Does This “Incident” Count as a Nursing Home Fall? What Families Should Know

In nursing homes, a “fall” generally means any unplanned descent to the floor or another lower surface, whether anyone saw it happen, and whether there is an obvious injury.

Families may hear softer labels in the first phone call or chart note, such as “slid,” “assisted,” “lowered to the floor,” or “found on the floor.” Those phrases are easier to swallow, but they can also blur the reality of the event and delay the next steps that are supposed to follow.

This guide breaks down what typically constitutes a fall in a nursing home, why the wording matters, and what families can do in the first 24 hours to protect their loved one and preserve the facts.

Quick Answer: What Constitutes a Fall in a Nursing Home?

In plain terms, a nursing home fall is any unplanned descent to the floor or another lower surface, with or without injury.

That definition covers more situations than many families expect. Many care settings and reporting frameworks treat the following as falls:

• A witnessed fall (staff sees it happen)
• An unwitnessed fall (no one sees it, but the resident ends up on the floor)
• A resident “found on the floor” (including near the bed, in the bathroom, or next to a wheelchair)
• An intercepted or “assisted” fall (staff try to catch or steady the resident, but cannot prevent the person from reaching a lower surface)

Does it count if staff “helped” or “lowered” the resident?

Usually, yes. If staff were supporting your loved one but still had to guide them down because they could not maintain balance, that is commonly treated as a fall. Facilities may describe this as a “controlled descent” or “assisted to the floor,” but the distinction matters because it influences your next steps.

What typically falls outside that definition?

Details can get technical, but here are practical examples that are less likely to be treated as a fall:

• A purposeful movement to the floor that is part of therapy or an exercise plan
• A planned transfer that is completed safely without a loss of balance
• A collapse caused primarily by an overwhelming external force (for example, being struck by equipment), rather than a mobility event

When a facility minimizes an incident, families can bring the conversation back to basics: did the resident end up on the floor or another lower surface in an unplanned way? If so, it should be treated as a fall unless the documentation clearly shows otherwise.

Why the Definition Matters for Your Family

How the facility frames the incident influences what your family does next, from the medical response and the documentation to whether the care plan actually changes.

How a nursing home frames an incident can influence what happens next, including:

• Whether your loved one receives a timely medical assessment (especially important after any possible head impact)
• What is documented in nursing notes, incident reports, and care plan updates
• Whether staff reassess fall risk and adjust supervision, transfers, toileting help, footwear, bed height, or assistive devices
• Whether the event is treated as a one-off or as a warning sign of a bigger safety breakdown

Families may hear a calm, clipped summary on the phone and still feel their stomach drop. Later, after a visit or a hospital update, it becomes clear that the moment was bigger than the words used to describe it.

When someone is suddenly in pain, unusually sleepy, more confused than normal, or unsteady in a way that is new, families want straight answers and a real plan. What did staff observe, what assessment was completed, who was notified, and what changes are being made to reduce the chance of another fall?

Common Nursing Home Fall Scenarios That Deserve a Closer Look

Many falls happen even when staff are trying to do the right thing. Older adults can be unsteady, and many residents have complex medical needs.

But some fall scenarios are predictable. They happen in the same places, for the same reasons, especially when staffing, supervision, or care planning breaks down.

1. Falls During Transfers

Transfers are one of the highest-risk moments for a resident. Moving between bed, wheelchair, toilet, or walker often requires the right device and enough staff support. When residents are rushed or assisted without proper support, the risk of loss of balance during a transfer increases.

2. Toileting-Related Falls and Delayed Call Light Response

Bathroom trips are another common risk point. Residents may try to stand on their own if help does not arrive quickly enough.

Patterns to watch include:

• Long delays after pressing the call button
• Repeated explanations that the resident “tried to go alone”
• Falls in bathrooms or beside the bed, especially overnight

3. Falls After Medication Changes

New or adjusted medications can increase fall risk, particularly those that cause dizziness, drowsiness, low blood pressure, or confusion. If a fall follows a medication change, it is reasonable to ask what was prescribed, when it started, and whether additional monitoring was in place.

4. Falls Involving Known Fall-Risk Residents or Serious Injury

When a resident is already identified as a fall risk, prevention measures should be active and consistent. These may include supervision levels, bed height adjustments, footwear, alarms, or transfer assistance

When It May Be Time to Talk to a Nursing Home Fall Lawyer

Some falls are accidents, while others point to preventable safety failures. It may be time to explore legal guidance if you are seeing patterns like:

• Repeated falls with no meaningful care plan changes
• Delayed medical attention after the incident
• Inconsistent explanations or staff who cannot answer basic questions
• Serious injuries that do not match the “minor” story
• A resident found on the floor with no clear supervision plan

If something about the facility’s explanation doesn’t sit right, talking with a nursing home fall lawyer can help you get to the truth. And with Morgan & Morgan, the process is easy, your attorney puts you first, and there are no upfront costs involved.

You know your loved one best. If you suspect nursing home negligence, get started today with a free, no-risk case evaluation.

Frequently Asked Questions

1. Does it count as a fall if staff “lowered” my loved one to the floor?

In many care settings, yes. If a resident began to lose balance and staff had to guide them down to prevent a harder impact, it is still commonly treated as a fall because it was an unplanned descent to a lower surface.

2. If no one saw it happen, is it still considered a fall?

Often, yes. Nursing homes should still treat a resident who is found on the floor as having experienced a fall, even if it was unwitnessed, because the safety and medical response needs to be the same.

3. Does it count if they slid from a wheelchair or bed onto a mat?

It can. A slide from a bed, wheelchair, or toilet to a mat or the floor is still an unplanned descent. Even if the facility uses gentler language, the incident may still require evaluation and care plan changes. What matters are the finer details and, more importantly, the follow-up.

4. What injuries are most concerning after a nursing home fall?

Head injuries and fractures are among the biggest concerns, especially hip fractures and any symptoms that suggest a concussion or internal bleeding. New confusion, unusual sleepiness, dizziness, severe pain, or sudden inability to walk should be taken seriously.

5. What should a nursing home do immediately after a fall?

A nursing home should assess the resident, monitor for changes, notify appropriate medical providers and family, document what happened, and reassess fall risk and the care plan.