When you place a family member in a nursing home, you trust that facility to keep them safe. If your loved one has fallen, or if you suspect a fall was never reported to you, that trust may have been broken. Falls should raise serious concerns and may warrant a closer look to determine whether a nursing home negligence case should be pursued.
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How Can I Tell If My Loved One Fell in the Nursing Home?
This question comes up in almost every case we handle. Sometimes families are notified immediately. But in many situations, the family is the last to know.
Physical Signs to Watch For
Unexplained bruising: Bruising on the hips, shoulders, arms, or head that was not present during your last visit deserves a direct explanation from staff.
New pain or complaints of soreness: A resident who suddenly guards one side of their body, winces when moved, or repeatedly points to a hip, back, or shoulder may have an undiagnosed injury.
A change in the way they walk or move: Sudden reluctance to stand, a new limp, or a refusal to bear weight on one leg are common signs of an undetected fracture.
Increased confusion or agitation: Sudden cognitive changes can be a sign of a concussion, an undiagnosed head injury, or the psychological aftermath of a frightening fall.
Torn or soiled clothing: Evidence that a resident was on the floor before being helped back to bed.
Cuts, abrasions, or swelling: Any wound that staff cannot clearly explain warrants follow-up.
When the Story from Staff Doesn’t Add Up
Arizona law and federal nursing home regulations require facilities to maintain accurate documentation and to notify family members after a fall.
If the facility cannot produce coherent records, that failure is itself evidence worth preserving.
Common signs that the facility's account may be incomplete:
Staff give different explanations on different visits
The incident report was not filed until days after the event
Staff cannot tell you which employees were on duty when the fall happened
The explanation changes when you ask specific follow-up questions
You are told “we’re not sure how it happened” for what appears to be a significant injury
Documentation of the fall is missing from the records you request
A Fall in a Nursing Home Is Often the Start of a Much Bigger Problem
The full consequences of a nursing home fall do not appear immediately. They unfold over days, weeks, and months—and by the time the family understands what is happening, the damage is already severe.
The delayed consequences of a nursing home fall might look like:
The fall itself
Your loved one falls, often without being witnessed by staff. There may be a delay before anyone responds. The resident may sit on the floor, frightened and in pain, unable to call for help.
Undetected injury
Not all fractures are visible on initial examination. A hairline hip fracture, a slow intracranial bleed, or bruised internal tissue may not be obvious for hours or days. If staff do not order imaging promptly, these injuries are missed.
Hospitalization and surgery
For elderly nursing home residents, surgical anesthesia and the stress of hospitalization bring their own serious risks, including delirium and blood clots.
Reduced mobility
After surgery or a significant injury, residents become less mobile. They spend more time in bed. Muscles weaken faster than they can be rebuilt. Physical therapy is frequently inadequate in understaffed facilities.
Pressure injuries (bedsores)
Extended time in bed without proper repositioning causes skin breakdown. Pressure sores can develop within hours in a fragile resident and can progress to life-threatening infections.
Infection
Surgical wounds, catheter placements, and bedsores all become infection pathways. Pneumonia from immobility is also common. For elderly residents with compromised immune systems, these infections can be fatal.
Cognitive decline
The trauma of a fall, hospitalization, and disorientation accelerates dementia symptoms in many residents. Delirium following surgery or infection can cause lasting cognitive damage.
Fear of falling again
The CDC has cited studies that say many people who fall, even when uninjured, develop a persistent fear of falling. That fear causes them to move less, which accelerates the physical decline that makes falls more likely in the future.
Further falls
Weakened muscles, impaired balance, and new medications often increase fall risk after the first fall. Facilities that do not update their care plans in response to the first fall see residents fall again.
Wrongful death
For a significant portion of elderly residents, this chain ends fatally. Falls are a leading cause of injury and death among older adults in the United States.
Are nursing homes liable for residents falling?
Not every fall means the nursing home is automatically liable.
Nursing homes in Arizona and across the country are required under federal law (42 C.F.R. § 483.25) to maintain an environment that is as free from accident hazards as possible and to provide each resident with adequate supervision and assistance to prevent accidents.
A facility may be liable if it failed to:
Properly assessed your loved one’s individual fall risk
Developed and followed a care plan tailored to that risk
Provided adequate staffing to implement the care plan
Responded appropriately after a fall to prevent the next one
Monitored your loved one for delayed injuries in the hours and days after a fall
What Is a Nursing Home Is Required to Do After a Resident Falls?
Immediate Physical Evaluation
Staff must assess the resident immediately following a fall—checking for injury, taking vital signs, and determining whether emergency medical attention is needed. A cursory check without documentation is not sufficient.
Notification of Family and Physician
Arizona families have the right to be notified promptly when a loved one falls. The attending physician must also be notified so that medical orders can be adjusted, imaging ordered, and appropriate treatment initiated without delay.
Incident Report Documentation
The facility must prepare an incident report that documents the circumstances of the fall, the resident's condition at the time, and the immediate response taken. Incident reports that are vague, late, or internally inconsistent are a significant warning sign.
Investigation of Contributing Factors
A proper post-fall investigation identifies what caused the fall—environmental factors, staffing issues, medication effects, care plan failures—so that preventive measures can be implemented. Facilities that skip this step are setting the stage for the next fall.
