An average nursing home or "skilled nursing facility" with 100 beds will report the occurrence of 100 to 200 falls every year, with many additional falls going unreported. On top of that, it's estimated that between half and three-quarters of residents fall each year in nursing homes. (These numbers come courtesy of the Centers for Disease Control and Prevention's Falls in Nursing Homes page.)

It's no surprise that the risk of falling is a common reason why an elderly person (and his or her family members) might choose the option of an assisted living facility. So it's reasonable for the resident and the family to expect that the facility and its employees will anticipate and account for this risk, and minimize the chance of fall-related injuries. When a fall does occur, it doesn't automatically mean the facility or one of its employees was at fault from a legal standpoint, but these incidents can rise to the level of negligence or malpractice.

How and When Is Risk of Falling Assessed?

All skilled nursing facilities have a legal obligation to properly assess the health and needs of each resident at intake, and to create and follow an individualized care plan that will adequately protect the health and safety of the resident.

A resident’s care plan should include a complete evaluation of all factors that might cause or contribute to falls. That means full consideration of the resident's health issues, such as:

• general loss of strength and balance
• limitations on mobility
• medications that can cause dizziness, drowsiness, or poor reaction time
• dementia, and
• impaired vision.

The care plan should also include an inventory of all equipment and assistive devices that will be necessary to provide adequate care to the resident and keep them reasonably safe from falls, including:

• walkers and other mobility aids
• assessment of safe height for beds, chairs, and toilets
• positioning of grab bars and rails, and
• installation of cushioned surfaces.

Liability for Nursing Home Falls

It's important to note that in the "skilled nursing facility" setting, not every fall is preventable, and not every instance of resident injury will lead to a viable personal injury lawsuit. But if the care facility or one of its employees acted negligently, or failed to take reasonable steps to prevent a fall from occurring, that can lead to liability. That's a broad concept, so let's look at a few specific examples. If any of the following occurs in the nursing facility setting and a resident ends up suffering a fall-related injury as a result, there is likely a good case for liability:

• failure to develop an adequate care plan based on the resident's health condition and individual needs
• failure to regularly reassess and modify the resident's care plan
• failure to provide care in accordance with the resident's care plan
• use of improper care techniques (in transferring the resident wheelchair to bed, for example)
• hiring unqualified employees or providing insufficient training
• understaffing, especially as it prevents the provision of safe and adequate care
• failure to follow facility protocol (concerning care alarms or resident access to call buttons, for example), and
• failure to remedy environmental hazards within a unit or in public areas, including wet floors, inadequate lighting, and defective flooring.

Watch for Signs of a Fall

A nursing home resident might not report the occurrence of a fall, for a variety of reasons. So it's important for relatives and friends to be on the lookout for any indication of fall-related injuries, like bruises and abrasions. If you suspect that a fall has occurred, check with the resident's care providers and ask to see the resident’s chart. Under federal law, a copy of the chart must be provided to any relative who is acting as a guardian and has the legal right to see it.

Is It Malpractice?

When a fall occurs in a nursing home, it's not always easy to know whether a resulting legal claim will be based on a malpractice theory of liability, or if it will be more akin to a standard slip and fall case. There's no need to worry about this issue at the outset. It's a question that depends on the specific circumstances that led to the fall, and it's one that is best answered by an experienced attorney. Learn more about Selecting a Good Lawyer for Your Injury Case.