Beyond The Score: Reevaluating The Morse Fall Scale For Fall Risk Assessment Among Hospitalized Veterans

J Hosp Med. 2026 Aug 12. doi: 10.1002/jhm.70411. Online ahead of print.

ABSTRACT

BACKGROUND: Inpatient falls cause substantial harm and cost. The Morse Fall Scale (MFS) is widely used for fall risk assessment. Yet, the scale's ability to differentiate patients who are at high risk for falling remains unclear.

OBJECTIVES: This study evaluated whether the admission MFS total score or individual categories differentiated between patients who did and did not fall in an inpatient setting.

METHODS: A retrospective cohort design was used. Inpatients who had a complete MFS assessment on admission, from June 2022 to May 2024, were included. Fall occurrence was identified using post-fall documentation. Group differences were analyzed, and a logistic regression analysis identified predictors of falls.

RESULTS: Among 5004 patients, 3.5% fell. Compared to patients who did not fall, those who fell had significantly higher MFS total scores. Mean scores for both groups were above the cutoff for high fall risk (i.e., ≥45). A prior fall history, impaired mental status, assistive device use, and weak/impaired gait were associated with the occurrence of a fall.

CONCLUSIONS: While several risk factors were associated with the occurrence of a fall, the majority of the patients were assessed to be at high risk for a fall using the MFS. These findings suggest that the total score may not be useful for differentiating those who may fall and that future research should prioritize individualized interventions targeting high-risk characteristics. Tailoring interventions to address specific risk factors may enhance fall prevention effectiveness and optimize resource allocation in acute care settings.

PMID:42584035 | DOI:10.1002/jhm.70411