Families rely on Care Compare, the Medicare tool that provides quality ratings for nursing homes. But according to a new report from the Office of Inspector General (OIG), nearly half of the most serious falls in nursing homes—those resulting in major injury and hospitalization—were never reported by the facilities responsible for care.
These findings shed light on a deeply concerning trend: nursing homes are failing to meet federal reporting obligations, leaving families in the dark and residents vulnerable to repeated harm.
Who’s Failing to Report – And Why?
The report reveals that for-profit, chain-affiliated, and larger nursing homes were the worst offenders. These facilities had the highest rates of unreported falls. In addition, the likelihood of a fall going unreported increased if the resident was:
Younger
Male
A short-stay patient
Covered solely by Medicare
This data suggests a systemic failure that disproportionately affects vulnerable populations—especially those who may not have long-standing advocates within the facility.
Why This Matters for Families and Public Health
Nursing homes’ self-reported data is used to calculate fall rates on Care Compare. Facilities that report fewer falls appear safer—even if that’s not the truth. The OIG report found that the nursing homes with the lowest reported fall rates were also the least likely to report actual falls. In other words, “low fall rates” may reflect underreporting—not better care.
This distorts public understanding and misleads families trying to make informed decisions. It also compromises federal oversight, weakens enforcement, and allows poor-performing facilities to escape scrutiny.
Recommendations for Change
In response, the OIG has called for two key reforms:
Improve Accuracy and Oversight: CMS must take more aggressive steps to verify the completeness of fall reporting data in nursing home assessments.
Expand Data Integrity Across the Board: Similar oversight should be applied to other quality measures, such as infection rates, medication errors, and pressure ulcers.
CMS has agreed with both recommendations—an encouraging step, but one that must be followed by meaningful enforcement.
What You Can Do if a Loved One Was Injured in a Nursing Home
If your family member suffered a fall in a nursing home—especially one resulting in hospitalization—and you suspect it was never documented, you have the right to seek answers.
At Valentine Law Group, we specialize in nursing home abuse and neglect cases, and we fight for the safety, dignity, and legal rights of every elder. Our team knows how to uncover what really happened—even when facilities try to hide the truth.