72-Hour Monitoring
The resident must be monitored for 72 hours after the fall, with documented neurological checks at regular intervals. This monitoring record is one of the first things we request when evaluating whether a facility met its post-fall obligations.
Care Plan Review and Update
The care plan must be reviewed and updated to reflect the circumstances of the fall and any identified changes in the resident's condition or risk level. A care plan that was not updated after a fall is strong evidence that the facility was not taking the fall seriously.
How Solomon & Relihan Investigates Nursing Home Fall Cases
We focus on finding out not only how the fall happened, but also whether the nursing home missed warning signs before the fall and failed to respond properly afterward.
We work with qualified medical experts when needed to evaluate the standard of care in the nursing home and explain how the facility’s failures contributed to the harm your loved one suffered.
Our investigation often includes a close review of:
Incident reports to see whether the event was documented accurately, promptly, and by the right staff member
Fall-risk assessments to determine whether the resident had already been identified as high risk
Care plans to see whether the facility put the right precautions in place and updated them after prior falls or changes in condition
Medication records to identify drugs, dosage changes, or combinations that may have increased fall risk
Staffing logs to evaluate whether there were enough staff members on duty to meet the residents needs
Call-light records to determine whether requests for help were delayed or ignored
Neurological monitoring notes to see whether the resident received proper 72-hour post-fall monitoring
Witness interviews with staff, residents, and family members who may have relevant information
Photographs of the resident’s injuries, the room, and any hazards that may have contributed to the fall
Hospital records to connect the fall to fractures, head injuries, surgery, hospitalization, or later decline
Compensation in Arizona Nursing Home Fall Cases
When a nursing home’s negligence causes or contributes to a fall, Arizona law may allow the resident and family to pursue compensation for the full harm that followed.
A nursing home fall claim should account for the full timeline of harm. That includes not only the fall itself, but also the hospitalization, immobility, infection, cognitive decline, repeated falls, or death that may follow.
Medical expenses, including emergency care, hospitalization, surgery, rehabilitation, and treatment related to fall-related decline
Pain and suffering, including physical pain, emotional distress, and loss of quality of life
Punitive damages in cases involving extreme neglect or a serious disregard for resident safety
Increased care needs when the resident requires a higher level of assistance after the fall
Wrongful death damages if the fall and resulting complications contributed to the resident’s death
Frequently Asked Questions About Nursing Home Falls
Does the nursing home have to notify me if my loved one falls?
Yes. Federal regulations require nursing homes to notify the resident’s representative if a fall causes an injury that may require physician intervention, leads to a significant change in condition, or requires a significant change in treatment. If you were not notified of a fall, that failure to communicate is a violation of your loved one’s rights and may be relevant to your legal claim.
What if the fall was unwitnessed and no one knows exactly what happened?
Unwitnessed falls are very common, and they do not prevent you from bringing a legal claim. An unwitnessed fall may itself be evidence that the resident was left without adequate supervision. Solomon & Relihan builds the case through records, staffing data, call-light logs, and the circumstances of the fall—not solely through eyewitness accounts.
My loved one has dementia. Does that affect whether the nursing home can be held responsible?
No. In fact, dementia increases the facility’s legal duty of supervision. Facilities that admit residents with cognitive impairment accept the obligation to implement care plans that account for the resident’s specific risks, including the risk that the resident may not recognize danger or remember that they need assistance to walk. A facility cannot use dementia as an excuse for inadequate supervision.
The facility told us falls are common in nursing homes. Does that mean they're not responsible?
Falls are, unfortunately, frequent in nursing homes. But, frequency does not mean inevitability or acceptability. The fact that falls happen often in nursing homes is precisely why federal law requires rigorous fall-risk assessments, individualized prevention measures, and careful post-fall monitoring. When a facility fails to implement these required measures, it cannot escape liability simply because falls are statistically common.
How long do we have to file a nursing home negligence claim in Arizona?
Arizona’s statute of limitations for personal injury and medical negligence claims is generally two years from the date of injury or from the date the injury was discovered or reasonably should have been discovered. Wrongful death claims generally must be filed within two years of the date of death. These deadlines are strict—waiting too long can permanently bar your claim. We encourage families to consult with us as soon as they suspect negligence so that evidence can be preserved and options can be evaluated.
What if my loved one's condition declined after the fall but they did not die? Can we still pursue a claim?
Yes. You do not need to have suffered a wrongful death in order to bring a nursing home negligence claim. If your loved one experienced significant harm as a result of a preventable fall—including hospitalization, surgery, worsening dementia, loss of mobility, or a major reduction in quality of life—those harms may be compensable under Arizona law.
Can we file a complaint with the state in addition to pursuing a legal claim?
Yes, and the two are not mutually exclusive. Arizona Department of Health Services (ADHS) investigates complaints against licensed nursing homes. Filing a complaint can trigger an inspection, create an official record of violations, and in some cases result in citations that become relevant evidence in a civil lawsuit. Our firm can advise you on both avenues.
How does Solomon & Relihan charge for nursing home fall cases?
We handle nursing home negligence cases on a contingency fee basis. That means there is no upfront cost to your family, and you pay attorney’s fees only if we recover compensation on your behalf. We believe that access to legal representation should not depend on a family’s ability to pay, particularly when they are already dealing with the financial and emotional burden of a loved one’s injury.