How often are patients assessed for falls? A Comprehensive Guide

September 22, 2025 •

4 min read

According to the CDC, more than one in four older adults falls each year, but fewer than half tell their doctor. Knowing how often are patients assessed for falls is crucial for proactive care and prevention, helping to identify and mitigate risks before an incident occurs.

Quick Summary

Healthcare providers screen all adults 65 and older annually, with more frequent, in-depth assessments triggered by a fall, reported unsteadiness, or other identified risk factors, including during hospital admissions or changes in a patient’s condition.

Key Points

Annual Screenings: Adults 65 and older should be screened for fall risk at least once a year by their primary care provider.
Positive Screen Triggers Deeper Assessment: If an annual screening suggests increased risk, a more comprehensive evaluation of gait, balance, and other factors is performed.
Hospital Patients Assessed Regularly: Inpatient fall risk assessments occur on admission, at the start of each shift, and whenever a patient's condition changes.
Frequent Reassessment in Long-Term Care: Residents in long-term care facilities undergo comprehensive assessments upon admission and are regularly reassessed.
Post-Fall Monitoring is Critical: After a fall, patients are closely monitored, often for 24 to 72 hours, to assess for any new or worsened symptoms.
Assessment Tools Vary by Setting: Different assessment tools, from simple questionnaires to performance-based tests, are used depending on the clinical environment.
Intervention Follows Assessment: The ultimate goal of assessment is to inform effective, personalized interventions to reduce fall risk, such as exercise programs or home safety modifications.

The Standard Annual Screening in Primary Care

For community-dwelling adults aged 65 and older, a yearly fall risk screening is standard practice, as recommended by organizations like the American Geriatrics Society and the Centers for Disease Control and Prevention (CDC). This initial screening typically involves a series of simple questions designed to quickly identify individuals who might be at increased risk. The healthcare provider may ask:

Have you fallen in the past year?
Do you feel unsteady when standing or walking?
Are you worried about falling?

Answering yes to any of these questions, particularly reporting a fall, prompts a more thorough assessment. The goal is to catch potential issues early, before a more serious fall occurs. Regular screening during annual wellness visits provides a consistent touchpoint for monitoring a patient's fall risk over time.

When a More Comprehensive Assessment is Required

If an initial screening indicates a potential risk, a more comprehensive assessment is necessary to determine the underlying factors. This deeper evaluation can be triggered by a positive screening result, a history of falls, or a new health complaint related to balance or mobility. This might include:

Physical and Functional Evaluation: Testing gait, balance, and leg strength using tools like the Timed Up-and-Go (TUG) or the 30-Second Chair Stand Test.
Medication Review: Identifying any medications, such as sedatives or certain blood pressure drugs, that might increase fall risk.
Health History: Discussing chronic conditions like vision impairment, osteoporosis, or cognitive issues that contribute to falls.
Home Safety Assessment: A review of potential environmental hazards within the patient's home, like loose rugs or poor lighting.
Orthostatic Blood Pressure Checks: Measuring blood pressure while lying and standing to check for drops that can cause dizziness.

Fall Assessments in Inpatient and Long-Term Care

The frequency and nature of fall risk assessments differ significantly within hospital and long-term care settings due to the higher risk and constant supervision involved. These environments follow strict protocols to ensure patient safety.

Hospitalized Patients

Initial Admission: A fall risk assessment is conducted upon a patient's admission to a hospital unit. The results help staff develop an individualized care plan.
Regular Monitoring: Ongoing assessments are performed periodically, often at the beginning of each nursing shift, or on an hourly basis for high-risk patients. This involves hourly rounding to check on a patient's needs and ensure their safety.
After a Status Change: A reassessment is performed whenever a patient's condition changes, such as after surgery, a change in medication, or a noticeable decline in mobility.

