Nursing Home Fall, Fracture and Transfer Injury Lawyers

Is a Fall in a Nursing Home Neglect?

Often, yes. A fall is not automatically neglect, but federal law requires nursing homes to keep residents as free of accident hazards as possible and to give each resident adequate supervision and assistance devices to prevent accidents (42 C.F.R. 483.25(d)). When a known fall risk is ignored, or a resident is dropped during a transfer, that is usually a care failure.

“Facilities like to say falls happen. Sometimes they do. But when the care plan says two aides and a lift, and one aide tries it alone at 3 a.m., that is not an accident. That is a staffing decision.”

Jim Higgins, Nursing Home Neglect Attorney

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A Case We Handled: A Broken Hip No One Diagnosed

A resident of a senior living facility in Tennessee fell in another resident’s room. She was left with a broken and dislocated hip, a black eye, and loss of circulation to her hand. The facility did not recognize the fracture, and her injuries compounded while she remained in its care.

Her daughter, who held power of attorney, spent months emailing the facility, the long term care ombudsman, and the hospital trying to get answers. Then she called us.

Here is what the investigation uncovered:

• The former Director of Nursing testified. Her deposition described failures inside the facility and became the centerpiece of our demand.
• A former nurse came forward. She agreed to speak with us about what she saw.
• Text messages between the family and nursing staff were produced in discovery.
• State records were fought over. We subpoenaed Adult Protective Services records from the Tennessee Department of Human Services and defeated the defense’s motion to quash.
• Documentation we contended was falsified. We argued that records created to avoid liability should remove Tennessee’s damages cap.

The facility initially denied liability. The case settled for a significant confidential amount just before more facility employees were scheduled to be deposed.

“The fall was only the beginning. A broken hip went unrecognized while her daughter was asking, in writing, what was wrong. Families should never have to diagnose a fracture themselves. We built this case on the facility’s own people, and that is what moved it.”

Jim Higgins

Transfer Injuries: When a Resident Is Dropped

Many of the worst “falls” we see are not falls at all. They are transfer failures, where a resident is dropped or injured while being moved between a bed, wheelchair, toilet, or shower chair.

Every resident who needs help moving should have a transfer method written into the care plan:

• One person assist with a gait belt
• Two person assist for residents who cannot bear weight safely
• Mechanical lift (Hoyer or sit to stand), which manufacturers and facility policies typically require two trained staff to operate

The most common failures:

• One aide doing a two person transfer because the floor is short staffed
• Wrong sling size or a worn sling on a mechanical lift
• No gait belt, or an aide lifting under the arms
• No reassessment after the resident’s strength or weight changes
• Rushing, especially at shift change and at night

Transfer drops cause hip and leg fractures, head injuries, and skin tears that can become infected. Read more about head injuries and concussions in nursing homes.

Why Nursing Home Falls Happen

• Understaffing. Call lights go unanswered and residents try to get up alone. See understaffing and neglect.
• No fall risk plan. The resident was assessed as high risk, and nothing changed.
• Missing safeguards. Low beds, floor mats, alarms, nonslip footwear, and toileting schedules were ordered but not used.
• Medication effects. Sedatives, blood pressure drugs, and medication errors cause dizziness and confusion.
• Unsupervised wandering. Residents with dementia leave their rooms or the building. See elopement.
• Bed rail entrapment. Improper or poorly fitted bed rails trap residents and cause their own falls, fractures, and head injuries.

What the Law Requires After a Fall

Federal rules also require a certified nursing home to:

• Plan for the risk. Address fall and transfer risk in the comprehensive care plan (42 C.F.R. 483.21(b)).
• Notify you. Promptly tell the physician and the resident’s representative about an accident that results in injury and may require physician intervention (42 C.F.R. 483.10(g)(14)).
• Report injuries of unknown origin. Report alleged neglect and serious bodily injuries to the administrator and the state survey agency, within 2 hours when serious bodily injury is involved (42 C.F.R. 483.12(c)).

Assisted living and other senior living facilities are governed mainly by state licensing rules, not these federal regulations, but they still owe residents reasonable care.

