Nursing Home Falls: When Supervision Fails
Falls don't just happen. They result from inadequate supervision, ignored fall risk assessments, and understaffing. When a facility knows a patient is at risk and fails to protect them, they're liable.
Key Takeaways
- Facilities must assess risk: Admission assessments identify fall-prone patients
- Prevention is required: Bed alarms, supervision, mobility aids must be implemented
- Falls can be fatal: Hip fractures have 30% one-year mortality in elderly patients
Fall Risk Factors Facilities Must Assess
Nursing homes are required to assess fall risk upon admission and regularly thereafter. High-risk patients require additional precautions:
History of falls
Prior falls are the strongest predictor of future falls
Cognitive impairment
Dementia, confusion, or delirium increase fall risk dramatically
Mobility limitations
Weakness, balance problems, need for assistive devices
Medications
Sedatives, blood pressure meds, antipsychotics cause dizziness
Incontinence
Rushing to bathroom, especially at night, causes falls
Vision impairment
Poor vision contributes to tripping hazards
Age 85+
Advanced age significantly increases fall risk
Recent hospital stay
Deconditioning and new medications increase risk
Common Fall Prevention Failures
When falls occur, we investigate whether the facility implemented required prevention measures:
No bed/chair alarms
High-risk patients should have alarms alerting staff when they attempt to stand unsupervised.
Inadequate supervision
Fall-prone patients, especially those with dementia, require regular visual checks.
Failure to respond to calls
When patients call for help to use the bathroom and no one responds, they try to go alone.
Missing mobility aids
Walkers and wheelchairs must be within reach. Patients shouldn't walk without prescribed devices.
Environmental hazards
Wet floors, cluttered walkways, poor lighting, and lack of handrails contribute to falls.
Medication mismanagement
Over-sedation or new medications without fall risk reassessment.
Common Fall Injuries in Nursing Homes
Falls are especially dangerous for elderly nursing home patients:
| Injury | Consequences |
|---|---|
| Hip fracture | Surgery required, long recovery, 30% one-year mortality rate, permanent mobility loss |
| Head trauma (TBI) | Subdural hematoma, cognitive decline, coma, death—especially on blood thinners |
| Spinal injuries | Compression fractures, paralysis, chronic pain, decreased mobility |
| Wrist/arm fractures | Surgery, loss of function, FOOSH injuries from catching oneself |
| Soft tissue injuries | Bruising, lacerations, hematomas—can be severe on blood thinners |
Proving Fall Negligence
We investigate whether the facility met its duty to prevent foreseeable falls:
Fall Risk Assessment
Was your loved one assessed as high-risk? Did the facility know?
Care Plan
What precautions were supposed to be in place? Were they implemented?
Staffing Records
Was there adequate staff to properly supervise fall-risk patients?
Incident Reports
How did the facility document the fall? Any prior falls?
Witness Statements
What did staff and other patients observe about supervision levels?
Expert Testimony
Nursing experts testify on standard of care and how facility fell short.
Frequently Asked Questions
Falls Are Preventable. Negligence Is Actionable.
If your loved one fell in a nursing home, the facility may be liable. We investigate staffing, supervision, and prevention protocols to prove negligence.
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