Nursing Home Falls – Fractures and Head Injuries
Minnesota elder care facilities needs to address their nursing home falls policies and issues which have put the residents of the facility at risk. Falls are usually preventable with properly trained staff who take sufficient time when assisting elderly and vulnerable nursing home residents.
Reasons for Falls – Nursing Home Falls
- According to MN Falls Prevention, falls are the number one cause of trauma deaths, non-fatal major trauma and other trauma care in Minnesota. The vast majority of these cases are among older Minnesotans. • Minnesota’s fall death rate is almost twice the national average and it is increasing. Every hour an older adult dies as the result of a fall. • The total costs for non-fatal falls among Minnesotans 65 years of age and older were $162 million for hospital charges and $20.4 million for emergency department charges in 2005. • Hip fractures are among the most serious fall-related injuries. Twenty percent die within the first year post-fracture, half never regain their previous level of functioning, and many are unable to live independently after their injury. • Falls among the elderly are driving health care costs and significantly impacting quality of life for our older adults.
What you can do –
- Sign-up for the statewide falls prevention listserv. The listserv is a vehicle to share information related to the falls prevention initiative. To subscribe to the listserv, please visit: http://mailman.stpaul.visi.com/mailman/listinfo/fallsprevention
- Visit the Minnesota Falls Prevention Initiative website at http://www.mnfallsprevention.org/ The website contains more detailed information related to conducting fall risk screenings and assessments, implementing falls prevention interventions in your community, linking community.The US Center for Disease Control, CDC, also has a great website which addresses Older Adults and Falls, provides very useful information including:
Costs of Falls Among Older Adults, Nursing Home Falls
- Eye Can See Clearly Now
- Move Your Body
- How big is the problem?
- How are costs calculated?
- How costly are fall-related injuries among older adults?
- How do these costs break down?
- Type of injury and treatment setting
How big is the problem, Nursing Home Falls?
- In 2000, falls among older adults cost the U.S. health care system over $19 billion dollars or $28.2 billion in 2010 dollars. With the population aging, both the number of falls and the costs to treat fall injuries are likely to increase.
- One in three adults age 65 and older falls each year.1,2
- Of those who fall, 20% to 30% suffer moderate to severe injuries that make it hard for them to get around or live independently, and increase their risk of early death.3
- Older adults are hospitalized for fall-related injuries five times more often than they are for injuries from other causes.3
- In 2009, emergency departments treated 2.2 million nonfatal fall injuries among older adults; more than 582,000 of these patients had to be hospitalized.4The costs of fall-related injuries are often shown in terms of direct costs.
How are costs calculated – Nursing Home Falls?
- Direct costs are what patients and insurance companies pay for treating fall-related injuries. These costs include fees for hospital and nursing home care, doctors and other professional services, rehabilitation, community-based services, use of medical equipment, prescription drugs, changes made to the home, and insurance processing.5
- Direct costs do not account for the long-term effects of these injuries such as disability, dependence on others, lost time from work and household duties, and reduced quality of life.
How costly are Nursing Home fall-related injuries among older adults?
- In 2000, the total direct medical costs of all fall injuries for people 65 and older exceeded $19 billion: $0.2 billion for fatal falls, and $19 billion for nonfatal falls.6
- By 2020, the annual direct and indirect cost of fall injuries is expected to reach $54.9 billion (in 2007 dollars).5
- Among community-dwelling older adults, fall-related injury is one of the 20 most expensive medical conditions.7
- In 2002, about 22% of community-dwelling seniors reported falling in the previous year. Medicare costs per fall averaged between $9,113 and $13,507.8
- Among community-dwelling seniors treated for fall injuries, 65% of direct medical costs were for inpatient hospitalizations; 10% each for medical office visits and home health care, 8% for hospital outpatient visits, 7% for emergency room visits, and 1% each for prescription drugs and dental visits. About 78% of these costs were reimbursed by Medicare.7
- In a study of people age 72 and older, the average health care cost of a fall injury totaled $19,440, which included hospital, nursing home, emergency room, and home health care, but not doctors’ services.9
Age and sex – How do these costs break down?
