In the United States, nursing homes are required to report resident falls, especially when a fall results in injury, hospitalization, or death. Federal regulations governing nursing homes mandate that incidents causing serious harm be reported to state health departments or oversight agencies.
State laws often have additional reporting requirements. Many states require nursing homes to report falls that result in fractures, head injuries, or other significant harm within a specific time frame.
Some states also require internal incident reporting and follow-up investigations to determine whether the fall was preventable and whether staffing, supervision, or safety protocols played a role.
Even when a fall doesn't cause obvious injury, nursing homes are generally expected to document the incident in the resident’s medical record and assess whether changes to the care plan are needed.
If a nursing home fails to report a fall properly, it may be a sign of negligence or an attempt to conceal poor care. Unreported or poorly documented falls can put residents at ongoing risk and may violate regulations.
Families who suspect a fall was not reported should request records, ask questions, and consider getting help from a nursing home lawyer to understand their options.
Are Nursing Homes Liable for Falls?
If a nursing home was responsible for causing or for failing to prevent a fall, the facility can be held accountable for any injuries the resident sustained.
Falls in nursing homes are common due to a combination of resident-related risk factors and systemic care issues like neglect. Many residents are older adults with limited mobility, balance problems, or chronic medical conditions like dementia that increase the risk of falls.
Inadequate supervision, understaffing, or delayed responses to call lights may contribute to these incidents by forcing residents to move without assistance. Poor facility maintenance, unsafe flooring, and improper use of mobility aids can further increase the risk of falls.
Nursing home residents are often at greater risk of falling due to:
- Cognitive impairments like dementia or confusion
- Delayed assistance with toileting or mobility needs
- Muscle weakness, balance issues, or limited mobility
- Medication side effects, including dizziness or drowsiness
- Neglect or negligence
- The facility's failure to implement or follow fall-prevention care plans
- Understaffing or inadequate supervision
- Unsafe environmental conditions, such as wet floors or poor lighting
When falls occur repeatedly, they may signal deeper issues with staffing levels, training, or adherence to safety protocols. Nursing homes are responsible for identifying fall risks and taking reasonable steps to prevent harm.
"Unexplained fractures often point to a fall that could have been avoided. If your loved one has experienced an injury, it could mean the nursing home failed in its legal duty to protect them. These are usually preventable harms, and families have every right to demand answers."
– Ricky LeBlanc, Managing Attorney of Sokolove Law
Do Nursing Homes Have to Report Falls?
Nursing homes generally have a duty to report falls, particularly if a resident is injured or placed at serious risk. Federal regulations require Medicare- and Medicaid-certified facilities to document all falls and report incidents that result in serious bodily injury, hospitalization, or death to state authorities.
Many states also impose additional reporting requirements, making fall reporting a key part of resident safety and regulatory compliance.
Reporting falls in nursing homes is typically required when the:
- Fall results in serious injury, like fractures, head trauma, or internal bleeding
- Resident requires hospitalization or emergency medical treatment
- Fall contributes to or results in a resident’s death
- Incident suggests abuse, neglect, or inadequate supervision
- Resident was identified as a high fall risk and proper precautions were not followed
- State law mandates reporting of all significant incidents, regardless of injury severity
When a fall must be reported, facilities are expected to document what happened, notify the resident’s physician and family, and take corrective action to prevent future incidents. Failing to report a fall properly may indicate negligence or an effort to conceal unsafe conditions, and it can place residents at continued risk.
A federal watchdog agency found that nursing homes failed to report 43% of falls resulting in serious injury and hospitalization of Medicare-enrolled residents, despite legal reporting requirements. For-profit and chain nursing homes were the most likely to omit these reports.
Nursing Home Fall Incident Report Sample
A nursing home fall incident report is an official record completed by facility staff whenever a resident is involved in a fall.
It documents when and where the fall happened, the circumstances leading up to it, any injuries sustained, immediate medical response, witness statements, preventive measures already in place, and actions taken afterward to reduce future risks.
