HEALTH & JUSTICE: Small Hazards, Serious Claims: Fall Risk in Your Medical Practice
By Joshua J. Owen, J.D.
Sturgill, Turner, Barker & Moloney, PLLC
As a physician, you have likely treated patients who suffered serious injuries from falls. Fall prevention is especially important for older adults because patients over age 64 are disproportionately affected. Even small environmental hazards such as loose rugs, curled rug edges, or folds in floor coverings can create a meaningful risk of falls and injury. As patients age, reduced step height and step length can make it easier to catch a toe on the edge of a rug.
Whether you own a medical practice or work within a larger organization, it is important to recognize the potential premises-liability exposure created by slips, trips, and falls on practice property.
Bottom Line
In a busy practice, strong safety procedures are essential. To help minimize liability, ensure timely maintenance, place appropriate warnings, take necessary safety precautions, and train staff to watch continuously for fall hazards. If someone reports a fall at the practice, gather as much information as possible while the details are fresh.
Slips, trips, and falls are among the leading types of personal injury cases in the United States. The risk is especially significant for older adults. According to the CDC, falls are the leading cause of injury for adults age 65 and older, and one in four older adults reported falling each year in 2020–2021. Kentucky data reflects the same concern. The Kentucky Injury Prevention and Research Center’s March 2024 assessment reported 44,569 fall-related emergency-department visits among Kentucky residents older than sixty-four. The Kentucky Safety Prevention Alignment Network reported 53,309 inpatient hospitalizations for unintentional fall-related injuries among Kentucky residents older than sixty-four from 2018 through 2023.
Rugs can be a specific source of concern. A January 2013 article in Injury & Violence, “Slipping and tripping: fall injuries in adults associated with rugs and carpets,” estimated that from 2001 through 2008, geriatric falls associated with rugs resulted in 17,408 emergency-room visits each year in the United States.
The consequences can be severe. In John Fernandez’s January 14, 2026, article, “Neurosurgeon Explains High Risks from ‘Small Falls’—Especially for Older Adults,” Dr. Brian Snelling explains that even a small fall can cause significant brain changes in older adults. The risk of death from falls also increases with age. According to the CDC, the 2023 unintentional fall death rate for adults age 65 and older in the United States was 69.9 per 100,000 population.
Falls can and do occur in physician practices. ECRI, a nonprofit patient-safety organization, found that 10.2% of the falls logged into its database in 2025 occurred in outpatient-care settings. Premises-liability claims can also result in substantial verdicts depending on the severity of the injury. According to the Kentucky Trial Court Review’s 2025 Year in Review, the average plaintiff’s premises-liability verdict in Kentucky from 2018 to 2025 was $194,363.
In Kentucky, a plaintiff bringing a premises-liability claim arising from a slip, trip, or fall must prove four elements:
- A legal duty;
- A breach of that duty;
- Causation; and
- Damages.
This article focuses on a practice’s legal duty owed to business invitees. A business invitee enters by invitation in connection with the business and for the business’s benefit, such as a patient or a friend or family member accompanying a patient. Business owners must address known hazards, check for hidden safety issues, and take reasonable steps to keep invitees safe. This includes maintaining the premises in a reasonably safe condition by discovering, preventing, or warning of hazardous conditions. Potential hazards include spilled substances, slippery floors, bunched or curled rugs, cluttered walkways, floor irregularities, equipment blocking hallways, untreated snow and ice, and unmarked steps or ramps.
If the facility or property is leased, the lease terms may affect which party owes particular duties to visitors.
A busy practice should use consistent procedures to identify hazards, correct them promptly, and document the response. Consider the following steps:
- Remove rugs altogether when possible or keep them away from high-traffic areas and exam rooms.
- If your practice decides to use rugs In lower-traffic areas, use rugs with non-slip or non-skid backing, keep them under ¼ inch thickness to reduce the risk of feet catching, secure the edges to the floor, and choose colors that contrast clearly with the surrounding flooring, so edges are visible.
- Ensure timely maintenance, place proper warnings, and take appropriate safety precautions. When floors are mopped or waxed, use caution signs and leave them in place until the floors are dry and no longer slippery. Use slip-resistant door mats with beveled edges and inspect them regularly to make sure they do not bunch up or become saturated with liquid.
- Staff should be trained to continuously watch for curled rug edges, rug bunching, dropped medical supplies, electrical cords, and other trip hazards. Prevention measures may include marking step edges or elevation changes, maintaining adequate lighting, using slip-resistant surfaces in high-risk areas, improving drainage and ventilation to keep surfaces dry, installing handrails, cleaning frequently, and following good housekeeping practices.
- If someone reports a fall, gather as much information as possible, including photographs of the area, a narrative of what happened, and the reason the visitor was present. Notify the practice’s insurance carrier promptly and investigate the incident by preserving and reviewing any available security footage, identifying contributing factors, and developing a plan to reduce the likelihood of a similar event. Be cognizant that Kentucky is a one-party consent recording state, thus conversations can be recorded by the injured person without one’s consent or knowledge. Anything you say to the person might be recorded for later.
In summary, to reduce the risk of liability for falls at the practice, start by identifying hazards inside and outside the facility, then remove them or provide clear warnings. Establish consistent maintenance and housekeeping policies, train staff on how to respond to fall incidents, and investigate promptly when a fall occurs. A thorough investigation can help identify the cause, reduce the chance of a repeat incident, and support a stronger defense against premises-liability claims.
Joshua J. Owen is an insurance and civil litigation attorney with Sturgill, Turner, Barker & Moloney, PLLC. He can be reached at jowen@sturgillturner.com or 859.255.8581. This article is intended as a summary of state and/or federal law and does not constitute legal advice.