Broken Hip in a Nursing Home: Mortality Risk, Liability, and Family Options

Your parent was fine during your last visit. Then you get the call — a fall, a broken hip, an ambulance. Suddenly everything has changed. Hip fractures in nursing home residents happen at four times the rate of older adults living at home, and the one-year death rate is 27.3 percent. This is not a minor injury. It is a medical crisis that demands immediate action.

Your Family Has the Right to Answers

A broken hip in a nursing home is often a preventable injury. Federal law requires every nursing home to assess fall risk and put safeguards in place. If the facility failed your loved one, your family has legal options. Request a free case review — the consultation is free and there is no obligation.

What Is a Nursing Home Hip Fracture?

A hip fracture is a break in the upper part of the thighbone, near the hip joint. In nursing home residents, nearly all hip fractures result from falls — usually from standing height or lower. This may sound like a short distance, but for an older adult with weakened bones, it is enough to cause a devastating break.

Research shows that how a person falls matters as much as whether they fall. Falling sideways increases hip fracture risk by 5.5 times. Landing directly on the hip raises the risk by 3.4 times. This is important because it means the direction and mechanics of the fall are predictable — and nursing homes can take steps to protect the hip during a fall. Hip protectors, for example, reduce fracture risk by 55 percent.

Nursing home residents are especially vulnerable. They break their hips at a rate of 23.0 per 1,000 person-years, compared to just 5.7 per 1,000 for older adults living in the community. That four-fold difference reflects the frailty, medication use, and environmental hazards found in long-term care settings.

Warning Signs of a Hip Fracture

After a fall, watch for these signs that a hip may be broken:

• Severe pain in the hip or groin area
• Inability to stand, walk, or bear weight on the affected leg
• The injured leg appears shorter than the other
• The foot on the injured side turns outward
• Swelling and bruising around the hip
• Stiffness or inability to move the leg
• Pain that gets worse with any movement of the leg
• Resident refuses to get out of bed after a fall

If you notice any of these signs, insist on immediate medical evaluation including X-rays or other imaging. Hip fractures that go undiagnosed lead to worse outcomes.

When the Nursing Home Is Responsible

Nursing homes have a federal duty to protect residents from foreseeable harm, including falls that cause hip fractures. This duty requires the facility to:

• Conduct a fall risk assessment at admission and after any change in condition
• Create a care plan that addresses each identified risk factor
• Provide assistive devices like walkers or grab bars as needed
• Review medications that increase fall risk
• Ensure adequate staffing so residents get help when they need to move
• Consider hip protectors for high-risk residents

When a nursing home knows a resident is at risk for falls — and most nursing home residents are — failing to act on that knowledge is negligence. A resident with a history of falls, medications that cause dizziness, or problems with balance deserves extra protection. If the facility did nothing, that failure may have directly caused the hip fracture.

Research shows that only individualized, multifactorial fall prevention programs actually reduce falls. Single-approach programs do not work. The nursing home must tailor its approach to each resident.

Ask the facility what specific fall prevention measures were in place for your loved one before the fracture happened. If there is no clear answer, that silence may itself be evidence of negligence.

The Deadly Consequences of a Hip Fracture

A broken hip in an elderly nursing home resident is one of the most dangerous injuries in medicine. The numbers are stark:

Within 30 days of a hip fracture, 11.5 percent of patients die. Men face nearly double the risk of women — 17.7 percent versus 9.2 percent. Patients with five or more health conditions have a 30-day death rate of 28.3 percent.

Within one year, 27.3 percent of hip fracture patients are dead. The death rate is three times higher than people of the same age and sex who did not break a hip. By about four years after the fracture, 79 percent of patients have died.

Timing of surgery matters enormously. A study of over 42,000 patients found that surgery within 24 hours of the fracture results in a 5.8 percent death rate. Waiting longer than 24 hours raises that to 6.5 percent. Every hour of delay increases the risk of complications.

Even those who survive often never recover their independence. Many go from walking on their own to needing a wheelchair or becoming bedridden. The broken bones that seemed survivable can set off a cascade of decline that is hard to reverse.

This Is Not Your Fault

If your loved one broke a hip in a nursing home, you may be feeling overwhelmed. You may wonder if you should have visited more often or asked more questions. But the responsibility for keeping residents safe belongs to the nursing home — not to you. The facility accepted that duty when it admitted your loved one. If it failed, a nursing home injury attorney can help your family understand what happened and what to do next. You do not have to carry this alone.

What to Do Right Now

If your loved one broke a hip in a nursing home, take these steps immediately:

1. Ensure they receive surgery quickly. Research shows that surgery within 24 hours of a hip fracture leads to better survival rates. If there is a delay, ask the medical team why and document the reason.
2. Document the injury. Take photos of bruises and the fall location. Write down what staff told you about how the fall happened, when it was discovered, and who was on duty.
3. Request the full medical record and incident report. Ask for the fall risk assessment, the care plan, and any documentation of previous falls. You have a legal right to these records.
4. Report the incident to your state. Every state has an agency that investigates nursing home complaints. Find your state’s reporting information here and file a formal complaint.
5. Contact a nursing home injury attorney. A hip fracture from a preventable fall may be grounds for a negligence claim. A free consultation is available to help your family understand your options.
6. Track your loved one’s recovery. Keep a written log of their condition, any setbacks, and all medical appointments. This record can be important later.

What Compensation May Cover

If a nursing home’s negligence led to your loved one’s hip fracture, your family may be able to seek compensation. A claim could include:

• Medical costs — surgery, hospitalization, rehabilitation, physical therapy, and any additional care needed because of the fracture
• Pain and suffering — the severe physical pain of a hip fracture and the emotional distress of losing mobility and independence
• Loss of quality of life — many hip fracture patients never walk again, losing the ability to care for themselves or enjoy daily activities
• Wrongful death — if your loved one died following a hip fracture, the family may recover funeral expenses and damages for loss of companionship
• Ongoing care needs — some hip fracture survivors require permanent assistive care that would not have been needed without the injury

Compensation is never guaranteed. Every case depends on the specific facts and your state’s laws.

By the Numbers

• 4x higher hip fracture rate in nursing home residents vs. community-dwelling elderly (J Am Geriatr Soc, 2002)
• 27.3% die within one year of a hip fracture (BMC Musculoskelet Disord, 2011)
• 11.5% die within 30 days of a hip fracture (Eur J Trauma Emerg Surg, 2025)
• 319,000 older adults hospitalized for hip fractures each year (CDC, 2026)
• 55% reduction in fracture risk with hip protectors (J Bone Miner Res, 2020)
• 5.5x higher fracture risk from a sideways fall (J Bone Miner Res, 2020)