- The costs of fall injuries increase rapidly with age.6
- In 2000, the costs of both fatal and nonfatal falls were higher for women than for men.10
- In 2000, medical costs for women, who comprised 58% of older adults, were two to three times higher than the costs for men.6
Type of injury and treatment setting
- In 2000, the direct medical cost of fatal fall injuries totaled $179 million. About 78% of fall deaths, and 79% of total costs, were due to traumatic brain injuries (TBI) and injuries to the lower extremities.6
- Injuries to internal organs were responsible for 28% of fall deaths and accounted for 29% of costs.6
- Fractures were both the most common and most costly nonfatal injuries. Just over one-third of nonfatal injuries were fractures, but these accounted for 61% of total nonfatal costs—or $12 billion.6
- Hospitalizations accounted for nearly two-thirds of the costs of nonfatal fall injuries and emergency department treatment accounted for 20%.6
- On average, the hospitalization cost for a fall injury is $17,500.10
- Hip fractures are the most frequent type of fall-related fracture. The average hospitalization cost was $18,000; this was 44% of the direct medical costs for hip fractures.11
- Hausdorff JM, Rios DA, Edelber HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Archives of Physical Medicine and Rehabilitation 2001;82(8):1050–6.
- Hornbrook MC, Stevens VJ, Wingfield DJ, Hollis JF, Greenlick MR, Ory MG. Preventing falls among community-dwelling older persons: results from a randomized trial. The Gerontologist 1994:34(1):16–23.
- Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall-related injuries in older adults. American Journal of Public Health 1992;82(7):1020–3.
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web–based Injury Statistics Query and Reporting System (WISQARS) [online]. Accessed November 30, 2010.
- Englander F, Hodson TJ, Terregrossa RA. Economic dimensions of slip and fall injuries. Journal of Forensic Science 1996;41(5):733–46.trial. The Gerontologist 1994;34(1):16–23.
- Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and nonfatal falls among older adults. Injury Prevention 2006;12:290–5.
- Carroll NV, Slattum PW, Cox FM. The cost of falls among the community-dwelling elderly. Journal of Managed Care Pharmacy. 2005;11(4):307-16.
- Shumway-Cook A, Ciol MA, Hoffman J, Dudgeon BJ, Yorston K, Chan L. Falls in the Medicare population: incidence, associated factors, and impact on health care. Physical Therapy 2009.89(4):1-9.
- Rizzo JA, Friedkin R, Williams CS, Nabors J, Acampora D, Tinetti ME. Health care utilization and costs in a Medicare population by fall status. Medical Care 1998;36(8):1174–88.
- Roudsari BS, Ebel BE, Corso PS, Molinari, NM, Koepsell TD. The acute medical care costs of fall-related injuries among the U.S. older adults. Injury, Int J Care Injured 2005;36:1316-22.
- Barrett-Connor E. The economic and human costs of osteoporotic fracture. American Journal of Medicine 1995;98(suppl 2A):2A–3S to 2A–8S.
Common Nursing Home Fall Injuries
Unlike complex medical conditions, infections and disease, or neglect such as medication errors, or poor practices leading to urinary tract infections, falls are almost always preventable with proper care. In fact, federal regulations make it clear that there should be falls or other alleged accidents in nursing homes and skilled nursing facilities.
Here are some summaries on various topics related to nursing home falls and fractures:
Nursing Home Fall Injuries Lawyer
If you or someone you love is in a skilled nursing facility or nursing home and suffers fall injuries contact Attorney Kenneth LaBore for a free consultation to discuss the fall or injuries and he does not charge a fee unless there is a verdict or settlement offer with the wrongdoer. Call Kenneth LaBore at 612-743-9048 or toll free at 1-888-452-6589 or send an email to KLaBore@MNnursinghomeneglect.com.