One fall can be an accident. Two falls in a month with the same conditions present each time is a pattern. Three falls, and the nursing home still has not updated the care plan or added fall precautions? That is a documentation of nursing home neglect. Nursing home fall injuries are among the most common sources of serious harm in long-term care, and they are among the most preventable. The facility already knew your loved one was at risk. The question is whether they did anything about it.
Why Falls Are Common in Nursing Homes, But Not Always Unavoidable
The CDC estimates that roughly 1,800 nursing home residents die each year from fall-related injuries, and many more suffer hip fractures, head trauma, or internal bleeding. Risk factors include impaired balance or gait, polypharmacy (particularly sedatives, blood pressure medications, and diuretics), cognitive impairment, low call-light response times, and wet floors.
Federal regulations at 42 C.F.R. § 483.25(d) require facilities to ensure residents receive adequate supervision and assistive devices to prevent accidents, but only to the extent reasonably possible. That language matters. A facility has no absolute duty to prevent every fall. It does have a duty to identify risk, plan for it, and act consistently.
Signs the Facility Ignored a Known Fall Risk
The following are warning signs that a facility saw the risk coming and failed to respond:
- The admission assessment flagged the resident as high fall risk, but no specific fall prevention interventions were ordered
- The resident’s care plan has not been revised after the first or second fall
- Call lights are not being answered promptly, and residents attempt to get up unassisted because they cannot wait
- Bed alarms, chair alarms, or non-slip footwear were ordered but not consistently used
- Staff attribute every fall to the resident’s “confusion” without addressing environmental factors
- The incident report from the first fall was never shared with the family
When a fall produces a hip fracture or traumatic brain injury, two injuries with high long-term mortality in older adults, the legal stakes rise significantly.
Questions to Ask After a Second or Third Fall
After any fall, request a care conference immediately. Come prepared:neglec
- What specific fall prevention interventions are currently in the care plan?
- Was the care plan revised after the last fall? If not, why not?
- What was the staffing ratio on the unit at the time of the fall?
- Were bed or chair alarms in use and functioning?
- What medications is the resident currently taking, and has a pharmacist reviewed for fall-risk drugs?
- What are the measurable goals for the next 30 days, and who is accountable for them?
Vague answers — “we’re monitoring him closely” or “we do the best we can”- are not acceptable care planning. Push for written commitments, specific interventions, and a timeline for re-evaluation.
Documentation and Incident-Report Requests
Under Texas law and federal regulations, residents and authorized family members have the right to request and receive all records related to care, including incident reports. Do this in writing and keep a copy. Request:
- All incident/accident reports related to falls (with date, time, location, staff on duty)
- Nursing notes from the 24 hours before and after each fall
- Current and prior versions of the fall-risk section of the care plan
- Staffing records (Payroll-Based Journal data) for the unit on relevant dates
- Any internal quality-improvement records related to fall rates
Photograph any bruises, lacerations, or swelling as soon as you observe them. Write down exactly what the nurse or administrator told you, with the time and date. If the facility offers to show you an incident report but not give you a copy, note that in your records and request a copy in writing the same day.
When Repeated Falls May Support a Legal Claim
Texas courts have found nursing home liability for fall-related injuries when the facility: (1) had documented knowledge of fall risk; (2) failed to implement or follow its own care plan; and (3) that failure caused or contributed to the injury. The more incidents that preceded the injury, each representing another opportunity the facility had to intervene, the stronger the notice argument becomes.
Damages in fall-related nursing home cases can include medical bills, rehabilitation costs, pain and suffering, and, in wrongful death cases, loss of companionship. If the conduct was willful or grossly negligent, punitive damages may be available under Texas law.
How to Move a Loved One Safely If Needed
If you believe your family member is in immediate danger from repeated falls and unresponsive staff, you have the right to seek transfer. Contact the Texas Health and Human Services Commission (HHSC) or the Long-Term Care Ombudsman before or at the same time as initiating a transfer. An attorney can advise whether transferring will affect evidence or legal rights. In most cases, a well-documented transfer does not harm a future claim if records are preserved first.
| 📞 Speak with our attorneys today if repeated falls led to a fracture, head trauma, or hospitalization. We offer free case reviews and can help you act before evidence disappears. |