Falls and Fractures in Florida Nursing Homes, Assisted Living Facilities, Group Homes, &
Adult Day Care Centers

What Constitutes a “Fall”?​

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According to the Centers for Medicare and Medicaid Services (“CMS”), a fall is defined as any event where a resident is found on the floor, regardless of whether or not anyone witnessed how the resident came to the floor. If a resident ends up on the floor and there’s no clear explanation, it is presumed to be a fall. 

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Common Injuries from Falls​

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Falls can cause devastating injuries for elderly or disabled residents, including:

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• Hip fractures

• Broken femurs

• Ankle and wrist fractures

• Spinal cord injuries

• Head trauma and brain bleeds

• Subdural hematomas

• Lacerations and soft tissue injuries

Many of these require surgery or hospitalization and can permanently reduce quality of life.

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Complications that May Follow a Fall​

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Oftentimes, many elderly residents in nursing homes and assisted living facilities are too frail to undergo surgical intervention, thereby forcing them to live their remaining days suffering in excruciating pain. For individuals who are believed to be capable of handling surgery, including those in group homes, recovery is often slow; and, many times, disabled individuals never return to their prior level of function and ability to enjoy life.​

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Falls can also lead to a downward spiral, resulting in a "failure to thrive". Residents and/or disabled individuals who were previously mobile may become immobile, thereby increasing depression and loneliness. Those unwilling to accept this newfound immobility may attempt to walk again, only to fall a second time, worsening the original injury and causing new or exacerbated injuries.

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Most Falls are Preventable

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While not every fall can be avoided, most falls occur because staff ignore or inconsistently follow basic safety protocols. Upon admission, nursing homes and assisted living facilities are expected to perform a fall risk assessment that considers a resident’s mental status, fall history, mobility, vision, gait, balance, continence, medications, blood pressure, and underlying conditions such as Parkinson’s disease, Alzheimer’s, stroke, vertigo, hypotension, arthritis, or osteoporosis.

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Based on these risk factors, the facility must assign a fall risk score and create an individualized care plan to reduce fall risk. That plan must be reviewed and updated regularly, especially after a fall or change in condition, and the interventions outlined must be carried out in a timely, consistent manner. When facilities fail to implement or follow through on these safety measures, preventable injuries happen. These are not just oversights, they are signs of neglect.

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What Should Happen After a Fall

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After the fall, the facility should conduct a “post-fall” assessment to determine what medical and/or nursing interventions might be necessary. This may include, but not be limited to, a neurological assessment, a head-to-toe skin check for signs and symptoms of bruises that might identify the location of further injuries, assessing for signs and symptoms of pain in the lower and upper extremities, and taking the resident’s vitals. A “post-fall” assessment should have regular follow-ups. In consultation with the resident’s physician, the facility must also determine whether X-rays are warranted and whether the resident should be transferred to the hospital for a higher level of care. In addition, the facility should investigate the circumstances surrounding the fall and make the necessary care plan updates and associated care adjustments.

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Contact FIDJ for a Free Case Review

If you or a loved one suffered a fall and sustained an injury at a nursing home, assisted living facility, group home, or adult day care center, contact the experienced attorneys at FIDJ for a FREE case review.

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*The information contained herein is not medical advice.