The call comes during a hectic morning and from a nurse you met only once.
Your mother has fallen and injured herself and is on her way to the hospital. Someone will update you when they know more. The nurse never mentions exactly how the fall happened or whether it could have been prevented.
Often, it should have. About half of all nursing home residents fall each year, according to the Agency for Healthcare Research and Quality, and a fall that bruises a 40-year-old can break an 85-year-old’s hip. Many of those broken hips are preventable nursing home injuries, and the reasons often show up in the facility’s own records.
That’s where a nursing home negligence lawyer in Philadelphia starts looking.
Here’s where nursing home fall prevention breaks down, from outdated risk assessments to short-staffed shifts, ignored hazards, and unmonitored medications.
Fall Risk Assessments and Care Plans That Never Change
A fall alone doesn’t prove the nursing home was negligent. Liability for resident falls usually depends on whether the facility knew the risk and did what the law required to address it.
Federal rules require it to find out. A nursing home must give every resident a full assessment within 14 days of admission, review it quarterly, repeat it yearly, and redo it within 14 days of a significant change in health. That assessment covers how the resident moves, past falls, and medications, and it feeds a care plan that should spell out safeguards like a low bed, two staff members for every transfer, or scheduled help getting to the bathroom.
The trouble is that residents change faster than the paperwork does. A hospital stay, a new prescription, or a first fall can turn a steady walker into a high fall risk within days. About one in three residents who fall will fall again within the year, according to the same agency.
Federal inspection guidelines expect a facility to watch whether its safeguards work and change them when they don’t. So, after a fall, what changed? If your parent has dementia and has fallen three times, a care plan that still tells staff to “remind resident to use call light” has stopped functioning as a ‘care plan.’
Short Staffing and the Call Light That Goes Unanswered
Plenty of nursing home falls happen on the way to the bathroom in the middle of the night. A resident that’s supposed to have help presses the call light and waits as long as they can.
If help doesn’t come, the resident tries to do it on their own.
The aide on that shift might be doing everything humanly possible to care for the residents. Pennsylvania’s overnight minimum is one nurse aide for every 15 residents, and one aide can’t be at 15 bedsides at once.
Meeting the state minimum doesn’t end the question, since federal law requires enough staff to keep residents safe. When nursing home staffing levels can’t keep up, the records often show failure to supervise residents, like a high-risk resident left alone in the bathroom or hourly checks logged every three hours. If your loved one fell overnight or on a weekend, take a close look at that shift’s staffing records.
Medicare’s Care Compare tool also reports each facility’s weekend staffing and staff turnover.
Hazards Someone Should Have Fixed
Federal long-term care safety standards set a higher bar than most families expect. The federal rule on accidents requires a nursing home to keep the resident environment “as free of accident hazards as is possible.”
The usual culprits are pretty ordinary and include:
- Wet floors, especially in bathrooms and dining rooms
- Dim hallways and rooms without night-lights
- Missing or loose grab bars and handrails
- Beds left raised, or bed and wheelchair brakes left unlocked
- Call lights, walkers, or glasses left out of reach
- Clutter and equipment parked in walkways
None of these require a renovation to fix.
Hazards also leave a paper trail. Maintenance requests, work orders, and earlier incident reports can show that the facility knew about the problem before anyone fell and hurt themselves.
If you notice the bathroom light in your parent’s room was out for two weeks, write down when you saw it and who you told.
When the Medication List Becomes a Fall Risk
The CDC links several common types of medication to falls. These include antidepressants, antipsychotics, benzodiazepines, opioids, sleep aids, and seizure medications. Blood pressure drugs can leave a resident dizzy on standing, and diuretics, or water pills, send residents to the bathroom more often—sometimes in a hurry.
The warning signs of medication side effects in senior care are often subtle, like a little unsteadiness after a new sleeping pill. Staff should notice, and federal rules require a licensed pharmacist to review every resident’s medications monthly and report problems to the doctor and director of nursing.
Outright errors, like a doubled dose or another resident’s pills, increase the risk.
When a new prescription starts on a Monday and the first fall comes that Thursday, the chart should show whether anyone noticed the connection.
A Preventable Fall Leaves a Record
Nursing homes often call a fall an “accident” even when warning signs were already in the resident’s chart, staffing schedule, or maintenance log; it was preventable.
At Shrager, Sachs, & Blanco, our attorneys help Philadelphia families find out whether a loved one’s fall was preventable. Our firm focuses heavily on medical malpractice, so reading care plans, nursing notes, and medication records is part of our day.
If your loved one was hurt in a fall, contact our firm for a free consultation to see whether you have a personal injury claim for a nursing home fall. In many cases, the nursing home already wrote down why your parent was at risk of falling.
The question is…what it did next.
