Nursing Homes Fail to Report Nearly Half of Serious Falls: OIG Confirms Ongoing Pattern of Underreporting

A September 2025 federal report from the Office of Inspector General (OIG) adds to growing evidence that nursing homes are consistently failing to report serious falls. The OIG has flagged "fall" underreporting before, and this latest analysis confirms that the problem is widespread and persistent.

What the OIG Confirmed

OIG reviewed one year of data, linking hospital claims with nursing home assessments, and found that 43 percent of serious falls requiring hospitalization were never reported. This missing information feeds directly into the Medicare Care Compare website, the public tool used to calculate star ratings, creating a dangerously misleading picture of safety.

Who Are the Worst Offenders When it Comes to Underreporting

The OIG found that for-profit, chain-owned, and large nursing homes were the worst offenders, failing to report about 45 percent of serious falls.

Which Residents Were Most Affected

Certain residents were more likely to have their preventable falls in nursing homes hidden:

• Residents younger than 65 who are often people with varying disabilities had the highest rate of unreported falls at 55%.

• Men had falls unreported 48% percent of the time, compared to 41% of underreported falls for women.

• Short-stay residents with fewer than 100 days in the facility had more than half of their falls unreported at 54% while long-term residents had much better reporting with only 27% of their falls underreported.

• Medicare-only residents saw 53% of their falls unreported, compared to 37% underreporting for residents with both Medicare and Medicaid.

Why This Matters.

The consequences of underreporting are significant.

1. Families are misled. The Medicare Care Compare website shows artificially low fall rates, giving unsafe facilities higher star ratings than they deserve. In fact, OIG found that nursing homes with the lowest fall rates on paper were actually the least honest in reporting.

   
   

2. Residents remain at risk. Preventable falls in nursing homes are often tied to understaffing, a lack of proper supervision and monitoring, a failure to properly assess residents, and a failure to implement fall precautions.

Can Nursing Home Falls Be Prevented?

Oftentimes, yes. The OIG found that 98% of residents who suffered serious falls already had one or more risk factors identified in their care assessments. That means nursing facilities knew who was at risk but failed to protect them. In addition, facilities with increased staffing ratios had lower fall rates.

What Families Can Do

Public ratings and government data do not tell the whole story. Families evaluating a nursing home should:

• Visit in person and observe staff interactions, how quickly call bells are answered, and whether enough staff are present and working. For more information about what to look for when touring a nursing home, read our blog titled, "What to Look for When Touring a Nursing Home: Questions to Ask & Warning Signs".

  
  

• Review their loved one’s nursing records and attend care plan meetings to ensure their loved one is receiving the care and treatment they deserve.

  
  

• Ask questions about fall-prevention programs and past incidents.

  
  

While families can try to help, the ultimate duty and responsibility to protect residents from preventable falls lies with the facility.

FIDJ Holds Facilities Accountable for Preventable Falls and Related Injuries

At FIDJ, we represent victims and their families when a resident suffers a preventable fall and a related injury. If your loved one suffered a fall and sustained an injury or died, contact the experienced attorneys at FIDJ for a free, confidential, no-pressure case review.