Stopping Falls Before They Happen in Nursing Homes

Falls are frequent and serious in nursing homes. Here are the risk factors, what the CDC advises, and the questions that prod a facility to act.

Updated 2026

This guide is informational and is not medical advice.

Category: safety-and-health · Updated 2026

Falls rank among the most frequent and most damaging events in nursing homes, and they are not merely an inescapable consequence of growing older. The CDC notes that falls are a leading cause of injury-related death among older adults and that they happen often in nursing homes, with many residents falling more than once. The encouraging part is that most falls can be avoided when proper assessment, staffing, and surroundings are in place.

This guide covers the leading risk factors, what evidence-based prevention involves, and the questions families can pose to separate a genuine fall-prevention program from a slogan.

Why falls are more frequent here

Nursing home residents often carry several risk factors at the same time:

Weakness, poor balance, and limited mobility
Dementia or confusion that clouds judgment
Medications that bring on dizziness, drowsiness, or low blood pressure
Vision and foot problems
Urgency to reach the bathroom, chiefly at night
Unfamiliar surroundings and new equipment

CDC's STEADI initiative for fall prevention lists these as modifiable risk factors that care teams can screen for and act on. Facilities that assess every resident at admission and again after any change in condition are better positioned to head off the next fall.

What solid fall prevention includes

Domain	What to look for
Assessment	Fall risk screening at admission, after a fall, and when medications change
Medications	Review of drugs that raise fall risk, with deprescribing when possible
Environment	Clear paths, good lighting, grab bars, non-slip surfaces, call cords within reach
Mobility	Physical therapy, strengthening, and correct use of walkers or wheelchairs
Toileting	Scheduled toileting and prompts, above all at night
Staffing	Enough staff to answer calls promptly and watch high-risk residents

The staffing link

Fall prevention hinges on staff being free at the instant a resident tries to stand alone. A facility with thin nurse staffing or heavy turnover can struggle to answer call lights quickly, which pushes risk up. CMS folds staffing and turnover into its public data, and falls with major injury appears among the quality measures. Set those figures against what you observe on a tour, particularly at night. See CMS Staffing Ratings Explained.

Questions families should ask

How do you assess each resident's fall risk, and how often is it reassessed?
What is your fall rate, and how has it shifted over the past year?
How do you review medications that raise fall risk?
What follows a fall, including a head injury check?
Do staff answer call lights, and what is the typical response time?
How do you bring families into a fall-prevention plan?

When a fall occurs, you have the right to be told and to understand the care plan response. Resident rights under 42 CFR §483.10 include being informed about care and treatment.

What families can do

Families can help by bringing proper shoes and eyeglasses, keeping frequently used items within reach, reporting changes in strength or alertness, and asking about the medication list after any hospitalization. If a fall occurs, request the incident report and the updated care plan in writing. Preventing the second fall is often more attainable than preventing the first.

Sources: CDC STEADI; CDC Falls Prevention; CMS Care Compare; 42 CFR Part 483, Subpart B. Health content is informational only and not medical advice.

Related guides

Frequently asked questions

Do falls in nursing homes signal neglect?

Not necessarily. Falls can occur even under good care. The pattern is what counts: repeated falls, slow responses to call lights, or skipped assessments may point to a problem worth raising with the ombudsman or the state survey agency.

What should happen after a fall with a head injury?

The resident should be evaluated promptly for head injury, especially when they take blood thinners. Ask what assessment was performed and whether a physician or emergency care was involved. Seek medical care if you have concerns.

Can medications bring on falls?

Yes. Some drugs for sleep, anxiety, blood pressure, and pain can cause dizziness or drowsiness. A medication review can lower risk, and facilities should reassess after any medication change.

Do restraints stop falls?

Restraints carry serious risks of their own and are tightly regulated. Federal rules protect the right to be free from unnecessary restraints and require alternatives to be considered. Ask how the facility prevents falls without restraints.

Where can I see a facility's fall-related data?

Care Compare reports falls with major injury as a quality measure. You can also ask the facility directly for its fall rate and prevention plan.

Data sources

CMS Provider Data Catalog · CMS Care Compare. This guide is provided for information and is not medical advice. Processing date: 2026-10-06.

Required disclosures

For general information only, not medical advice. This website shares public data and general information. It does not offer medical advice, diagnosis, or treatment guidance, and it cannot replace a consultation with a qualified health care professional or with Medicare.

Independent and unaffiliated. NursingFacilities.org is a private, independently run directory. It is not affiliated with, nor endorsed or operated by, the Centers for Medicare & Medicaid Services (CMS), Medicare, or any government agency. CMS has not reviewed or endorsed this site.

Confirm details before acting. Facility records come from public federal datasets and may lag or contain errors. Always verify current ratings, services, availability, and coverage directly with the provider and on Medicare.gov.

Certain outbound links on this site are partner or affiliate links. If you use them we may receive a commission, and your price does not change. This never influences the data we publish.