A recent CMA Alert discussed a recent report by the HHS Office of Inspector General (OIG) finding that skilled nursing facilities fail to report 43% of residents’ falls in a 1-year period reviewed by OIG. In an accompanying Data Snapshot, Serious Falls Resulting in Hospitalization Among Medicare-Enrolled Nursing Home Residents, July 2022-June 2023, OEI-05-24-00181 (Sep. 2025), OIG provides more detailed information about the effects of falls on residents, costs to the Medicare program, and facility characteristics associated with falls:
- Residents experienced 42,864 falls resulting in major injury and hospitalization
- 1,911 residents died
- Nursing homes had identified “almost all” of the residents who fell as at risk for falls (primarily balance problems (92%) and psychotropic medications (69%)) before the residents fell
- Medicare and enrollees paid more than $800 million for the residents’ hospitalizations
- Nursing homes with more registered nurses had lower rates of resident falls
- Nursing homes with higher overall star ratings had lower rates of resident falls
- For-profit facilities had higher rates of resident falls
Read the original Alert at medicareadvocacy.org/skilled-nursing-facilities-failed-to-report-falls-with-major-injury-and-hospitalization and download the Data Snapshot at oig.hhs.gov/documents/evaluation/10955/OEI-05-24-00181.pdf
October 9, 2025 – T. Edelman