Warning Signs After a Fall

• Pain when moving a leg or hip, or refusing to bear weight
• One leg that looks shorter or turned outward
• New bruising, especially on the face, hips, or arms
• Sudden confusion or sleepiness after a fall (possible head injury)
• A story from staff that changes, or no incident report at all

If your loved one “just isn’t right” after a fall, insist on an X-ray or a hospital evaluation. A missed hip fracture gets worse every day it goes untreated.

What to Do Right Now

1. Get medical care first. Ask for imaging and a physician evaluation.
2. Ask for the incident report and the name of every staff member involved.
3. Ask for the care plan. Check what transfer method and fall precautions were required.
4. Write down what you were told, by whom, and when. Keep emails and texts.
5. Report it. In Tennessee, you can contact Adult Protective Services, the Department of Health, and the long term care ombudsman.
6. Call a lawyer early. Tennessee generally allows one year to file a health care liability claim (Tenn. Code Ann. 29-26-116), and 60 days’ written notice is required before filing (Tenn. Code Ann. 29-26-121).

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What a Fall or Transfer Injury Claim Can Recover

A claim may recover medical bills, pain and suffering, loss of enjoyment of life, and, when a death follows, wrongful death damages for the family. Tennessee generally caps noneconomic damages at $750,000, or $1,000,000 for catastrophic injuries (Tenn. Code Ann. 29-39-102). The cap does not apply when a defendant intentionally falsified, destroyed, or concealed records to evade liability (Tenn. Code Ann. 29-39-102(h)(2)).

How The Higgins Firm Handles These Cases

The Higgins Firm is a litigation-focused nursing home neglect firm. We take serious injury and wrongful death cases, such as fractures, head injuries, and deaths that follow a fall, and we prepare every case for trial. We litigate in Tennessee, Kentucky, Georgia, and Illinois, and we work with referring attorneys nationwide. See our Tennessee nursing home abuse lawyers page.

We pull the care plan, fall risk assessments, incident reports, staffing schedules, and call light data, and we talk to the people who worked the floor. You pay nothing unless we recover.

Call 888-806-9299. No Fee Unless We Win.

Frequently Asked Questions

Is a nursing home responsible if my parent fell?

Not for every fall, but often. Federal law requires nursing homes to keep residents as free of accident hazards as possible and to provide adequate supervision and assistance devices. If the facility knew your parent was a fall risk and did not follow the care plan, it may be liable for the injuries.

What is a transfer injury in a nursing home?

A transfer injury happens when a resident is hurt while being moved between a bed, chair, toilet, or shower. Common causes are one aide doing a transfer that the care plan says requires two people, improper use of a mechanical lift, or no gait belt. These injuries often cause fractures and head trauma.

Does a Hoyer lift require two people?

Facility policies and lift manufacturers typically require two trained staff to operate a mechanical lift such as a Hoyer. When a single aide operates the lift alone and the resident is dropped, that departure from policy is strong evidence of neglect. Ask for the care plan to see what was required.

Does the nursing home have to tell me my loved one fell?

Yes. Federal rules require a certified nursing home to promptly notify the resident’s physician and representative of any accident that causes injury and may require physician intervention. If you learned about a fall from a hospital, another resident, or a bruise, ask why the facility did not call you.

What if the nursing home did not notice a broken hip?

A missed fracture is a separate failure from the fall itself. Staff are expected to assess residents after a fall and get imaging when there is pain, deformity, or refusal to bear weight. Delayed diagnosis can increase pain, complications, and the risk of death, and it can strengthen a neglect claim.

How long do I have to file a nursing home fall claim in Tennessee?

Generally one year from the injury or its discovery under Tenn. Code Ann. 29-26-116, with an outside limit of three years except for fraudulent concealment. Tennessee also requires 60 days’ written notice before suit and a certificate of good faith with the complaint, so early investigation matters.

Does it cost anything to talk to The Higgins Firm?

No. The case review is free, and we handle nursing home fall and transfer injury cases on a contingency fee. You pay no attorney’s fee unless we recover money for you or your family.