Fall History is the Only Morse Fall Scale Item That Differentiates Nursing Home Residents Who Fall From Those Who do...

The Morse Fall Scale is a widely used fall risk assessment tool. However, limited evidence exists on whether this scale reliably differentiates individuals at high risk for falls in nursing homes. In a sample of nursing home residents, the purpose of this study was to evaluate if the Morse Fall Scale score or any individual scale items differed between residents who did and did not fall.

This retrospective cohort study includes data collected from the electronic health record. A fall was defined as the presence of a post-fall progress note.

Included individuals who were admitted to a single Community Living Center between June 1, 2022, and May 31, 2024, and had a complete fall risk assessment on admission.

Means and frequency counts were used to describe the characteristics of the sample. Differences in characteristics between residents who did and did not fall were evaluated using t tests and χ² tests.

Of the 650 residents included in the analysis, 19% fell. A higher proportion of residents who fell reported a history of falls. No significant differences were found in age, body mass index, sex, marital status, or race between residents who did and did not fall. No significant differences were found in total score, secondary diagnosis, intravenous access, mental status, ambulatory aid, or gait status between residents who did and did not fall.

A history of falling was the only item that significantly differed between residents who did and did not fall, suggesting that this piece of historical information is important when considering fall risk. The remaining Morse Fall Scale items did not differentiate well in nursing home residents because of less variation in the characteristics captured by the scale.