Long-Term Care Facilities

Initial Comprehensive Assessment: A comprehensive fall risk assessment is a key part of the initial admission process for residents in a long-term care or skilled nursing facility.
Regular Reassessments: Assessments are conducted on a regular schedule, such as quarterly, and also whenever there is a significant change in the resident's health or if a fall occurs.
Post-Fall Procedures: Following a fall, a detailed investigation and assessment are conducted to identify the cause and update the care plan accordingly. This often includes increased monitoring for a specified period, such as 72 hours.

Key Fall Assessment Tools in Practice

Various tools are used by healthcare professionals to evaluate fall risk. Their application depends on the setting and the patient's condition. Here is a comparison of some common methods:


Tool	Primary Purpose	How it Works	Common Setting	Duration
Timed Up-and-Go (TUG)	Measures mobility, balance, and gait.	Patient stands from a chair, walks 10 feet, turns around, walks back, and sits down. Time is recorded.	Primary care, inpatient	Short
30-Second Chair Stand Test	Measures lower body strength and endurance.	Patient stands and sits as many times as possible within 30 seconds.	Primary care, long-term care	Short
4-Stage Balance Test	Measures static balance.	Patient holds four progressively difficult positions for 10 seconds each.	Primary care	Short
Morse Fall Scale	Predicts inpatient fall risk.	Assesses six variables: history of falls, secondary diagnosis, ambulatory aid, IV/saline lock, gait, and mental status.	Inpatient hospital	Quick
Hendrich II Fall Risk Model	Predicts inpatient fall risk.	Assesses eight risk factors including confusion/disorientation, depression, and symptomatic hypotension.	Inpatient hospital	Quick

The Importance of Follow-Up and Intervention

Assessment is only the first step. The true value lies in the interventions that follow. For high-risk individuals, this can involve multifactorial approaches tailored to address their specific risk factors. This may include referrals to physical therapy for gait and balance training, medication adjustments, or in-home environmental modifications.

Furthermore, empowering patients and their families with information is vital. Education can help older adults understand their risk factors and participate actively in prevention strategies, like exercise programs or adopting home safety measures. Following up on recommended interventions is critical to ensuring long-term success in reducing fall risk.

For more detailed information on fall prevention strategies and resources, the CDC's STEADI initiative is an excellent starting point: STEADI - CDC's Older Adult Fall Prevention.

Conclusion

Understanding how often are patients assessed for falls reveals a layered and systematic approach designed to maximize patient safety. While annual screenings are standard for older adults, the frequency and depth of assessments increase with a patient's risk level or with changes in their health status. This layered approach, from quick screenings in primary care to vigilant hourly rounds in a hospital, underscores the commitment to proactive fall prevention. Through regular assessments and effective interventions, healthcare providers and patients can work together to significantly reduce the risk of debilitating falls and improve overall quality of life.

Frequently Asked Questions

In a hospital, patients are typically assessed for fall risk upon admission, at the start of every nursing shift, and following any significant change in their medical condition or status. For high-risk patients, hourly safety rounds are common practice.

A fall risk assessment involves a healthcare provider gathering information about your health history, asking questions about past falls, and often performing physical tests of your balance, gait, and leg strength. A medication review and home safety check are also common components.

According to the CDC and other health organizations, all adults aged 65 and older should undergo an initial fall risk screening annually as part of their routine care.

STEADI (Stopping Elderly Accidents, Deaths, & Injuries) is a CDC-led initiative that provides a framework for healthcare providers to screen, assess, and intervene to reduce fall risk in older adults. It includes a series of questions and assessment tools.

Common tools include the Timed Up-and-Go (TUG) test, the 30-Second Chair Stand Test, and the 4-Stage Balance Test for balance and mobility. In hospital settings, scales like the Morse Fall Scale are frequently used.

Yes. If you have concerns about your balance, have experienced a fall, or are worried about falling, you can and should request a fall risk assessment from your primary care provider. They can then recommend appropriate interventions.

Yes. Following a fall in a long-term care facility, a resident will receive a comprehensive assessment. This post-fall assessment helps identify contributing factors and leads to an updated care plan to prevent future incidents.