Increased fall rates in nursing home residents after relocation to a new facility

To examine the change in fall rates after relocation of nursing home residents from one facility to another and to identify resident risk factors for changes in falls following relocation.

Retrospective review of incident reports to identify falls, followed by chart review of a longitudinal cohort.

An academic nursing home whose residents and programs moved from a 125-year-old, 233-bed facility to a newly constructed 255-bed facility.

A total of 210 nursing home residents were moved from one facility to the other. Of these, 133 individuals who lived in the old facility for 9 months before the move and in the new facility for 6 months after the move formed the longitudinal cohort.

In the 3 months after the move, the fall rate increased from 0.34 to 0.70 falls per resident per quarter in the entire nursing home population (P < .001) and subsequently returned to baseline. In the longitudinal subgroup the fall rate went from 0.26 to 0.60 (P < .005). Fall-related injuries in the longitudinal subgroup went from 0.058 injuries per resident per quarter at baseline to 0.15 (P < .001). However, the injury rate per fall did not change. There were no characteristics associated with being a faller in the quarter before the move. Dementia and not being bedbound were associated with being a faller after the move. Individuals who were ambulatory or wheelchair mobile had a significant risk of increasing the number of falls after the move, and individuals with dementia had a strong but insignificant trend in this direction.

The incidence of falling doubled after relocation of nursing home residents to a new facility. An increase in falls was seen in individuals who were not bedbound. Although nursing home relocation may be a relatively uncommon occurrence, it is reasonable to infer that older individuals who change their living environments are at increased risk for falls and fall-related injuries.