What Happens in a Typical Nursing Home Fall Case?

Falls are one of the leading causes of serious injuries and fatalities among nursing home residents. According to the Centers for Disease Control and Prevention (CDC), between 50-75% of nursing home residents fall each year, often due to inadequate care or unsafe conditions. Many of these incidents are preventable, particularly when staff fail to follow established care protocols.

In this blog, we’ll walk through a typical nursing home fall case using a fictional example to explain how these nursing home neglect claims are handled—from the moment of the fall to medical treatment, investigation, and resolution, whether through settlement or trial.

The Incident: A Fictional Case

Margaret, an 82-year-old nursing home resident, has been classified as a high fall risk due to her limited mobility and prior history of falls. The staff at the nursing home is required to assist Margaret with transfers and bathroom visits to prevent accidents. One evening, Margaret activates her call light to request help going to the restroom. Unfortunately, staff fail to respond in a timely manner, forcing Margaret to attempt the transfer on her own.

As she tries to stand, Margaret loses her balance and falls, suffering a fractured hip. The staff find her on the floor in pain and call for an ambulance. Margaret is taken to the hospital, where she undergoes surgery and begins a long and painful recovery.

Step 1: Seeking Medical Treatment

Margaret’s first priority is receiving appropriate medical care. At the hospital, doctors diagnose Margaret with:

• Hip Fracture: A common and serious injury among elderly individuals, often requiring surgery and extensive rehabilitation.
• Bruising and Soft Tissue Damage: Secondary injuries from the fall.

Margaret undergoes hip replacement surgery and is transferred to a rehabilitation center for several weeks of physical therapy. Her medical records and bills, which document the extent of her injuries and treatment, become critical evidence in her case.

Step 2: Reporting the Incident

Margaret’s family is deeply concerned about the nursing home’s failure to respond to her call light, so they take the following steps:

1. Filing a Complaint with the Nursing Home: The family submits a formal complaint to the nursing home administration, requesting an internal investigation and written report of the incident.
2. Calling the Illinois Department of Public Health (IDPH): The family contacts the IDPH to report the fall and their concerns about the nursing home’s negligence. The IDPH takes the complaint seriously and launches an unannounced in-person investigation at the facility.

The IDPH Investigation

IDPH investigators visit the nursing home without prior notice, inspecting:

• Call light response logs to determine how long it took staff to respond to Margaret’s request for help.
• Staffing schedules to evaluate whether the facility was adequately staffed on the night of the fall.
• Margaret’s care plan to ensure it properly identified her as a high fall risk and included protocols for safe transfers.

The IDPH interviews staff, reviews surveillance footage, and speaks with other residents. After completing the investigation, the IDPH issues a report of findings, which concludes that the nursing home violated state regulations by failing to respond promptly to call lights and adequately assist high-risk residents. These findings provide strong evidence to support Margaret’s legal claim.

Step 3: Consulting a Nursing Home Negligence Attorney

The family consults an experienced Naperville nursing home negligence attorney, who:

• Reviews the IDPH report, Margaret’s medical records, and the nursing home’s incident report.
• Explains the nursing home’s legal duty to provide adequate care under Illinois law.
• Advises the family on pursuing a negligence claim to hold the facility accountable.

The attorney agrees to take the case, assuring the family that they will advocate for Margaret’s rights and fight for fair compensation.

Step 4: Investigating the Case

Margaret’s attorney conducts a thorough investigation to strengthen the case, including:

• Analyzing Call Light Records: Confirming that staff failed to respond to Margaret’s request for help in a timely manner.
• Reviewing Care Plans: Examining whether Margaret’s fall-risk assessment and care plan were followed appropriately.
• Interviewing Witnesses: Speaking to staff and residents who can corroborate the nursing home’s inadequate response.
• Consulting Experts: Collaborating with medical and nursing home care experts to evaluate whether the facility’s actions fell below industry standards.

This investigation reveals systemic issues in the nursing home, including chronic understaffing and repeated delays in responding to residents’ needs.

Step 5: Filing a Claim with the Nursing Home’s Insurance

The attorney files a claim with the nursing home’s liability insurance company, seeking compensation for:

• Medical Expenses: Covering Margaret’s surgery, hospital stay, and rehabilitation.
• Pain and Suffering: Reflecting the physical pain and emotional distress caused by her injuries.
• Future Medical Needs: Accounting for ongoing physical therapy and potential complications.
• Loss of Quality of Life: Recognizing Margaret’s reduced mobility and independence after the fall.

The nursing home’s insurance company assigns an adjuster to investigate the claim, often seeking ways to minimize liability.

Step 6: Negotiating a Settlement

Margaret’s attorney negotiates with the insurance company, presenting evidence of negligence, including:

• The IDPH report, which confirms regulatory violations.
• Call light logs and witness statements documenting the nursing home’s failure to provide timely assistance.
• Medical records showing the severity of Margaret’s injuries and the long recovery process.

After extensive negotiations, the insurance company agrees to a settlement of $350,000, covering Margaret’s damages and holding the nursing home accountable for its negligence.

Step 7: Preparing for Trial (If Necessary)

If the insurance company refuses to offer a fair settlement, the case may proceed to litigation. In Margaret’s case, let’s consider what would have happened if negotiations failed:

• The attorney would file a lawsuit against the nursing home, alleging negligence and regulatory violations.
• Both sides would exchange evidence during discovery, including depositions from staff and expert witnesses.
• At trial, the attorney would argue that the nursing home’s failure to follow Margaret’s care plan directly caused her fall and injuries.

At trial, a jury would determine liability and award damages based on the evidence presented.

Step 8: Resolution

In most cases, nursing home claims resolve through settlement, as in Margaret’s case. However, when cases go to trial, a judge or jury determines liability and awards damages. If Margaret’s case had gone to trial, her attorney’s preparation and evidence would likely have resulted in a favorable verdict.

Why Accountability Matters in Nursing Home Fall Cases

Nursing home negligence is not just about one incident—it reflects systemic issues that can endanger all residents. By holding facilities accountable, families like Margaret’s help ensure safer conditions for others.

“When a loved one is harmed in a nursing home, accountability isn’t just about justice—it’s about ensuring every resident receives the care and dignity they deserve.” – John J. Malm, Naperville nursing home abuse lawyer

How John J. Malm & Associates Can Help With Your Naperville Nursing Home Abuse and Neglect Case

At John J. Malm & Associates, we understand the devastating impact nursing home negligence can have on residents and their families. With offices in Naperville and St. Charles, our award-winning team has recovered millions for personal injury victims across Illinois. With over 90 years of combined litigation experience, we are committed to helping families hold negligent nursing homes accountable.

Why Choose Us?

• Proven Results: Millions recovered for personal injury and nursing home negligence clients.
• Experienced Team: Decades of experience handling complex nursing home cases.
• Personalized Attention: Tailored strategies and one-on-one support for every client.
• No Fees Unless We Win: You don’t pay unless we recover compensation for you.

Contact us today to schedule your free consultation. Let us help you secure the justice and compensation your loved one deserves. Your recovery starts here.