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A Matter of Balance: Falls Prevention in Ohio’s Nursing Homes

Image shows an older woman wearing a headscarf and smiling at the camera. The image includes the words 'Nursing Home Quality Improvement Project' in a purple rectangle on the left.


A Matter of Balance is an award-winning, evidence based falls intervention that is specifically designed to reduce fear of falling, stop the fear of falling cycle, and improve activity levels among community-dwelling older adults. The curriculum includes lectures, group discussions, mutual problem solving, role-play activities, exercise training, assertiveness training, and home assignments. Participants practice exercises to improve strength, coordination and balance, as well as learn how to conduct a home safety evaluation and get up and down safely. Classes are led by coaches who are recruited and trained by master trainers.                                                                                                                                                              

After six months, community participants report more control over factors that could cause them to fall, increased exercise and activity levels and fewer falls. They feel more comfortable talking about their fear of falling and plan to continue exercising. Ninety-eight percent of participants would recommend A Matter of Balance to their friends and loved ones.
The Ohio Department of Aging is bringing A Matter of Balance to the nursing home setting through this Nursing Home Quality Improvement Project. Initial project launch will be limited to 10 nursing homes on a first-come basis; if additional homes express interest, they will be put on a wait list for Phase II.

How to Join

Nursing home must complete a Participation Agreement and submit it to the Ohio Department of Aging by December 1, 2015 to participate in the A Matter of Balance: Falls Prevention in Ohio’s Nursing Homes project. Each home must sign a Memorandum of Understanding with Matter of Balance during coach training.

Brief Description of Required Activities

  •  Sign a Memorandum of Understanding with Matter of Balance - provided during coach training.
  •  Maintain at least two staff members as Matter of Balance coaches (an 8 to 10 hour training);
  •  Host at least two (2) Matter of Balance workshops for 8-14 participating residents that have been identified as at risk for falls (workshops are an 8 class series offered once or twice a week for 2 hours);
  •  Participate in Ohio Department of Aging introductory webinar(s);
  •  Utilize data and monitoring tools to assess effectiveness of Matter of Balance for participating residents**;
    • Submitting data on the Advancing Excellence in America’s Nursing Homes mobility tracking tool is recommended;Submit
    • MOB class data to ODA as required
  •  Join the Ohio Older Adults Falls Prevention Coalition
  •  Celebrate 2016 Falls Prevention Awareness Day through an event sponsored by the home (e.g. participant recognition event, family education day, senior walk, etc.)

Date(s) of Project

Phase I: December 1, 2015 to December 31, 2016
Phase II: Spring of 2016, contingent on funding availability

Evidence of Participation in the Project

Expected evidence of participation in the project should be kept by the nursing home for use in state survey to demonstrate compliance with Sec. 3721.072 (B) which states that “Beginning July 1, 2013, each nursing home shall participate every two years in at least one of the quality improvement projects included on the list made available by the department of aging under the nursing home quality initiative established under section 173.60 of the Revised Code.”

  1. The nursing home should be able to report all MOB class data to ODA per the MOB data collection process.
  2. The nursing home should be able to produce the Matter of Balance coach certification of at least two current staff.
  3. The nursing home should be able to produce a Falls Team roster and summary data from the Advancing Excellence mobility tool or comparable data source.

Relevant links

A Matter of Balance
Advancing Excellence in America’s Nursing Homes campaign tool
Ohio Older Adults Falls Prevention Coalition
STEADI (Stopping Elderly Accidents, Deaths & Injuries) Tool Kit
Frequently Asked Questions
Matter of Balance Coach Job Description


Tia Gulley
A Matter of Balance Program Manager