Preventing Falls in Nursing Homes

Falls are common and serious in nursing homes. Learn the risk factors, what CDC recommends, and the questions that push a facility to act.

Category: safety-and-health · Updated 2026

Falls are one of the most common and consequential events in nursing homes, and they are not simply an unavoidable part of aging. The CDC reports that falls are a leading cause of injury-related death among older adults and that falls are common in nursing homes, with many residents falling more than once. The good news is that most falls are preventable when the right assessment, staffing, and environment are in place.

This guide explains the main risk factors, what evidence-based prevention looks like, and the questions families can ask to tell a serious fall-prevention program from a slogan.

Why falls happen more in this setting

Nursing home residents often have several risk factors at once:

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

CDC's STEADI initiative for fall prevention describes these as modifiable risk factors that care teams can screen for and address. Facilities that assess each resident on admission and after any change in condition are more likely to prevent the next fall.

What good fall prevention looks like

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

The staffing connection

Fall prevention depends on staff being available at the moment a resident tries to get up alone. A facility with low nurse staffing or high turnover may struggle to answer call lights quickly, which raises risk. CMS includes staffing and turnover in its public data, and quality measures include falls with major injury. Compare those numbers with what you observe on a tour, especially at night. See CMS Staffing Ratings Explained.

Questions families should ask

How do you assess each resident's fall risk, and how often do you reassess?
What is your fall rate, and how has it changed over the past year?
How do you review medications that increase fall risk?
What happens after a fall, including a head injury check?
Are call lights answered by staff, and what is the average response time?
How do you involve families in a fall-prevention plan?

If a fall happens, you have the right to be informed 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 often-used items within reach, reporting changes in strength or alertness, and asking about the medication list after any hospitalization. If a fall occurs, ask for the incident report and the updated care plan in writing. Preventing the second fall is often more within reach 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

Are falls in nursing homes a sign of neglect?

Not always. Falls can happen even with good care. The pattern matters: repeated falls, delayed response to call lights, or missing assessments may indicate 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 if they take blood thinners. Ask what assessment was done and whether a physician or emergency care was involved. Seek medical care if you have concerns.

Can medications cause falls?

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

Do restraints prevent falls?

Restraints carry their own serious risks 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 informational and is not medical advice. Processing date: 2026-10-05.

Important disclosures

Informational only, not medical advice. This directory publishes public data and general information. It does not provide medical advice, diagnosis, or treatment recommendations, and it is not a substitute for consulting a qualified health care professional or Medicare.

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