Preventable Falls in Nursing Homes: When Is It Negligence

Families expect nursing homes to keep residents safe. So when a loved one falls—especially when the fall leads to a broken hip, head injury, or sudden decline—it’s normal to wonder: Was this just an accident… or was it preventable negligence?

 

The hard part is that falls can happen for many reasons. Some truly are unavoidable. But many nursing home falls are predictable, preventable, and tied to problems like understaffing, poor supervision, or ignoring a resident’s known fall risk.

On The Sampson Law Firm’s website, the firm notes that nursing home negligence cases can involve a wide range of injuries and that families may need help safeguarding a resident’s rights and pursuing compensation when a facility’s standard of care is violated. The Sampson Law Firm With that in mind, here’s how to think about preventable falls, and when a fall starts to look like negligence instead of “bad luck.”

 

A nursing home’s job isn’t to guarantee that a resident will never fall. It’s to take reasonable steps—based on the resident’s condition—to reduce the risk of harm. That starts with assessment. If your loved one has dementia, poor balance, medication side effects, weakness after surgery, dizziness, or a history of falling, then the facility should recognize that risk and build a plan around it. When a home knows a resident is high-risk and still fails to put basic protections in place, that’s when a fall often becomes more than an “accident.”

 

Negligence usually shows up in the details.

 

Sometimes it’s the environment: a wet bathroom floor with no warning sign, clutter in a walkway, poor lighting, a missing handrail, an unsafe wheelchair, or a bed set too high. Other times it’s the care: a resident who needs help transferring is left alone; call lights go unanswered; toileting assistance is delayed until the resident tries to get up without help; a walker is out of reach; a care plan says “assist to stand” but staffing levels make that unrealistic. Falls also happen when facilities don’t communicate—one shift knows a resident is unsteady, the next shift doesn’t, and the resident pays the price.

 

It can also be medication-related. Many residents are on prescriptions that affect balance, alertness, blood pressure, or coordination. If medications are changed and the facility doesn’t monitor the resident appropriately—or ignores obvious side effects—fall risk can spike fast. The same goes for dehydration, poor nutrition, untreated infections, and low blood sugar, all of which can increase confusion and instability.

 

So when does a preventable fall become negligence?

 

A helpful way to think about it is: Did the nursing home have reason to anticipate the risk, and did it fail to act reasonably? If your loved one had a documented history of falls, needed assistance walking, was flagged as a fall risk, or had a care plan requiring supervision—and the facility didn’t follow its own plan—that’s often a major warning sign. If staffing was so thin that residents routinely waited too long for help, that can matter too. If the facility didn’t reassess after earlier near-falls or warning incidents, that can also point toward negligence.

 

On the other hand, there are cases where a fall may not be negligence even though the injury is severe. A resident may stand suddenly despite repeated reminders, or a medical event (like a fainting episode) may occur without warning. Facilities can’t physically restrain residents simply to eliminate risk, and they still must respect resident rights. But the difference is whether the nursing home did the reasonable things first—assessments, supervision, clear care planning, and a safe environment.

 

Kentucky law also recognizes that residents have rights while in long-term care. Kentucky’s resident rights statute includes protections related to voicing grievances “free from… interference, coercion… or reprisal,” which matters if a family fears retaliation for raising concerns after a fall. Legislative Research Commission

 

If your loved one falls, the next steps you take can make a big difference—both for safety and for figuring out what happened.

 

Start by pushing for proper medical evaluation, even if the facility says “they seem fine.” Head injuries, internal bleeding, and fractures can be missed early, especially in older adults. Then ask questions and document everything: when it happened, where it happened, who was responsible for supervision, how long it took staff to respond, whether call lights were working, whether the resident had been labeled a fall risk, and whether the care plan required assistance. Request an incident report (and keep notes if the facility refuses). If you can, photograph the area where the fall happened and any hazards you see.

If you believe neglect contributed to the fall, you can also report concerns. Kentucky offers an online reporting system for non-emergency situations and instructs people to call the Child/Adult Abuse Hotline at 1-877-597-2331 if they can’t submit online or if the situation is urgent; the site also notes online reports aren’t monitored on weekends/holidays. Kentucky Health Services Kentucky’s Adult Protective Services explains it investigates suspected abuse, neglect, or exploitation of adults as defined by state law. Cabinet for Health and Family Services

 

Finally, keep timing in mind. Kentucky has a one-year limitation period for many personal injury actions under KRS 413.140. Legislative Research Commission Deadlines can be tricky, and nursing home cases can require fast preservation of records, so it’s smart to speak with counsel sooner rather than later—especially if the facility’s story doesn’t match what you’re seeing.

 

If you’re looking for a Louisville personal injury attorney or Louisville personal injury lawyer at a personal injury law firm in Louisville to review a nursing home fall, The Sampson Law Firm’s nursing home malpractice page encourages families to reach out about suspected negligence and potential compensation. The Sampson Law Firm

 

This blog is for general information only and not legal advice. If you believe your loved one is in immediate danger, call 911.