This module will review the Regulatory requirements for not only fall prevention but also what to do once a fall occurs. By understanding the regulatory requirements around falls, the facility will be able to develop strategies to assess residents and design a plan to mitigate the falls.

F689, free of Accident/Hazards/Supervision/Devices is the federal tag that is most likely to be cited related to a fall issue.   The intent of F689 is that the resident environment remains free of accident hazards as much as possible and that each resident receives adequate supervision and assistance to prevent accidents.  Each resident or their responsible party should be aware of the risks and potential hazards related to falls and the various devices used to reduce falls. This then leads to an interdisciplinary approach to falls prevention, including the use of root cause analysis.   

Registration is free to AHCA/NCAL members

Follow the Instructions Below to Register: 

• To avoid technical problems, use Google Chrome. 
• Members will need to log in using their existing email and password first. 
• Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
• If you have forgotten your password click here. 
• If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register.

Email educate@ahca.org if you need assistance.

CLICK HERE TO ACCESS MORE MODULES ON FALLS PREVENTION

A culture of safety in nursing homes is a critical framework that prioritizes the well-being and security of both residents and staff. It fosters an environment where everyone is encouraged to communicate openly about potential risks, incidents, and near misses without fear of retribution. This transparency allows for continuous learning and improvement, with the goal of preventing harm. In such a culture, safety protocols and guidelines are not just regulatory requirements, but are integrated into the daily operations of the facility. This commitment to safety enhances the quality of care, promotes trust and confidence among residents and their families, and contributes to a positive work environment for staff.

This module offers the nursing home leaders information about a culture of safety framework that incorporates key elements from the Requirements of Participation (F689 Accidents) and offers critical questions for leaders to reflect on and to challenge each other within their organization. Establishing and maintaining a culture of safety requires leaders to live and demonstrate expected behaviors and actions every day. 

Registration is free to AHCA/NCAL members

Follow the Instructions Below to Register: 

• To avoid technical problems, use Google Chrome. 
• Members will need to log in using their existing email and password first. 
• Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
• If you have forgotten your password click here. 
• If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register.

Email educate@ahca.org if you need assistance.

CLICK HERE TO ACCESS MORE MODULES ON FALLS PREVENTION

A team approach is required to effectively implement a falls prevention program that can help reduce the number of falls and fall-related injuries at a skilled nursing facility or assisted living community. Staff should know the risk factors contributing to falls and ways to prevent them. In addition, they should be able to manage injuries that result from falls.

Staff should understand what it means to work in a safe environment, where they can work together as a team and share information openly. It also means they understand that keeping residents safe is the most important consideration.

Important strategies include:

• Provide staff with education, including an overview of guidelines and how they will be implemented.
• Highlight effective intervention studies.
• Establish responsibilities among staff for fall prevention activities.
• Measure your progress and share updates with staff.
• Encourage staff by highlighting successes and identifying positive impacts of implementation.

Registration is free to AHCA/NCAL members

Follow the Instructions Below to Register: 

• To avoid technical problems, use Google Chrome. 
• Members will need to log in using their existing email and password first. 
• Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
• If you have forgotten your password click here. 
• If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register.

Email educate@ahca.org if you need assistance.

Maintaining function is one of the key factors in fall prevention.  Falls increase in the elderly because coordination, balance and gait decline.  When strength, power, and endurance are decreased, a slip or trip can turn into a fall. Any lower limb disability can increase the risk of falling, and difficulty rising from a seated position in a chair is associated with an increased risk as well It is also important to note that sedentary individuals fall more frequently than active individuals. (National Library of Medicine, 2023).

During survey, maintaining function is also reviewed. 

• F676, Activities of Daily Living, states that a resident is given the appropriate treatment and services to maintain or improve the ability to carry out activities of daily living. 
• F675, Quality of Life, states each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being. 

This module will discuss ways to maintain function in our residents through strategies including:

• Restorative Nursing
• Therapy
• Activities
• Modalities

 Using these interventions, the goal is that the residents continue to function at their highest level.

Registration is free to AHCA/NCAL members

Follow the Instructions Below to Register: 

• To avoid technical problems, use Google Chrome. 
• Members will need to log in using their existing email and password first. 
• Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
• If you have forgotten your password click here. 
• If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register.

Email educate@ahca.org if you need assistance.

According to the Centers for Disease Control and Prevention (CDC), 1 in 4 individuals over the age of 65 fall each year. Once an individual has fallen, they often fear additional falls or sustain
an injury which decreases their mobility and places them at increased risk for future falls.

Once a resident falls, interventions preventing future falls must be put in place. This requires conducting a proper investigation that seeks the root causes of the fall. For nursing facilities,CMS regulation F689, Free of Accident/Hazards/Supervision/Devices, requires a review of prior incidents/incidents to determine the root cause and to identify, implement and monitor effective interventions.

The investigative process should include input from the Interdisciplinary Team, including the staff at the bedside. The staff can provide insight into the residents’ customary routine and their ideas for preventing future falls. This team should also include the resident and their family, especially if falls occurred prior to admission so a realistic plan is developed

Registration is free to AHCA/NCAL members

Follow the Instructions Below to Register: 

• To avoid technical problems, use Google Chrome. 
• Members will need to log in using their existing email and password first. 
• Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
• If you have forgotten your password click here. 
• If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register.

Email educate@ahca.org if you need assistance.

Nursing staff should know the risk factors contributing to falls and ways to prevent them. In addition, they should be able to manage injuries that result from falls. Staff should understand what it means to work in a safe environment, where nursing staff can work together as a team and share information openly. It also means they understand that keeping residents safe, and not worrying about who might be to blame when things go wrong, is the most important consideration.

Staff will learn how to apply the elements of Quality Assurance Performance Improvement (QAPI) and Root Cause Analysis (RCA) to identify and resolve individual and systemic concerns and accomplish goals based on individualized health and safety needs.

Registration is free to AHCA/NCAL members

Follow the Instructions Below to Register: 

• To avoid technical problems, use Google Chrome. 
• Members will need to log in using their existing email and password first. 
• Once you are logged in to the website you will be able to register by clicking the green register button at the top of the page. 
• If you have forgotten your password click here. 
• If you are new to the site, you can create an account here. Answer all fields on the create an account page- especially locating your company name. You can search by name or zip code. After creating an account, you will be able to register.

Email educate@ahca.org if you need assistance.