Nearly half of nursing homes are underreporting serious falls. That puts them at risk. Here's what it means, and how to stay ahead.
In September 2025, the Office of Inspector General (OIG) released a striking finding: 43% of U.S. nursing homes failed to report resident falls that resulted in major injury. These underreported events weren’t just minor oversights, they were serious injuries that should have been documented, reported, and addressed through formal channels like CMS’s Minimum Data Set (MDS). You can find the full OIG report here.
This is more than a paperwork issue. It’s a patient safety issue. And it’s a regulatory red flag.
The bottom line: Falls are happening, but not always being documented or reported properly. That not only puts residents at risk, but leaves facilities exposed to audits, penalties, and reputational harm.
Failing to report falls accurately isn’t always deliberate. Many facilities rely on manual systems, busy staff, and reactive protocols that make it easy for events to slip through the cracks. But regulators and families don’t care why it happened, they care that it did.
The risks are real:
The OIG’s report signals an era of increased scrutiny. Facilities that can’t show clean, consistent data on falls and fall risk will be left vulnerable.
OneStep is a clinically validated fall prevention platform that uses real-world gait and mobility data to help nursing homes and SNFs:
With OneStep, staff can assess a resident’s fall risk in seconds just by placing a smartphone in their pocket during a short walk. Our AI analyzes real-world gait patterns to flag risks early, enabling proactive care.
“OneStep provides an inside look at patients’ mobility using real-world data. It helps me see how they’re doing when I’m not there, allowing us to deliver truly proactive care — before a fall or other serious issue occurs.” - Will Dieter, Senior Clinical Director, Fox Rehabilitation
Whether it's a routine assessment or an actual fall, OneStep provides objective, timestamped data that supports MDS Section J reporting and internal incident documentation. No more guesswork, missing notes, or inconsistent assessments.
“When you think about quality reporting, value-based purchasing, and Five-Star ratings — function plays a huge role. Having baseline data helps us make better discharge decisions and keep people safe at that next level of care.” - Leigh Ann Frick, President of Care Navigation
OneStep allows you to continuously monitor mobility across your resident population. You can track whether interventions are working, flag when someone is declining, and engage families with clear progress reports.
With the OIG paying close attention, having defensible data is no longer optional. OneStep helps ensure your fall data is accurate, complete, and aligned with claims helping you stay compliant and audit-ready. Don’t just prevent falls. Prove you prevented them.
The days of relying solely on subjective observation and post-fall paperwork are over. The OIG report makes it clear: every fall must be accounted for.
With OneStep, your facility can:
We make fall risk visible, measurable, and actionable in real life, not just in theory.
Want to see how your current fall risk protocols compare?
Schedule a Fall Risk Readiness Assessment with OneStep. We’ll review your current process, show you what’s missing, and offer concrete ways to protect your residents and your compliance.
Every step tells a story. Make sure yours are being told.
To learn more about how OneStep supports SNFs and senior care, go here.