Falls at Assisted Living Facilities

falls, fall, assisted living, ALF, nursinghome, elder, elderly


Falls are very common in assisted living facilities (“ALF”). A fall often results in serious injuries, including broken bones, traumatic brain injuries, strokes, and even death. ALFs and nursing homes must strive to prevent falls. This article addresses the responsibilities of an ALF.


Falls are common in ALFs and nursing homes. In a recent study, between 50-75% of nursing facility residents fall each year. A significant percentage of the falls results in severe injuries and result in hospitalization. It is therefore critical to screen and assess all residents for fall risks at admission, and periodically, before the first fall occurs. 

Many falls occur while residents are walking unassisted. Other falls occur when the senior attempts to get out of bed or attempts to go to the bathroom. There are many reasons why residents fall. Some of the more common factors include:

  • Poor physical condition, including diminished balance, strength and endurance
  • Impaired cognition
  • Medications that are prescribed, including sedatives and pain medications
  • Dizziness
  • Vision problems
  • Agitation, confusion, altered mental state
  • Illness, disease
  • History of falls

Other factors that contribute to falls include those created by the ALF including:

  • Wet floors
  • Floor surface
  • Cluttered rooms
  • Layout of rooms, including difficulty moving from one place to another
  • Lack of handrails, and grab bars in bathrooms
  • Lack of call lights
  • Poor lighting
  • Incorrect bed height
  • Improper fitted or maintained wheelchairs
  • Lack of staffing
  • Failure to educate staff on the needs of the resident
  • Lack of training on fall prevention

Admission and Assessment

Before a senior is accepted as a resident, an intake meeting is supposed to be held. The meeting is to include the professional staff members and also the family members with the resident. The family, especially those given the authority to speak for the resident, have a right to be included in the conference, either in person or on the phone. The purpose of the meeting is to assess the elder, including learning as much as possible about the person’s medical history, physical health, physical abilities, decision-making skills, and needs. The assessment should include fall history, ability to walk, medications, and mental status. 

Regular or periodic care conferences and assessments are required in addition to the initial evaluation. These meetings are also required after the resident suffers a change in condition. The resident, or family of the resident, if authorized, can and should obtain a copy of the current care plan.

Care Plans

ALF’s are supposed to create detailed plans for the care of each resident. The plan is called a care plan in a nursing home. The document is known as a service plan in an ALF. A service plan must be created at admission. The plan needs to be updated regularly and after a significant change of condition. For example, if a senior is assessed as a fall risk at admission, the plan needs to reflect that fact. Similarly, the plan needs to be updated if and when a resident becomes a fall risk.


Unfortunately, many ALFs put profit over patient care. They cut corners. They fail to assess the resident at admission or at regular intervals. Also, they are understaffed and/or their staff is untrained. As a result, the needs of the resident are not met and falls occur.


If your loved one has been injured or killed in a nursing home or ALF, you have rights. Schedule a free consultation about your case. No pressure, only advice.