Nursing home fall fracture lawyer

Residents in nursing facilities fall, and some falls cannot be prevented without restraining people in ways the law rightly prohibits. That is the honest starting point. What the record usually shows in a serious fall case is something narrower and more troubling: a resident assessed as a high fall risk, a care plan naming the interventions that would reduce it, and no evidence that those interventions were in place when the fall happened. A hip fracture in an elderly resident is frequently the beginning of a terminal decline rather than an orthopaedic event, which is why these cases are pursued. Law Offices Of SRIS, P.C. has practiced since 1997 and handles injury claims in Virginia, Maryland, the District of Columbia, New Jersey and New York. Reach our location at (888) 437-7747.

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The distinction the case turns on

Not every fall is negligence. Residents have the right to move, to walk, to refuse assistance and to accept risk, and physical and chemical restraint is restricted for good reason. A facility that assessed a resident properly, planned appropriate interventions, put them in place and revised them as the resident changed has met its obligation even if a fall occurred.

The claim arises where that chain breaks. A risk assessment never done, or done once on admission and never repeated after a change in medication, mobility or cognition. A care plan naming interventions that the record does not show were implemented. A first fall that produced no reassessment, followed by a second and more serious one. Or a fall in a resident who needed assistance to transfer, at a time when nobody was available to provide it.

The records that establish it

Fall risk assessments and the scoring used, at admission and on each required review. The care plan and every revision, showing what interventions were selected. Documentation that those interventions existed in fact — bed height, floor mats, non-slip footwear, appropriate lighting, a functioning call light within reach, mobility aids present and correctly sized, toileting schedules where continence was a driver.

The medication record, which is often decisive. Sedatives, antipsychotics, hypnotics, antihypertensives and diuretics all bear on falls. A new prescription or a dose change shortly before a fall, without a corresponding reassessment, is a recognizable pattern.

Prior fall reports and incident reports, and what the facility did after each. The therapy and mobility notes. Nursing notes for the shift. And the operational record: staffing schedules and actual hours against census, agency use, and call-light response data where the system captures it.

Facility inspection and complaint findings are generally public, and a citation history for falls, assessment or staffing carries weight on notice.

Why the injury is rarely just the fracture

A hip or pelvic fracture in a frail elderly resident sets off a sequence. Surgery carries anaesthetic and cardiac risk in that population; immobility during recovery brings pneumonia, pressure injury, deconditioning and delirium; and a resident who was walking before the fall frequently does not walk again. Loss of independence has consequences for placement, for cognition and for life expectancy.

Presenting that sequence requires the whole clinical picture rather than the fracture alone: the functional baseline before the fall, the surgical and hospital course, the rehabilitation trajectory, and the decline afterwards. Head injury deserves separate attention because unwitnessed falls in residents on anticoagulants can produce intracranial bleeding that is recognized late, and the timing of assessment after an unwitnessed fall is itself frequently at issue.

What the facility will argue

That the resident was independent and entitled to move freely. That restraints were prohibited, so nothing more could have been done — which conflates restraint with supervision and environmental measures. That the resident was non-compliant with instructions or refused assistance. That the fall was unwitnessed and therefore unexplained. That the decline reflects age and comorbidity rather than the fracture. And that the fall was the sort of event that occurs in any facility regardless of care.

Each is met from the record: what the assessment said, what the plan required, what the medication record shows, and whether staffing on that shift permitted the plan to be delivered.

Records, arbitration clauses and structure

Request the complete chart in writing and specify the components, including the electronic record audit trail, which shows when entries were made rather than when care was given. Incident reports are frequently withheld on the basis of internal review privileges, and whether that position holds varies by state and is worth testing.

Admission agreements often contain arbitration clauses signed during admission, sometimes by a relative without authority to bind the resident. Enforceability depends on who signed, what authority they held, how the document was presented and whether signing was a condition of admission. Obtain the agreement early and examine it rather than assuming it forecloses the claim.

Ownership in this sector commonly separates the licensed operator from a property entity and a management company. Identifying which entity controlled staffing and budget can matter both to liability and to what stands behind a judgment.

Available insurance coverage

Facilities carry professional and general liability coverage, sometimes at limits modest relative to the exposure, and sometimes through self-insurance or a captive. Management companies and staffing agencies carry their own. Where a hospital or surgeon is implicated in the post-fracture course, professional liability coverage responds on different terms. Health plan reimbursement rights and government program recovery claims attach to settlements and are usually large where surgery and extended rehabilitation followed. Declarations pages and complete forms with endorsements should be obtained rather than assumed.

