Home health agencies (HHAs) failed to report 55% of the nearly 40,000 falls resulting in major injury and hospitalization between 2020 and 2021, a top government watchdog group found in a 2023 report.

Since 2019, Medicare-certified HHAs are required to report all falls to the federal government but did so only about 45% of the time, the Department of Health and Human Services (HHS) Office of the Inspector General (OIG) found.

Among those nearly 40,000 fall incidents, 85% resulted in a bone fracture, 11% led to a head injury with altered consciousness, and 9% caused a subdural hematoma.

The proportion of unreported falls was higher among relatively younger home health patients as compared to their older counterparts; people who identify as Black, Hispanic, or Asian were also more likely than white patients to have their incidents fall through the cracks, according to the OIG.

The report illustrates that even under the supervision of a HHA, fall injuries remain a common risk for older adults and people living with disabilities, and small steps to prevent these injuries can have significant benefits for providers and patients alike; in 2020 alone, falls among older adults led to 920,000 hospitalizations that cost a total of $70 billion in medical expenses, the Centers for Disease Control & Prevention found.