Serious Injuries from Nursing Home Falls

Unfortunately, nursing home falls are very common. About 10% to 20% of those falls result in serious injuries. Centers for Medicare & Medicaid Services (CMS) defines a fall in a nursing home facility as a “failure to maintain an appropriate lying, sitting, or standing position, resulting in an individual’s abrupt, undesired relocation to a lower level.” This includes when a resident loses balance, trips, slips, stumbles, or falls for any reason at the facility.

Nursing Home’s Liability For Resident Falls

One of the secrets that nursing homes do not want you to know is that they are liable for resident falls. A nursing home’s liability is higher for residents who fall and are seriously injured when negligence was involved.

Falls Due to Nursing Home Negligence
If the fall occurred because of any of the reasons below, the facility should be held responsible. Many falls are preventable and happen due to negligence.

1.) Understaffed Facilities
Many nursing homes are understaffed. In many cases, the certified nursing assistants are understaffed, underpaid, and overworked. When employees call in sick or are absent, the employees who are working must pick up the slack, leaving them burdened with too much to do, including paperwork. This overabundance of work and tasks leave the employees with an inability to provide attentive care to every resident. This leads to neglecting residents, and in particular, residents who are at risk of falling. Safety of all residents, especially those prone to falls, is crucial and should be a priority.

2.) Poorly-Trained Staff & Lazy Staff
Poor training leaves employees / staff members without the necessary and required skills to accurately monitor and care for all residents, especially those who are at risk of falling and suffering an injury. Tragically, whenever an injury is serious enough, it can lead to death for these at-risk and age-fragile residents. Necessary training includes proper and mandatory transfer techniques. Transfer techniques help staff safely transfer patients out of bed and into a wheelchair and from a wheelchair back into bed. Staff is trained on when and how to monitor patients who have a high risk of falling. At most nursing homes, as in many businesses and institutions, there is a mixture of hard-working staff members who are dedicated to the safety and care of their residents, as well as the lazy staff members who seem to be there to pass the time and collect a paycheck. This poses a serious problem because the hard-working staff members, who are having to pick up the slack, results in less time devoted to the care of the residents. Strong management and supervisory skills seem to be lacking in many facilities. They are necessary to oversee and ensure everyone is performing as required.

3.) Failure to Closely Monitor At-Risk Residents
All nursing homes are legally required to assess residents for fall risks when they are first admitted. These potentialities are based on medical history and constantly updated throughout their stay depending on their physical/mental condition. Performing a fall risk assessment should be done when designing a resident’s care plan to promote health and safety. When these assessments are done incorrectly or not completed, a resident could have a higher risk of falling.

Once a nursing home resident is determined to have a high risk of falling, it is the duty of nursing home staff members to keep an eye on him/her at all times. Staff should always be on-hand to provide assistance as well, such as when the resident needs to get out of bed or out of a wheelchair. Serious falls may occur if the staff leaves a high-risk resident unattended for just a few minutes.

Any time a resident falls at a nursing home, even if they are not seriously injured, another fall risk assessment should be completed immediately because the next fall could be serious or even fatal.

Nursing home personnel needs to keep in mind that some residents with severe dementia and/or those who lean out of their wheelchairs often should not be left unattended or unsupervised in their room. For example: A woman who had a previous history of a brain bleed three years earlier with severe dementia developed an obsession for picking up things off the floor. One day, she fell out of her wheelchair and sustained a laceration on her forehead. Fortunately, she did not have a brain bleed. But the family was very concerned about her risk of falling again because they knew the next fall could be more serious and possibly fatal. Family members expressed their concerns, but the staff would not take them seriously. Five days later, this resident was left unsupervised and unattended in her room. She fell out of her wheelchair in a similar way as before and broke her neck. Sadly, she suffered with complications from the C2 fracture and passed away six weeks later.

For residents who are deemed as high risk of falling out of their wheelchairs but safe in their beds, they should never be left alone in their wheelchairs. If no one can be in the resident’s room to watch him/her, the staff could look at two options: Keep the resident in front of the nurses’ station where someone can watch her/him or place him/her in an activity room or another room with other high risk residents and where there is constant supervision from the staff member(s).

4.) Malfunctions or Misuse of Equipment
This refers to equipment that is designed to protect residents from falls, such as walking aids, Hoyer lifts, and bed rails. When these things are defective, broken, or not used, there is a much higher risk for falls to occur. Nursing homes should conduct inspections of equipment to always ensure the equipment being used is in proper working order.

5.) Errors When Transferring Residents
One wrong move when a resident is being transferred out of bed into a wheelchair, or out of a wheelchair into a bed, or onto a toilet, or into a shower/bath can result in a serious fall. Many of the residents lack strength, flexibility, or coordination to prevent a fall. In many cases, the guidelines require that no less than two staff members move a resident in beds or from beds and other equipment.

6.) Medication Errors
Giving a resident medication, the wrong medication, wrong dosage, or missing a dose can have disastrous consequences that would increase a resident’s risk for falling. For example, a resident's blood pressure could drop, making him or her feel lightheaded, which can result in poor balance and coordination.

Serious Injuries After a Nursing Home Fall
Here are some serious injuries from falls:

  • Hip and femur fractures requiring emergency surgery, if possible (Some fractures have occurred and were impossible to repair, which resulted in lifelong dependency on others for movement and transfer.)

  • Broken arms, elbows, knees, and other orthopedic injuries

  • Closed-head and traumatic brain injuries, including brain bleeds

  • Cervical fractures

  • Facial injuries, including damaged teeth and orbital fractures

Residents may survive a fall, which could result in permanent injuries or a significant decline in health over the following months / years. It is harder for an elderly person to recover from serious injuries compared to that of a younger person.

Unfortunately, many of the serious fall-related injuries often lead to the resident’s death. When this occurs, medical examiners will note “an accident” on the Death Certificate was a contributing cause of death.

Any time a resident sustains a serious injury from a fall, especially if it leads to permanent disability, decline in health, or death, the resident’s family member(s) is encouraged to report the fall to the inspection agency in the relevant state, which oversees nursing homes, guidelines, and practices. In addition, the family member(s) should consult with an attorney for advice and appropriate legal remedies.

The amount of resulting pain, dependency, health decline, confusion, and a lower quality of life suffered by a nursing home resident is inconceivable and intangible. A fall or risk of fall should be unacceptable for ALL nursing homes and definitely unacceptable for the resident’s family members or guardians.


©Copyright 2020 All Rights Reserved.

Web Site Designed By: Bright Idea Web Solutions