Filing deadlines

Every injury claim is governed by a statute of limitations, and the periods differ by state and by claim type. For personal injury actions the period is two years in Virginia under Va. Code § 8.01-243(A), accruing at the date of injury; three years in Maryland under Md. Code, Cts. & Jud. Proc. § 5-101; three years in the District of Columbia under D.C. Code § 12-301(8); two years in New Jersey under N.J.S.A. 2A:14-2; and three years in New York under N.Y. C.P.L.R. § 214(5). These are general periods. Discovery rules, tolling for minors and incapacity, claims against government entities — the District imposes a six-month notice-of-claim requirement for claims against the District government — and claim-specific statutes can shorten or extend them. Do not rely on a general period for your own case; have the deadline confirmed on your facts.

Nursing home claims carry two further timing complications. Where the claim is characterized as medical negligence rather than ordinary negligence, several of these jurisdictions impose pre-suit certification or expert-support requirements and different accrual rules, and some cap categories of damages in medical malpractice actions. Where the resident has died, the wrongful death statute of the relevant state governs instead, with its own beneficiaries, measure of damages and period. Which characterization applies is a threshold question with real consequences for how and when the claim must be brought.

Frequently Asked Questions

Is every fall in a nursing home negligence?

No. Residents have the right to move and to accept risk, and restraint is restricted for good reason. A facility that assessed the resident, planned appropriate interventions, implemented them and revised them as the resident changed has met its obligation even if a fall occurred. The claim arises where the record shows that chain broke.

The facility says it could not use restraints. Is that an answer?

It answers a question nobody asked. Restraint is not the alternative to a fall; supervision, bed and chair positioning, footwear, lighting, an accessible call light, toileting schedules, mobility aids and medication review all reduce fall risk without restraining anyone. The care plan itself usually names those measures, which is why the question becomes whether they were actually in place.

Why do you ask about medications in a fall case?

Because sedatives, antipsychotics, hypnotics, blood pressure medication and diuretics all affect balance, alertness and blood pressure on standing. A new prescription or a dose change shortly before a fall, with no corresponding reassessment of fall risk, is a recognizable and provable failure. The medication administration record is one of the first documents requested.

My mother had fallen before. Does that make this fall her own doing?

It usually makes the case stronger rather than weaker. A previous fall is notice. It should have triggered reassessment and a revised care plan, and the facility’s own incident reports establish what it knew. A second, more serious fall after an unaddressed first one is a documented failure to respond.

The fall was unwitnessed. Does that end it?

No, and the absence of a witness raises its own questions: how long the resident was on the floor, when the fall was discovered, and how quickly assessment followed. Unwitnessed falls in residents taking anticoagulants can produce intracranial bleeding recognized late, so the timing of neurological assessment afterwards is often central.

What records should the family request?

The complete chart, itemised: fall risk assessments, the care plan and every revision, nursing notes for the shift, the medication administration record, prior incident and fall reports, therapy and mobility notes, and the electronic audit trail. Ask separately for staffing schedules and actual hours worked against census for the period.

She died some months after the fracture. Is there still a claim?

Very possibly. A hip fracture in a frail elderly resident frequently begins a decline through immobility, pneumonia, pressure injury and loss of independence, and the causal link between the fall and the death is a medical question rather than a matter of proximity in time. The claim would proceed under the wrongful death or survival statute of the state involved, which has its own beneficiaries, damages and period.

Does an arbitration clause in the admission paperwork stop us?

Not necessarily. Whether it binds the resident depends on who signed it, what authority that person actually held, how it was presented and whether signing was a condition of admission. Clauses signed by a relative without legal authority are frequently challenged successfully. The agreement should be obtained and examined rather than treated as the end of the matter.

About Mr. Sris

Mr. Sris is the owner and founder of Law Offices Of SRIS, P.C., which has practiced since 1997. He is a former prosecutor and is admitted in Virginia, Maryland, the District of Columbia, New Jersey and New York. Of Counsel attorneys contract directly with the firm and handle matters alongside him. In 2019 Mr. Sris testified before the Virginia House Courts of Justice Committee on House Bill 635.

Speak with Mr. Sris

Facility records and staffing data are the case, and incident reports and audit trails should be requested in writing early. Request a consultation. Reach our location at (888) 437-7747. Consultations are by appointment.

Last reviewed: August 24, 2026.

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