Increased Fall Rates in Nursing Home Residents After Relocation to a New Facility

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Abstract
OBJECTIVE: 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.DESIGN: Retrospective review of incident reports to identify falls, followed by chart review of a longitudinal cohort.SETTING: An academic nursing home whose residents and programs moved from a 125‐ year‐old, 233‐bed facility to a newly constructed 255‐bed facility.PATIENTS: 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.RESULTS: 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.CONCLUSIONS: 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 bed‐bound. 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.