Falls with Injury Are a Significant Problem for Long-Term Care Residents

April 1, 2021
April 1, 2021

The long-term care industry is struggling to deal with a variety of issues. Some such as preventing falls and ensuring emergency preparedness have been concerns for these facilities for quite some time; others such as new regulatory oversight and handling the COVID-19 pandemic are new to the mix. The result is that industry leaders are faced with a multitude of new challenges to manage simultaneously. Needless to say, grappling with the pandemic by itself would be more than all-consuming. When we overlay all of these other elements on top of COVID-19, we find many in this industry overwhelmed by the scope and variety of the issues at hand. This article is Part 2 of our attempt to look more closely at some of the serious concerns of organizations across the continuum of care.

Falls with Injury Are a Serious Concern for Long- Term Care Facilities and the People Who Reside in Them

It is unfortunate, but true, that falls are common among the residents in nursing facilities. According to the Agency for Healthcare Research and Quality (AHRQ), “Of the 1.6 million residents in U.S. nursing facilities, approximately half fall annually. About 1 in 3 of those who fall will fall two or more times in a year” (AHRQ, 2017). The consequences for frail elderly residents can be serious, having a significant impact on subsequent quality of life and ability to function. Even when no injury occurs, the resulting fear of the impact of a future fall can lead to a decrease in activity. Here are some statistics demonstrating the seriousness of falls as a long-term care issue:

  • 36% of potentially preventable hospital emergency room visits made by nursing home residents are injuries due to a fall.
  • Approximately 1,800 nursing home resident deaths each year can be attributed to fall-related injuries.
  • A typical 100-bed nursing home reports at least 100 - 200 falls per year. Some falls are never reported.
  • Adults aged 65 and older are four times more likely to die of fall-related injuries if they live in a nursing home compared to those that live at home or with loved ones.
  • Up to 75% of nursing home residents fall on an annual basis. This is more than double the rate for senior citizens who don’t live in nursing homes. Over a third of fall-related injuries happen to residents who can’t walk.
  • Although a relatively small number (2 to 6%) of falls result in fractures, 10 to 20% of nursing home falls cause extremely serious injuries.
  • According to the Centers for Disease Control and Prevention (CDC), around 16 to 27% of nursing home falls are a result on environmental hazards. (ISHN, 2017)

Falls are also a problem for facilities themselves—injury-related lawsuits can result in significant monetary judgements and lead to high insurance premiums. Nursing facilities typically have a falls management program (FMP) in place, which can constantly be improved. Though prevention is not always possible, “it is critical to have a systematic process of assessment, intervention and monitoring that results in minimizing fall risk” (AHRQ, 2017). Some of the features of a successful falls management program include strong leadership commitment, staff empowerment, widespread participation, individualized risk assessment and care, reporting without fear of punishment, communication, and the promotion of a culture of safety.


AHRQ, “The Falls Management Program: A Quality Improvement Initiative for Nursing Facilities,” AHRQ.gov: 2017 [last reviewed], Retrieved at https://www.ahrq.gov/patient-safety/settings/long-term-care/resource/injuries/fallspx/man1.html.
ISHN, “Typical nursing home reports 100-200 patient falls per year,” Industrial Safety & Hygiene News: July 6, 2017, Retrieved at https://www.ishn.com/articles/106828-typical-nursing-home-reports-100-200-patient-falls-per-year.

This blog post continues a series based on our article, Top Issues Across the Care Continuum - Part Two, which looks more closely at some of the serious concerns of healthcare organizations across the care continuum. An earlier blog post series was based on our article Top Issues Across the Care Continuum – Part One. Subsequent challenges to be examined during this blog post series include:

  • The Abuse Icon on the Nursing Home Compare Website is Problematic for Many Long-Term Care Organizations.
  • Emergency Preparedness, While Necessary, Is a Burden for Long-Term Care Facilities.
  • Nursing Homes Struggle with the Demands of Required Compliance Surveys and Regulatory Oversight.
  • Long-Term Care Faces Even More Requirements with QAPI Phase 2 and Phase 3 Regulations.
  • Changes Related to COVID-19 Will Impact Surveys and Visitation Policies in the Future

There is a long list of challenges for providers across the care continuum, outside of acute care. For example, with consistent wage pressures, shifting compliance regulations, and rising acuity levels among resident populations, the skilled nursing and LTC workforce is feeling more pressure than ever before. HealthStream works with organizations throughout non-acute care to address these challenges, from keeping pace with regulatory requirements to engaging and developing competent staff who can satisfy the demands of increased patient complexity. By partnering with HealthStream, organizations are equipped to seamlessly manage the pressures of surveyor visits, while remaining focused on high-quality patient and resident care. Learn more about HealthStream solutions for non-acute care organizations.

Request Demo