6.1 Fall Prevention in Illinois Long-Term Care Facilities
Key Takeaways
- Falls are the leading cause of injury in long-term care and the most common incident reported to IDPH
- 50-75% of nursing home residents fall each year; many falls are preventable
- Key prevention: call light within reach, bed in lowest position, non-slip footwear, toileting schedule
- Do NOT try to catch a falling resident — guide them safely to the floor and protect their head
- After a fall: stay with the resident, call for help, do not move them until nurse assesses
- Document all falls with an incident/occurrence report as required by Illinois regulations
Last updated: March 2026
Fall Prevention in Illinois Long-Term Care Facilities
Falls are the leading cause of injury and death from injury in adults over 65, and they are one of the most common reportable incidents in Illinois long-term care facilities. IDPH closely monitors fall rates, and facilities with excessive falls may face citations and corrective action plans. As a CNA, you are on the front line of fall prevention.
Fall Statistics in Long-Term Care
- 50-75% of nursing home residents fall each year (compared to 30% of community-dwelling elderly)
- Falls result in serious injury 10-25% of the time
- Hip fractures are the most serious fall-related injury — 25% of elderly hip fracture patients die within one year
- Falls are the most common incident reported to IDPH in Illinois LTC facilities
- Many falls are preventable with proper assessment and intervention
Fall Risk Factors
| Category | Risk Factors |
|---|---|
| Intrinsic (Patient) | Age >65, history of previous falls, weakness, unsteady gait, confusion, vision impairment, urinary urgency/incontinence, depression, fear of falling |
| Medication-Related | Sedatives, hypnotics, antihypertensives, diuretics, opioids, psychotropic medications, polypharmacy (4+ medications) |
| Extrinsic (Environmental) | Wet floors, cluttered pathways, poor lighting, improper footwear, unfamiliar environment, bed height, absence of grab bars |
| Situational | Toileting attempts, first day post-admission, nighttime, after position changes (orthostatic hypotension) |
Fall Prevention Strategies for CNAs
Patient-Centered Interventions:
| Strategy | Implementation |
|---|---|
| Call light | Always within reach — check every time you leave the room |
| Bed position | Lowest position when not providing care, wheels ALWAYS locked |
| Non-slip footwear | Proper-fitting shoes or gripper socks — never bare feet or loose slippers |
| Assistive devices | Walker, cane, wheelchair within reach and in good condition |
| Toileting schedule | Anticipate needs — take residents to the bathroom on schedule |
| Night lights | Ensure adequate lighting, especially path to bathroom |
| Personal items | Glasses, hearing aids, phone within arm's reach |
| Gait belt | Use during transfers and ambulation per care plan |
| Orientation | Orient new residents to their room, call light, and bathroom |
Environmental Safety:
| Area | Safety Measures |
|---|---|
| Room | Clutter-free, clear pathway to bathroom, bedside commode if needed |
| Bathroom | Grab bars, non-slip mats, elevated toilet seat, call light accessible |
| Hallways | Handrails, clear of obstacles, adequate lighting |
| Floors | Clean, dry, free of spills — report wet floors immediately |
| Wheelchair | Brakes locked when seated, footrests positioned correctly |
What to Do if a Resident Falls
IMPORTANT: Do NOT attempt to catch a falling resident — you risk injuring both yourself and the resident.
If you witness or discover a fall:
- Stay with the resident — Do NOT leave them unattended
- Call for help — Use the call light or yell for assistance
- Do NOT move the resident — Wait for the nurse to assess for injuries
- Keep the resident calm — Reassure them that help is coming
- Observe — Note any injuries, level of consciousness, and what happened
- Assist the nurse — Help with assessment and safe transfer as directed
- Document — Complete an incident/occurrence report as required
- Implement post-fall protocol — Follow facility policy for increased monitoring
Incident Reporting for Falls
Illinois requires documentation of all falls:
| Report Element | What to Include |
|---|---|
| Date and time | When the fall occurred or was discovered |
| Location | Exactly where the fall happened |
| Witnesses | Who saw the fall or discovered the resident |
| Circumstances | What the resident was doing when they fell |
| Injuries | Observed injuries or complaints of pain |
| Vital signs | Taken after the fall as directed by the nurse |
| Notification | Who was notified (nurse, physician, family) |
| Interventions | What was done after the fall |
Test Your Knowledge
You see a resident starting to fall in the hallway. What should you do?
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Test Your Knowledge
What is the MOST important fall prevention measure a CNA can implement for every resident?
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D