Falls have long been a concern in skilled nursing, but their consequences are receiving renewed attention. For fiscal year 2027, the Centers for Medicare & Medicaid Services (CMS) has included Falls with Major Injury (FMI) among eight quality measures in its expanded Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program. For skilled nursing operators, this reinforces the importance of reducing serious fall-related injuries—not only for resident well-being, but also for quality performance and financial outcomes.

Understanding Falls with Major Injury

CMS defines major injuries resulting from falls to include fractures, joint dislocations, closed-head injuries with altered consciousness, and subdural hematomas. The Falls with Major Injury (Long-Stay) measure evaluates the percentage of long-stay residents experiencing one or more falls resulting in major injury. Although CMS has tracked FMI for years, its inclusion in the expanded SNF VBP Program adds another dimension to how skilled nursing performance is evaluated.

These injuries can have lasting consequences, including hospitalization, reduced mobility, loss of independence, and increased care needs. For providers, they can also create operational and financial challenges. While the terminology is particularly relevant in skilled nursing, the underlying concern extends across assisted living, memory care, and other senior living settings.

Fall Management Must Address More Than Falls

Traditional fall management strategies focus heavily on reducing the likelihood of falls through assessments, individualized care plans, environmental modifications, and staff interventions. These approaches remain essential, but even comprehensive strategies cannot eliminate every fall. Reducing the severity of injuries when falls occur deserves attention alongside reducing fall frequency.

The built environment can play an important role in this effort. Flooring, in particular, is often selected for durability, maintenance, infection control, and aesthetics, while its potential contribution to reducing fall-related injuries may receive less consideration. Yet the surface a resident lands on can influence the impact forces experienced during a fall, making flooring an important consideration in a comprehensive fall management strategy.

Adding Protection Beneath the Floor

Impact-absorbing flooring systems offer a passive approach to fall management. Rather than requiring residents or staff to activate equipment, they provide protection continuously, including in resident rooms, bathrooms, and other high-risk areas. Viconic Fall Defense uses engineered energy-absorbing technology beneath compatible floor coverings to dramatically reduce impact forces when falls occur.

Real-world data reported by Viconic’s senior care provider partners demonstrate an 88% reduction in the rate of falls with major injury (FMI), a 72% reduction in the rate of fall-related emergency room visits, and a 40% reduction in the overall rate of injuries from falls. These findings reflect reported outcomes across participating skilled nursing, assisted living, and memory care environments, reinforcing the potential value of incorporating injury-reducing flooring into broader fall management strategies.

A More Complete Approach to Resident Protection

As CMS places greater emphasis on falls with major injury, skilled nursing leaders have another reason to evaluate how their environments support resident safety. But the opportunity extends beyond regulatory performance. Across senior care, reducing the consequences of falls can help preserve resident mobility, confidence, and independence while supporting the teams responsible for their care.

A comprehensive fall management strategy considers not only how to reduce the likelihood of falls, but also how to protect residents when falls happen. By incorporating injury-reducing flooring into the built environment, senior care providers can add another layer of protection that works continuously without disrupting daily routines or resident independence.

Learn more about the research and real-world outcomes behind Viconic Fall Defense.

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