How Do Nursing Homes Assess and Manage Fall Risks?

Falls are a leading cause of injuries among nursing home residents, many of whom suffer from mobility issues, cognitive decline, or chronic health conditions. Properly assessing and managing a resident’s fall risk is critical for nursing homes to prevent serious injuries. Understanding the methods used by nursing homes to evaluate fall risk and the legal implications of these assessments can help families ensure their loved ones are safe.

At John J. Malm & Associates, with offices in Naperville and St. Charles, we have seen firsthand how devastating falls in nursing homes can be. Our Naperville nursing home abuse and neglect firm is committed to helping families in Illinois seek justice when their loved ones are injured due to negligence. This blog will explore how nursing homes assess fall risk and what families should know about their rights.

The Importance of Fall Risk Assessments in Nursing Homes

Falls are a major concern for elderly patients in nursing homes. According to the Centers for Disease Control and Prevention (CDC), between 50% and 75% of nursing home residents experience at least one fall per year. These incidents often result in serious injuries such as fractures, head trauma, or even death. Fall risk assessments are designed to identify residents who are at higher risk of falling, allowing nursing homes to take preventive measures.

Properly conducted fall risk assessments are essential not only for the safety of the residents but also for protecting the nursing home from liability. When a nursing home fails to conduct thorough risk assessments or to take the necessary precautions based on those assessments, the facility may be held liable for injuries resulting from falls.

What Is a Fall Risk Assessment?

A fall risk assessment is a structured process used by nursing homes to evaluate an individual’s likelihood of falling. The goal is to identify risk factors that increase the chances of a fall and to implement interventions to mitigate those risks. Commonly used tools include the Morse Fall Scale, the Hendrich II Fall Risk Model, and the STRATIFY Risk Assessment.

Common Factors Considered in Fall Risk Assessments

There are several factors nursing homes evaluate when assessing fall risk. Some of the most common include:

• Age and Frailty: Elderly residents, especially those over the age of 80, are more prone to falling due to muscle weakness and balance issues. According to The National Institute on Aging, aging leads to a natural decline in muscle mass and joint flexibility, both of which increase fall risk.
• History of Previous Falls: One of the strongest predictors of future falls is a history of previous falls. Studies, including those published in the Journal of the American Geriatrics Society, show that individuals who have fallen once are more likely to fall again.
• Medication Use: Many nursing home residents take medications that can increase fall risk, particularly those that cause dizziness or drowsiness. Antidepressants, blood pressure medications, and sedatives are commonly cited as contributing factors. The Food and Drug Administration (FDA) has raised concerns about polypharmacy (taking multiple medications) in elderly populations, which can compound fall risks.
• Cognitive Impairment: Residents with dementia or other cognitive impairments often have poor judgment, making them more likely to attempt unsafe activities. According to Alzheimer’s Association, cognitive impairment can severely limit a resident’s ability to recognize unsafe conditions, further increasing their risk of falling.
• Mobility and Gait Issues: Residents who require walkers, canes, or wheelchairs may have limited mobility and coordination, which increases their fall risk. The CDC reports that reduced mobility and gait abnormalities are key risk factors for falls in nursing home populations.
• Environmental Hazards: Nursing homes should assess the physical environment for fall hazards such as wet floors, poor lighting, and cluttered walkways. According to the Occupational Safety and Health Administration (OSHA), many falls can be prevented by addressing environmental hazards in nursing homes.

Tools Used in Fall Risk Assessments

Several validated tools help nursing homes assess fall risks among nursing home residents. These tools are standardized and designed to evaluate multiple factors that could contribute to a fall. Some of the most common tools include:

Morse Fall Scale

The Morse Fall Scale is one of the most widely used fall risk assessment tools in nursing homes. It evaluates six key variables:

• History of falling
• Secondary diagnoses
• Use of ambulatory aids
• Intravenous therapy
• Gait
• Mental status

Each of these factors is scored, and the total score determines the resident’s level of fall risk. The higher the score, the greater the risk of falling. Studies published in the Journal of Advanced Nursing have validated the Morse Fall Scale as an effective predictor of falls in nursing home populations.

Hendrich II Fall Risk Model

The Hendrich II Fall Risk Model focuses on eight risk factors, including confusion, disorientation, depression, dizziness, and medications that affect balance. This tool is particularly useful for identifying risks in patients with cognitive impairment. Research published in The Gerontologist supports the Hendrich II model as highly effective for assessing fall risk in older adults.

STRATIFY Risk Assessment

The STRATIFY Risk Assessment is commonly used in hospitals and nursing homes to identify patients at risk of falling. It evaluates factors such as mobility, balance, and history of falls. This tool has been supported by clinical studies, including those in the British Medical Journal (BMJ), as an effective measure of fall risk in elderly populations.

Interventions After a Fall Risk Assessment

Once a fall risk assessment is completed, nursing homes are responsible for implementing interventions to minimize the risk. Some common interventions include:

• Assistive Devices: Providing walkers, canes, or wheelchairs to residents who need them.
• Physical Therapy: Offering regular physical therapy sessions to improve strength and balance.
• Medication Review: Adjusting medications that may contribute to dizziness or drowsiness.
• Environmental Modifications: Installing grab bars, improving lighting, and eliminating tripping hazards.
• Supervision: Increasing the level of supervision for high-risk residents, especially during activities such as walking or transferring from a bed or chair.

Legal Implications of Nursing Home Falls

Nursing homes have a legal obligation to protect their residents from foreseeable harm, including falls. When a nursing home fails to conduct proper fall risk assessments or neglects to implement necessary interventions, they can be held liable for injuries resulting from falls.

At John J. Malm & Associates, we have helped families in Naperville, St. Charles, and across Illinois hold negligent nursing homes accountable. If your loved one has been injured due to a fall in a nursing home, it’s important to understand your legal rights and pursue justice.

Steps to Take After a Fall in a Nursing Home

If your loved one has fallen in a nursing home, take the following steps:

1. Ensure Immediate Medical Care: Falls can result in fractures, head injuries, and other serious conditions that require prompt attention.
2. Request Documentation: Ask the nursing home for a copy of the fall risk assessment and any incident reports.
3. Consult with a Nursing Home Injury Attorney: At John J. Malm & Associates, our top-rated Illinois nursing home neglect lawyers can help you understand whether negligence played a role in your loved one’s fall and help you pursue compensation.

Contact John J. Malm & Associates for Illinois Nursing Home Fall Cases

At John J. Malm & Associates, we have extensive experience handling Illinois nursing home injury cases, including those involving falls. If your loved one has been injured in a nursing home fall, contact us for a free consultation. With offices in Naperville and St. Charles, we are here to help Illinois families hold negligent nursing homes accountable for their actions.