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March 9, 2017
How far would the stakeholders of your senior living facility (e.g. nursing staff, operators, and owners) go or be willing to spend to achieve a resident fall rate of less than 2.0 per 1,000 days? For a rate of less than 1.0 per 1,000 days? The CDC reports that the average cost of a fall is over $30,000 for the added care costs alone (not including potential litigation/settlement costs, which can vary widely between incidents), meaning there is significant financial incentive to lower the occurrence of falls in any healthcare setting, particularly in assisted living (ALF) and skilled nursing facilities (SNF). Obviously, SNF/ALF facilities with higher fall rates have more to gain by implementing procedures and technologies that can directly contribute to fewer falls.
Consider this innovative approach to reducing falls. In a recent three-month pilot study, Mission Health out of Ashville, North Carolina, eliminated patient falls entirely across a 98-patient study, with a technology commonly used in Microsoft Xbox consoles:
The technology uses depth sensors to detect movement, while infrared cameras create invisible barriers that trigger an alert…Through a two-way audio system, virtual sitters could intervene verbally to prevent a patient from getting up from a bed or chair, preventing a potential fall and circumventing the need for nurse intervention. 
Falling and mishandling residents is the number one insurance claim and litigation issue of senior living facilities, making this risk particularly concerning to senior living operators. Before the pilot study, this particular nursing unit had an overall fall rate of 5.74 per 1,000 patient days, “despite a multicomponent fall prevention program, compassionate care staff and strong culture of safety.” Although their initial fall rate was higher than the average rate nationwide of 3.6 per 1,000 days, the fact that they eliminated falls completely during this small pilot period is impressive.
Parker, Smith & Feek’s robust Healthcare Practice Group, which has dedicated experts in the senior living risk management space, takes into account all possible tools to minimize an operator’s professional liability risks. There are tried and true clinical policies and procedures that our clients utilize to lower these risks, particularly when handling residents who are more prone to fractures, lacerations, or the need for acute care and rehab post-fall. Our risk management team considers technological advances, such as the one seen in the Mission Health pilot program, to further minimize risks. However, this particular technology might take some time for proper adoption and analysis to truly warrant implementation for a resident. Philosophically, we believe stakeholder endorsement for implementing tried and true risk management practices and accountability to these programs can result in a triplicate of savings:
Partnering with a well-versed risk management consulting partner can help operators take a holistic approach to the handling of residents or patients. An industry leader in claims and risk management, Parker, Smith & Feek dedicates 8% of our full-time staff to risk management and claims, while the average commercial insurance brokerage only allocates 1% of their staff to help their clients address these very costly issues, pre and post fall/loss. Contact a licensed insurance broker experienced with long-term care should you have questions about your operations and possible solutions to drive down your fall rate and increase your bottom line.
 Burns EB, Stevens JA, Lee RL. The direct costs of fatal and non-fatal falls among older adults—United States. J Safety Res 2016:58.
 Donaldson, N., Brown, D. S., Aydin, C. E., Bolton, M. I., & Rutledge, D. N. (2005). Leveraging nurse-related dashboard benchmarks to expedite performance improvement and document excellence. Journal of Nursing Administration, 35(4), 163-172.+
The views and opinions expressed within are those of the author(s) and do not necessarily reflect the official policy or position of Parker, Smith & Feek. While every effort has been taken in compiling this information to ensure that its contents are totally accurate, neither the publisher nor the author can accept liability for any inaccuracies or changed circumstances of any information herein or for the consequences of any reliance placed upon it.