The Falls Management Program: A Quality Improvement Initiative for Nursing Facilities

Appendix B21: Facts and Flow Chart


  • 1 in 3 persons > 65 years will fall each year.
  • Of 1.7 million residents in nursing facilities, about 50% will fall each year.
  • Of those that fall, 30-40% will fall two or more times.
  • 10% of residents have a serious injury related to a fall.
  • About 65,000 patients suffer a hip fracture each year.

Consequences of Falls

  • Reduced quality of life
  • Decreased ability to function
  • Serious injury
  • Increased risk of death
  • Increased level of fear
  • Increased level of care
  • Increased paperwork for staff
  • Poor survey results
  • Lawsuits
  • High insurance premiums

The Falls Management Program (FMP)

The Falls Nurse Coordinator will conduct a Falls Assessment of your residents who are found to be at high fall risk during screening and after an initial fall. You will receive a Primary Care Provider Fax Report and Orders asking you to review the results and to order referrals or participate in the assessment as indicated. A copy of the 3-page Fax Report and Orders is attached. It is important that you respond to the fax ASAP so that the nurse coordinator can use your recommendations to develop an individualized care plan. Thereafter, whenever your resident falls, you will receive a Fax Alert. A copy is attached.


Flow chart: 1. Screen all residents: history of fall in past 180 days, initial fall, other MDS triggers. 2. Falls assessment: medds, behavior, footwear, foot care, vision, blood pressure, gait and transfer. 3. Physician, NP, PA role: medication review, podiatric problems, low vision, postural hypotension, unsafe gait, balance, seating. 4. Individualized care plan. 5. Weekly team meeting and followup on unit. 6. Recurrent falls-return to step 3.

Page last reviewed December 2017
Page originally created February 2010
Internet Citation: Appendix B21: Facts and Flow Chart. Content last reviewed December 2017. Agency for Healthcare Research and Quality, Rockville, MD.