whether it was an unavoidable accident or the result of missed assessments, poor supervision, or unsafe conditions.
Why Are Falls So Serious In Nursing Homes?
Falls are the leading cause of injury-related death among adults ages 65 and older, and the fall death rate is increasing.The age-adjusted fall death rate increased by 41% from 55.3 per 100,000 older adults in 2012 to 78.0 per 100,000 older adults in 2021.
In Arizona, nearly 27% of adults aged 65 and older experienced a fall in 2020, resulting in more than 300,000 incidents statewide.
The rising number of deaths from falls among older adults can be addressed by screening for fall risk and intervening to address risk factors such as use of medicines that may increase the likelihood of falling or poor strength and balance.
For more information on how to screen, assess, and intervene to reduce fall risk, visit https://www.cdc.gov/STEADI/.
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Why Falls Happen in Nursing Homes
Aging brings changes in balance, vision, strength, and reaction time. Many nursing home residents also live with memory loss, stroke, diabetes, or heart disease, which can raise fall risk. In a facility setting, risk rises further when staff are stretched thin or communication breaks down. Research in long term care shows that a large share of residents will fall each year and that many will fall more than once, especially when prevention steps are inconsistent. For general background see the CDC fall prevention data and the AHRQ falls resources for long term care.
Common contributors include
- Muscle weakness and deconditioning
- History of prior falls
- Cognitive impairment or delirium
- Medications that cause sedation, low blood pressure, or dizziness
- Transfer problems during toileting, bed to chair, or use of mechanical lifts
- Environmental hazards such as cluttered hallways, wet floors, poor lighting, or missing grab bars
What Facilities Are Required To Do
Federal rules require nursing homes to identify accident risks, provide supervision, and supply assistive devices to prevent avoidable accidents. This standard appears in CMS Tag F689 in Appendix PP of the State Operations Manual and it applies every day, not just after an injury. At a minimum, facilities should perform and update fall risk assessments, create an individualized plan, implement practical interventions, and revise the plan whenever a fall or near miss occurs.
Examples of reasonable fall prevention steps
- Proper footwear, walkers within reach, and functional call lights
- Bed or chair alarms when clinically appropriate
- Help with toileting on a regular schedule
- Safe transfers with adequate staff or lift devices
- Clear walkways and consistent lighting checks
- Timely physician or nurse practitioner review of medication side effects
How Can We Tell If a Fall Was Neglect?
Most nursing home falls are preventable when the plan is right and staff follow it. Be alert for patterns that suggest breakdowns in the standard of care.
- No up-to-date fall risk assessment or care plan in the chart
- Alarms or assistive devices not in use despite known risk
- Call lights unanswered for long periods and limited staff presence
- Repeated hazards on the unit such as wet floors, equipment in hallways, or dim lighting
- A fall that is not reported to you promptly or lacks a clear description of what happened
- No change to the care plan after a fall or a fall labeled as unavoidable without explanation
If you see any of these issues, document what you notice and ask how the plan will change to prevent another event. For a quick facility checkup, review public data at AZNursingHomeCompare.com.
What To Do If Your Loved One Falls
Your first priority is future safety and immediate medical care. Then take these practical steps to protect your family and create a clear record.
- Seek prompt evaluation for head injury, hip pain, new confusion, or weakness
- Write down the date, time, and exact location of the fall and who you spoke with
- Take photos of the scene and any visible injuries if appropriate
- Ask to review the care plan and request a care plan meeting to address fall prevention
- Request copies of incident reports, nursing notes, vital signs, and any imaging or labs
- Report serious concerns to Arizona Adult Protective Services and ADHS Long Term Care Licensing if you believe neglect is involved
When Does A Fall Become A Malpractice Case?
A fall can support a malpractice claim when the facility failed to recognize risk, failed to implement reasonable interventions, or failed to respond to warning signs. That includes missing transfer assistance, ignoring medication side effects, disabling or skipping alarms without an alternative plan, or failing to revise the care plan after a fall. Our team reviews the record for these lapses and compares them to the federal standard.
We Are Here To Help
If your loved one suffered a fall in an Arizona nursing home, Solomon & Relihan can help you understand what happened and what to do next. We investigate quickly, secure records, and work with clinical experts to determine whether the fall was preventable and whether the facility met its obligations.
Schedule a free consultation with our Arizona nursing home lawyers or learn more about nursing home malpractice.