Table 3 Fall measures, data sources, calculation, and time points

Demographics; Medical record

Gender, Age, and Race. Nominal

Fall rate; medical record, MDS, incident reports, census

Numerator: number of falls occurring in a 6-month period

Denominator: number of occupied facility bed days

Probability of recurrent falls; as above

Proportion of residents with two or more falls occurring in a 6 month period

Fall risk reduction; medical record, MDS, incident reports

Count of documented fall risk reduction indicators defined below

a) Orthostatic Blood Pressure

Documentation of blood pressure in two positions, OR discontinuing medication, adding volume expanding medication, compression stockings

b) Sensory Impairment

Documentation of presence or absence of visual impairment, OR Intervention to change corrective devices, add assistive technology to optimize sensory input

c) Footwear

Documentation that footwear was evaluated, modified, or recommended to patient

d) Gait and Assistive Devices

Physical therapy assessment or training, change in assistive device, or participation in restorative ambulation program

e) Toileting

Documentation of scheduled toileting or a previous attempt in residents with at least intermittent urinary or bowel continence

f) Environment

Documentation of a search for environmental factors contributing to fall risk (e.g., low toilet seat, room clutter, burned out light bulb) OR a change in environment likely to reduce falls or injury risk, including repairing grab bars, changing floor surfaces, changing lighting, re-arranging furniture, using a low bed or floor mat, and alarms

g) Psychotropic Medication Reduction [53–62]

Dose reduction or discontinuation of any of the following classes of psychoactive medications within 1 month of a fall; benzodiazepines, tricyclic antidepressants, antipsychotics, propoxyphene, and selected anticholinergic agents (diphenhydramine, sedating antihistamines, immediate-release oxybutynin, skeletal muscle relaxants)

h) Calcium and Vitamin D

Prescription of at least 1,000 mg of calcium daily or 800 IU of vitamin D daily, OR equivalent dose regimens. Multivitamins containing vitamin D and combination calcium/vitamin D preparations will be added to the total daily dose calculation.