Falls and Fractures in Nursing Homes: What Families Need to Know

You noticed the bruise first. Maybe it was on your mother’s arm, or your father’s forehead. The staff said it was “just a little fall.” But falls in nursing homes are never small. About half of all 1.6 million nursing home residents fall at least once every year, and these falls are the single most common cause of serious injury in long-term care facilities.

Your Family May Have Legal Options

If your loved one fell in a nursing home and suffered a fracture, head injury, or other harm, you are not alone. Federal law requires nursing homes to assess every resident’s fall risk and create a plan to prevent falls. When a facility fails to do this, families have the right to hold them accountable. Request a free case review — the consultation is free, and there is no obligation.

What Are Nursing Home Falls and Fractures?

A nursing home fall is any time a resident ends up on the floor or a lower surface without meaning to. This includes slips, trips, and collapses. Many falls lead to fractures — broken bones — because older adults often have weaker bones from osteoporosis or other conditions.

Falls in nursing homes happen at a rate of 3 to 5 per 1,000 bed-days. That means a 100-bed facility can expect a fall nearly every day. About 10 percent of all adverse events in nursing facilities involve injuries from falls. The most common fractures include broken hips, wrist fractures, spinal compression fractures, and other broken bones. Head injuries, including traumatic brain injury, are also a major concern. Falls are the most common cause of traumatic brain injury in older adults.

Warning Signs Your Loved One May Be Falling

Watch for these signs that a nursing home resident is falling or at risk of falling:

• Unexplained bruises, scrapes, or cuts — especially on the face, arms, or knees
• Swelling, tenderness, or inability to bear weight on a limb
• Complaints of dizziness, lightheadedness, or feeling unsteady
• New fear of walking or getting out of bed
• Changes in how they walk, such as shuffling or holding onto furniture
• Confusion or drowsiness that was not there before (may signal a head injury)
• Repeated “minor” falls that staff downplay
• Clothing or shoes that are too loose, without non-slip footwear
• Medications that cause drowsiness, such as sedatives or sleep aids
• Clutter, wet floors, or poor lighting in the resident’s room

If you notice any of these signs, ask the nursing home for the complete fall incident report. You have a right to see it.

When the Nursing Home Is Responsible

Nursing homes have a legal duty to keep residents safe from falls. This duty comes from federal regulations that apply to every facility that accepts Medicare or Medicaid funding. The law requires each nursing home to:

• Assess every resident’s risk of falling when they are admitted
• Create an individualized fall prevention plan based on that assessment
• Review and update the plan after every fall or change in condition
• Make sure staff follow the plan consistently

When a nursing home skips these steps, the result is often a preventable fall. Common failures include not reviewing medications that increase fall risk, not providing enough staff to help residents move safely, and ignoring a resident’s history of falls.

Research confirms that certain medications dramatically raise fall risk. Antipsychotics increase the odds of falling by 54 percent. SSRIs more than double the risk. Benzodiazepines raise it by 42 percent. If the facility prescribes these drugs without adjusting the fall prevention plan, that is a failure of care.

A large study of over 288,000 nurses found that nurse burnout is linked to more frequent patient falls. When facilities cut staffing to save money, residents pay the price.

Ask the facility this question: “Can I see my loved one’s fall risk assessment and the prevention plan you put in place?”

What Happens When Falls Go Unaddressed

The consequences of nursing home falls are severe and often permanent. A hip fracture carries a one-year death rate of 27.3 percent — three times higher than the general population of the same age. Within 30 days of a hip fracture, 11.5 percent of patients die. For those with five or more health conditions, that number jumps to 28.3 percent.

Even falls that do not cause fractures lead to a downward spiral. Residents who fall once become afraid of falling again. They move less, lose muscle strength, and become more likely to fall in the future. This cycle can turn an independent person into someone who is bedridden within months. Nursing staff must recognize this fear and address it in the care plan — not just document the fall and move on.

Falls are also the most common cause of traumatic brain injury in older adults. A head injury from a fall can cause bleeding in the brain, confusion, personality changes, and death — sometimes days after the fall happened.

The human cost is staggering. Each year, more than 3 million older adults visit the emergency room because of falls. Over 319,000 are hospitalized for hip fractures alone.

You Do Not Have to Face This Alone

Watching a loved one suffer after a preventable fall is painful. You may feel angry at the nursing home, guilty for not being there, or unsure about what to do next. These feelings are normal. What matters now is making sure your family member gets the care they need — and that the facility is held responsible if it failed in its duty. Request a free case review. There is no cost for the conversation.

What to Do Right Now

If your loved one has fallen in a nursing home, take these steps as soon as possible:

1. Make sure they get medical attention. Insist on a full medical evaluation, including imaging for fractures and head injury. Do not accept “they seem fine” as an answer.
2. Document everything. Take photos of injuries, the room, and any hazards you see. Write down the date, time, and what staff told you about the fall.
3. Request the incident report and medical records. You have a legal right to these documents. Ask for a copy of the fall risk assessment and care plan as well.
4. File a complaint with your state. Every state has an agency that investigates nursing home complaints. Find your state’s reporting agency here and file a formal complaint.
5. Contact a nursing home injury attorney. An attorney can help you understand your legal options and protect your family’s rights. A free consultation is available — there is no obligation.
6. Keep a written log going forward. Note every visit, every conversation with staff, and any new injuries or changes in your loved one’s condition.
7. Talk to the ombudsman. Your state’s long-term care ombudsman can advocate for your loved one inside the facility.

What Compensation May Cover

If a nursing home failed to prevent a fall, your family may be able to recover compensation. A successful claim could include:

• Medical expenses — hospital stays, surgery, rehabilitation, and ongoing care needs that resulted from the fall
• Pain and suffering — the physical pain and emotional distress your loved one experienced
• Loss of quality of life — if the fall caused permanent disability or loss of independence
• Wrongful death damages — if a loved one died as a result of the fall, the family may recover funeral costs and loss of companionship
• Punitive damages — in cases where the nursing home’s conduct was especially reckless, courts may award additional damages to punish the facility

Every case is different. The specific compensation available depends on your state’s laws and the facts of your situation.

By the Numbers

• ~800,000 nursing home residents fall at least once each year (AHRQ, current)
• 3 million older adults visit the ER for falls annually (CDC, 2026)
• 319,000 older adults hospitalized for hip fractures each year (CDC, 2026)
• 27.3% one-year death rate after a hip fracture (BMC Musculoskelet Disord, 2011)
• $202.9 million in civil money penalties imposed on nursing homes in 2024 (PMC, 2024)
• RR 0.67 — multifactorial fall prevention programs reduce falls by about a third (J Am Geriatr Soc, 2015)