Percentage of long-term care home residents who fell in the last 30 days

Percentage of long-term care home residents who fell

Percentage

The indicator is calculated using four rolling quarters of data by summing the number of residents that meet the inclusion criteria for the target quarter and each of the previous three fiscal quarters. This is done for both the numerator and denominator. The unadjusted value is the quotient of the summed numerator divided by the summed denominator, multiplied by 100 to get the percentage.

Number of long-term care home residents in the denominator who had a fall in the last 30 days recorded on their Resident Assessment Instrument - Minimum Data Set (RAI-MDS) 2.0 target assessment

Inclusions:

J4a = 1

Where,

J4A = Fell in the past 30 days [0,1]

0 = No

1 = Yes

Number of long-term care home residents in a fiscal quarter with a valid RAI-MDS 2.0 assessment

Inclusions:

To be considered valid, the resident assessment must: 

• Be the latest assessment in the quarter
• Be carried out more than 92 days after the admission date 
• Not be a RAI-MDS 2.0 Admission Full Assessment

This indicator can be risk adjusted at the individual covariate level and through direct standardization.

Individual covariates:

• Not totally dependent in transferring 
• Locomotion problem 
• Personal Severity Index (PSI)*: Subset 2: Non-Diagnoses 
• Any wandering 
• Unsteady gait/cognitive impairment 
• Age younger than 65 

Direct standardization: 

• Case Mix Index (CMI)** 

*PSI is statistically linked to the likelihood of death within six months 
**The relative resource use compared to the overall average resource use for all Ontario long-term care home residents

Continuing Care Reporting System (CCRS)

Canadian Institute for Health Information (CIHI)

Institution, Province, Region, Time

This indicator captures whether the resident fell in the last 30 days but does not capture whether the fall resulted in injury. Residents have a right to balance the risk of falls with their right to remain mobile and unrestrained; therefore, a certain number of falls are inevitable. The focus should be on reducing the number of falls, recognizing that some falls will occur, and preventing injuries associated with falls. The results for this indicator include only residents in long-stay beds. Rolling four quarter averages stabilize the rates from quarter-to-quarter variations, especially for smaller facilities, but make it more difficult to detect quarterly changes. Since residents are assessed on a quarterly basis, each resident can contribute to the indicator up to four times. Risk-adjusted values are censored if the denominator is less than 30. General limitations when using RAI-MDS 2.0 data include random error, coding errors and missing values. The COVID-19 pandemic affected many long-term care homes across Ontario, including their ability to complete assessments and/or submit data. Available data may vary by jurisdiction and facility. Results should be interpreted in the context of the COVID-19 pandemic.

Data are based on information from the mandatory Resident Assessment Instrument - Minimum Data Set (RAI-MDS) 2.0 assessment. The RAI-MDS 2.0 is a standardized assessment that is completed for each resident upon admission to a long-term care home and quarterly thereafter, by the resident’s care team, by reviewing the resident’s medical records and speaking to the resident and their family. Legacy agency Health Quality Ontario (HQO) used an evidence-informed process and expert panel, composed of Ontario-based long-term care home operators, clinicians and researchers, to produce Ontario benchmarks that represent good resident outcomes and high-quality care. The benchmark for this indicator was set at 9% by an expert panel through a modified Delphi process (2012 & 2015). Alongside public reporting performance indicators, benchmarks are an important tool for supporting long-term care homes and sector stakeholders in tracking progress, setting priorities or targets, and learning from homes that are excelling.

06/10/2025 11:04:00