✅ Medically reviewed by Dr. Thomas Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026

Fall Prevention in Nursing Homes — How Podiatry Reduces Fall Risk

Falls in Long-Term Care: A Podiatric Problem With Podiatric Solutions

Falls are the leading cause of injury among nursing home residents, causing hip fractures, head trauma, and accelerated functional decline. Foot-related factors are among the most common and most correctable contributors to fall risk in long-term care settings. Balance Foot & Ankle’s nursing home podiatry program includes a dedicated fall prevention component.

Foot-Related Fall Risk Factors

Peripheral neuropathy reduces proprioceptive feedback from the soles — the information the nervous system uses to maintain balance. Painful foot conditions cause compensatory gait patterns that increase instability. Toe deformities (bunions, hammertoes) alter the foot’s base of support. Poorly fitting footwear — too large, too loose, slippery soles, or inappropriate heel height — is one of the most modifiable fall risk factors. Thick or painful toenails affect how the foot contacts the ground during walking.

Our Fall Prevention Interventions

Neuropathy assessment and documentation for fall risk classification, footwear evaluation with specific recommendations (proper fit, adequate grip, heel height, closure security), nail and callus care to normalize foot function during walking, custom orthotics for residents with significant foot deformity or neuropathy, and communication with nursing staff about identified fall risk factors.

The Evidence Base

Studies demonstrate that podiatric intervention in nursing homes significantly reduces fall rates — with one major trial showing a 36% reduction in falls in the intervention group receiving podiatric care vs. standard care alone.

Call (810) 206-1402 to discuss our fall prevention program for your facility.

Fall Prevention Through Podiatry in Michigan Nursing Homes: Foot and Footwear Assessment

Falls in nursing home residents cause approximately 1,800 deaths per year in the United States and are a primary driver of CMS survey deficiencies for skilled nursing facilities. The podiatric contribution to fall prevention is substantive and often underutilized: foot pain, peripheral neuropathy, toe deformity, and inappropriate footwear each independently increase fall risk, and each is directly addressable through podiatric intervention. Balance Foot & Ankle‘s Michigan nursing home podiatry service includes a systematic fall risk foot assessment component — evaluating each resident’s footwear adequacy, identifying painful conditions that alter gait, screening for peripheral neuropathy that reduces proprioception, and making specific footwear recommendations that the facility can document in the care plan.

The specific podiatric fall risk factors that our nursing home assessments address include: inappropriately long toenails that catch on flooring and alter toe clearance during swing phase; bilateral callus buildup on the metatarsal heads that reduces plantar tactile feedback; footwear that is too large (common when residents’ edema fluctuates and families buy larger sizes), which causes tripping; and uncontrolled heel pain that causes residents to bear weight on their forefoot and alter their gait toward a flexed-knee, forward-leaning posture associated with increased fall risk. Michigan nursing homes that document a podiatry-based fall risk assessment program provide clear evidence of a multidisciplinary fall prevention approach for survey purposes. Our Livingston and Oakland county facilities can request a dedicated fall risk assessment visit by calling Balance Foot & Ankle at (810) 206-1402.

CMS survey surveyors specifically review fall risk assessments and care plan documentation for evidence of multidisciplinary approach — a podiatry-based foot risk assessment documented in the resident’s care plan is strong evidence of the systematic fall prevention program that surveyors expect. Michigan skilled nursing facilities that have received deficiencies related to fall prevention (F-tags F689 and related) benefit from adding a documented podiatry foot risk assessment component to their QAPI program. Balance Foot & Ankle provides a standardized fall risk foot assessment form compatible with MDS documentation requirements, and our visiting podiatrist completes the form at each visit to provide ongoing surveillance rather than a one-time snapshot. Facilities interested in this surveyor-ready documentation approach should contact our facility services team at (810) 206-1402.

Related Treatment Guides

• Diabetic Foot Care & Neuropathy
• Plantar Fasciitis & Heel Pain Treatment
• Custom 3D Orthotics
• Sports Foot & Ankle Injury Treatment

Residents at highest fall risk from foot-related factors — those with bilateral peripheral neuropathy, significant hammertoe deformity, or severe plantar fasciitis — benefit from more frequent podiatry assessment than the standard schedule provides. Balance Foot & Ankle‘s Michigan nursing home program adjusts visit frequency for high-fall-risk residents based on clinical indicators. Call (810) 206-1402 to discuss tailored fall prevention podiatry protocols for your facility.

Medical References & Sources

• American Podiatric Medical Association — Patient Education
• American Orthopaedic Foot & Ankle Society — Foot Conditions

Clinical References

1. Menz HB, Morris ME, Lord SR. Foot and ankle risk factors for falls in older people: a prospective study. J Gerontol A Biol Sci Med Sci. 2006;61(8):866-870.
2. Jessup RL. Foot pathology and inappropriate footwear as risk factors for falls in a subacute aged-care hospital. J Am Podiatr Med Assoc. 2007;97(3):213-217.
3. Spink MJ, Menz HB, Fotoohabadi MR, et al. Effectiveness of a multifaceted podiatry intervention to prevent falls in community dwelling older people with disabling foot pain: randomised controlled trial. BMJ. 2011;342:d3411.

Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

Board-Certified · FACFAS

Dr. Carl Jay, DPM

Board-Certified Podiatrist

Dr. Daria Gutkin, DPM

Podiatrist

Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.