Falls in Newly Admitted Nursing Home Residents: A National Study

Authors

  • Natalie E. Leland PhD, OTR/L,

    Corresponding author
    • Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry and Davis School of Gerontology, University of Southern California, Los Angeles, California
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  • Pedro Gozalo PhD,

    1. Center for Gerontology and Health Care Research, Warren Alpert School of Medicine at Brown University, Providence, Rhode Island
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  • Joan Teno MD, MS,

    1. Center for Gerontology and Health Care Research, Warren Alpert School of Medicine at Brown University, Providence, Rhode Island
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  • Vince Mor PhD

    1. Center for Gerontology and Health Care Research, Warren Alpert School of Medicine at Brown University, Providence, Rhode Island
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Address correspondence to Natalie E. Leland, Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry and Davis School of Gerontology, University of Southern California, 1540 Alcazar Street, CHP 133, Los Angeles, CA 90089. E-mail: nleland@usc.edu

Abstract

Objectives

To examine the relationship between nursing home (NH) organizational characteristics and falls in newly admitted NH residents.

Design

Observational cross-sectional study from January 1, 2006, to December 31, 2006.

Setting

NHs in the United States in 2006.

Participants

Individuals (n = 230,730) admitted to a NH in 2006 without a prior NH stay and with a follow-up Minimum Data Set (MDS) assessment completed 30 days or more after admission.

Measurements

The relationship between experiencing a fall noted on the MDS assessment and NH characteristics (e.g., staffing, profit and chain status, religious affiliation, hospital-based facility status, number of beds, presence of a special care unit, funding) was examined, adjusting for NH resident characteristics.

Results

Twenty-one percent of this cohort (n = 47,750) had experienced at least one fall in the NH at the time of the MDS assessment, which was completed for newly admitted NH residents who had at least a 30-day stay. NHs with higher certified nursing assistant (CNA) staffing had lower rates of falls (adjusted odds ratio = 0.97, 95% confidence interval = 0.95–0.99).

Conclusion

For newly admitted NH residents, NHs with higher CNA staffing had a lower fall rate. In an effort to maximize fall prevention efforts, further research is needed to understand the relationship between CNA staffing and falls in this NH population.

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