To determine the number of Minnesota nursing home residents who died after a fall, the Star Tribune analyzed 264,090 death certificates provided by the Minnesota Department of Health for 2002 through 2008.
Death certificates list how, why and where deaths occur. For accident-related deaths, including falls, the certificates are supposed to list the time, date and place of the injury, and describe the accident.
A computerized search of death certificates identified 1,057 deaths where a fall was listed and the injury occurred at a nursing home. Eighty-eight percent were signed by a county medical examiner, who under state law is supposed to review all trauma-related deaths and evaluate them under state and professional guidelines.
If a medical examiner did not sign the certificate, the death was included in the analysis if the certificate identified a fall injury and the cause of death was consistent with falling, such as a hip fracture or serious head injury.
In 60 percent of the cases, the nursing home name was listed on the certificate as the place of the injury. In 37 percent of the cases, the home was identified by matching the certificate's injury address to addresses in the state Health Department's facility directory. In 3 percent, the home was identified through state investigative reports.
About 150 deaths were not included in the analysis because the death certificate did not include enough information to determine whether the death occurred at a nursing home or an assisted living facility at the same address.