Nursing Home Fall Injuries — When a Resident's Fall Is the Facility's Fault

## When a Nursing Home Fall Is Negligence, Not an Accident

Falls are the leading cause of injury in nursing home residents and one of the most common subjects of nursing home litigation. Not every fall indicates negligence — some falls occur despite appropriate supervision and precautions. But falls that result from inadequate fall risk assessment, failure to implement fall prevention protocols, inadequate supervision of known fall-risk residents, or environmental hazards represent preventable events that constitute facility negligence.

Federal nursing home regulations require all residents to be assessed for fall risk upon admission and regularly thereafter, with individualized care plans that implement appropriate fall prevention measures. A facility that ignores documented fall risk factors and then fails to prevent a fall has violated both regulatory standards and its duty of care.

When Nursing Home Falls Constitute Negligence

A fall becomes a negligence case when one or more of the following contributed to the incident.

• **Failure to assess fall risk:** The resident had documented risk factors (prior falls, gait instability, sedating medications, cognitive impairment) that the facility failed to identify or document
• **Inadequate fall prevention implementation:** The care plan identified fall risk but failed to implement required interventions — bed alarms, non-slip footwear, lower bed height, call bell access
• **Failure to supervise:** A resident with known fall risk who required supervision was left unsupervised during a time when ambulation or transfer was foreseeable
• **Environmental hazards:** Wet floors, poor lighting, inadequate bed rail height, or other environmental conditions that a facility with proper maintenance practices would have identified and corrected
• **Understaffing:** Insufficient staff to provide required supervision for high-fall-risk residents — a systemic failure that directly causes preventable falls

Common and Serious Injuries From Nursing Home Falls

• Hip fractures: particularly serious in elderly patients, with recovery requiring surgery, rehabilitation, and resulting in significantly increased mortality risk
• Traumatic brain injuries: head impacts from falls can cause subdural hematomas and other intracranial injuries
• Vertebral fractures: spinal compression fractures from falls can cause permanent pain and limited mobility
• Wrist fractures: Colles' fractures from trying to catch a fall
• Soft tissue injuries: lacerations, contusions, and hematomas

Obtain all medical records related to the fall and the injuries promptly, and preserve all incident reports. Nursing home incident reports are internal documents that facilities sometimes resist producing, but they are discoverable in litigation and often contain admissions about the circumstances of the fall.