Here are a few nursing home fall incident report examples:
- In Ohio, the family of a 93-year-old man who fell 3 times in 5 days at the Avenue at Aurora Care and Rehabilitation Center and died from his injuries filed a lawsuit alleging the facility failed to implement proper safety measures, despite identifying him as a high fall risk.
- In Iowa, an 88-year-old resident suffered severe injuries after falling down 13 concrete stairs while seated in a wheelchair, leading to a negligence lawsuit against Odebolt Specialty Care and its owners, Care Initiatives.
- In Colorado, a wrongful death lawsuit alleges that memory care staff at Northglenn Heights Assisted Living left a 77-year-old resident on the floor for hours after multiple falls before providing medical care, leading to her death several months later.
- A 70-year-old nursing home resident at Grace Healthcare of Tucker in Georgia died weeks after hitting her head in a fall during a bed change, with a jury later awarding $1.8 Million to her estate.
- In Illinois, Pekin Manor was fined $25,000 after a 96-year-old resident fell after her walker got caught in a cord on the ground and suffered multiple injuries, including fractures to her spine.
- In Pennsylvania, a 74-year-old Alzheimer's patient fell from her bed despite being under 1-on-1 supervision, and a video showed her aide refusing to provide care while standing over the patient on the floor. The resident passed away less than 1 month later, and her family was awarded $14 Million.
“They deemed that he needed one-to-one assistance until they could transition him somewhere else, they being the nursing home. They don’t put interventions in place; he hits his back and his neck. Sadly, he gets a brain bleed. He has a broken neck, and he passes away.”
– Bruce Andrews, Son of a Nursing Home Fall Victim
Nursing home fall incident reports are essential for internal safety reviews, regulatory compliance, communication with families, and legal documentation if negligence is suspected. Proper reporting helps ensure accountability and drives improvements in resident care and fall prevention protocols.
What If a Fall in a Nursing Home Wasn't Reported?
Nursing homes are generally required to document and report falls internally as well as notify state agencies and the resident’s family in many cases, especially when the fall results in injury. Missing or delayed reports can signal deeper issues with care, supervision, or transparency, so it’s important not to ignore those concerns.
National data shows that unreported falls disproportionately involve younger residents, male residents, short-stay residents, and those covered only by Medicare.
If you believe your loved one's fall was not reported by the nursing home:
- Ask the facility for incident reports, medical notes, and care plan updates related to the suspected fall
- Request your loved one’s full medical records to look for signs of injury, unexplained pain, or sudden changes in condition
- Contact your state’s long-term care ombudsman for an independent investigation
- Speak with staff members on different shifts to compare accounts of what occurred
- Report concerns to the facility administrator or director of nursing in writing
- Document everything you observe, including injuries, behavioral changes, dates, and conversations with staff
- Take photos of visible injuries or unsafe conditions if appropriate
- File a complaint against the facility
- Contact a nursing home attorney to find out about your legal options
Unreported falls put residents at continued risk because underlying causes go undetected, and understaffing, unsafe conditions, or ignored fall-prevention plans may not be addressed. Medical treatment may also be delayed, allowing injuries like head trauma or fractures to worsen.
Advocating early and repeatedly can be critical to accountability, safety improvements, and protecting your loved one’s rights.
Taking Legal Action Over Nursing Home Neglect
At Sokolove Law, we understand how vulnerable residents are — and how serious a fall can be, especially one that may not have been properly reported.
If your loved one was hurt in a nursing home or long-term care facility, our nursing home abuse lawyers are here to fight for your family.
Our nursing home law firm has:
- Over 45 years of experience
- Successfully helped thousands of clients
- Recovered compensation across all 50 states
- No hourly fees or out-of-pocket costs
- Secured over $318 Million for nursing home abuse victims
Your family only has a limited amount of time to take legal action over a nursing home fall, regardless of whether it was reported or not. Statutes of limitations can be as little as 1 year in some states. Be sure to take this seriously and act quickly.
Call (800) 995-1212 right now or fill out our contact form to learn more about your legal rights and options.
