Falls remain one of the most serious risks in long-term care. A new report from the U.S. Department of Health and Human Services (HHS) shows just how significant—and hidden—the issue can be. 

According to the OIG, 43% of major falls in nursing homes went unreported in federal data between July 2022 and June 2023. That means families and policymakers who rely on CMS’ Care Compare website are often seeing fall rates that do not reflect reality. 

The report analyzed hospital Medicare claims alongside nursing homes’ Minimum Data Set (MDS) assessments. Nearly 43,000 residents experienced a fall with major injury requiring hospitalization, and almost 2,000 died while hospitalized. Yet nearly half of those events never appeared in required resident assessments. 

Underreporting was highest in larger facilities, and among short-stay, younger, or male residents. In fact, nursing homes showing the lowest fall rates on Care Compare were often those least likely to report falls—suggesting that low numbers may reflect reporting gaps rather than safer environments. 

OIG has recommended stronger oversight and validation efforts to improve compliance, and CMS has agreed to pursue changes, including a new fall measure that blends MDS data with claims to improve accuracy. 

The findings underscore two realities: accurate reporting is essential, and falls remain a persistent, high-impact risk. For providers, the task is not just to comply with reporting requirements but also to strengthen fall management strategies—through staff practices, resident assessments, and environmental design that reduces the likelihood of serious injury when falls occur. 

Find out how Viconic can help.