Can You Sue for Preventable Nursing Home Falls?

Yes. You can sue a nursing home for a preventable fall in Tennessee when the facility knew a resident was at risk and failed to take reasonable steps to protect them. Federal law is direct about this duty: a nursing home must keep the resident environment as free of accident hazards as possible and give each resident adequate supervision and assistance devices to prevent accidents. Not every fall is negligence. A fall that a care plan identified, predicted, and then nobody acted on is a different matter.

There is also a documented reporting problem in this industry, which is part of why families are so often told a fall was unavoidable.

What Does Federal Law Require?

Under 42 CFR Section 483.25(d), a facility must ensure that:

• The resident environment remains as free of accident hazards as is possible, and
• Each resident receives adequate supervision and assistance devices to prevent accidents

In practice, that duty runs through a chain of obligations: assess each resident on admission and after any significant change, identify fall risk factors, build an individualized care plan, actually carry out that plan, and update it after a fall occurs.

A break anywhere in that chain is where a claim usually lives.

When Is a Fall Considered Preventable?

The question is not whether staff could have physically caught the resident. It is whether the facility did what a reasonable facility should have done given what it knew.

Signs a fall may have been preventable:

• The resident was assessed as a fall risk and no interventions were put in place
• A care plan existed but was not followed, such as a two-person transfer done by one aide
• The resident had already fallen and nothing changed afterward
• Call lights went unanswered, so the resident tried to get up alone
• Assistive devices like a walker, grab bars, or proper footwear were missing or out of reach
• Environmental hazards: wet floors, clutter, poor lighting, bed at the wrong height, wheelchair not locked
• Medication effects from sedatives or new prescriptions were not monitored
• Chronic understaffing left nobody available to assist with toileting or transfers

Toileting is worth singling out. A large share of falls happen when a resident who needs help getting to the bathroom cannot wait any longer for someone to come.

The Underreporting Problem Families Should Know About

In September 2025, the U.S. Department of Health and Human Services Office of Inspector General released findings that should concern any family. Reviewing a one-year period from July 2022 through June 2023, the OIG found that nursing homes failed to report 43 percent of falls with major injury and hospitalization among Medicare-enrolled residents in their required Minimum Data Set assessments. That was 18,369 unreported falls out of 42,236 examined.

The OIG report also found that for-profit, chain-affiliated, and larger facilities failed to report most often, and that facilities showing the lowest fall rates on the public Care Compare website were the least likely to report the falls investigators examined.

Two things follow from that. First, a facility’s public fall statistics may not reflect reality. Second, the absence of a fall in the record does not mean the fall did not happen.

What Evidence Builds a Fall Case?

The medical chart tells the story, if you can get a complete copy.

• Fall risk assessments and the scores assigned
• The care plan and any updates after each incident
• Nursing notes around the time of the fall
• Incident and accident reports
• Medication administration records, especially sedatives and blood thinners
• Staffing schedules and assignment sheets for that shift
• Call light response logs where the system records them
• Prior falls, which establish the facility knew about the risk
• State survey and deficiency findings for the facility

Families have a legal right to these records. Federal rules require a facility to allow inspection within 24 hours of a request, excluding weekends and holidays, and to provide copies within two working days.

Unwitnessed Falls and Missing Answers

“We found her on the floor” is one of the most common explanations families hear. An unwitnessed fall is not a defense. If anything, it raises the question of why a resident known to be at risk was unsupervised.

Watch for: a delay between the fall and medical evaluation, a head injury never scanned, a fracture attributed to “unknown cause,” or a story that shifts between staff members. Those are the details worth documenting in writing while they are fresh.

What Compensation Is Available?

A claim can seek:

• Economic damages with no cap: surgery, hospitalization, rehabilitation, and ongoing care
• Noneconomic damages for pain and suffering, capped at $750,000, or $1 million for catastrophic injuries
• Wrongful death damages where a fall led to a fatal decline
• Punitive damages in cases of reckless conduct or falsified records

Hip fractures and head injuries in frail elderly residents frequently begin a decline that ends in death months later. That connection can be part of the claim.

Nursing Home Fall FAQs

Isn’t falling just part of aging?

Falls become more likely with age, which is exactly why facilities are required to assess risk and plan for it. The legal question is what the facility did with what it knew.

Can I sue if my parent signed an arbitration agreement?

Possibly. These agreements are frequently challenged, and their enforceability depends on how and when they were signed and who signed them. Have one reviewed before assuming it controls.

How long do I have to file in Tennessee?

Generally, one year from the injury or death under Tennessee Code Section 28-3-104.

How can I check a facility’s history?

Use the federal Care Compare tool for inspection results, staffing data, and penalties, keeping in mind the OIG’s findings about underreported falls.

Told the Fall Was Just an Accident?

Sometimes that is true. Often the chart shows a resident who was flagged as a fall risk on admission, whose care plan called for assistance, and who was left alone anyway. You are entitled to see that chart.

The Higgins Firm investigates nursing home neglect and fall injuries across Tennessee. Use our contact page for a free, private review. You pay nothing unless we recover money for your family.