[Direct answer]The institution has the responsibility to compensate. Nursing homes are obligated to provide care consistent with the agreed level of care under the nursing service contract, and they also have a duty to ensure safety. According to Article 119 of the Civil Code of the People's Republic of China (effective January 1, 2021), if they fail to fulfill their safety obligations and cause harm to others, they shall bear tort liability. If the nursing home fails to provide adequate care, fails to address slippery floors, or allows hidden safety hazards in its facilities that lead to elderly residents falling and sustaining injuries, the institution should bear corresponding liability according to its fault. At the same time, according to Article 117, the elderly's own diseases, mobility limitations, or family members concealing their health conditions, etc., which contribute to the occurrence of harm, may reduce the institution's liability. In practice, the liability is often shared based on the proportion of faults on both sides. The compensation scope includes medical expenses, nursing care fees, nutritional fees, transportation expenses, disability compensation, and compensation for mental distress. Action guidance: formalize the admission agreement and care level, retrieve the surveillance footage of the incident, seek medical treatment promptly, and apply for a disability assessment.

I. Problem background and typical scenarios

After elderly people move into nursing homes, falls are the most common type of nursing home disputes. Families believe that they have paid for care services but received inadequate care, while the nursing homes claim that the elderly people themselves suffer from osteoporosis, have mobility issues, or are uncooperative with care. The focus of the disputes typically lies in whether the level of care matches the actual care provided, whether there were staff present at the time of the incident, whether the environment and facilities are safe, and how the responsibilities should be apportioned among all parties involved.

II. Key points of contention

First, whether the care level stipulated in the pension service contract is consistent with the actual performance. Second, the specific content and judgment criteria of the obligation to ensure safety. Third, whether the elderly person's own fault and that of his/her family can reduce the liability. Fourth, the determination of the damage consequences and causality, especially in the context of the elderly person's pre-existing illness.

III. Professional analysis by Henglue Lawyers

Such cases proceed in four stages: "agreement - obligation - fault - compensation". 1. **Priority of agreement**: Nursing service contracts typically specify care levels, visit frequencies, assistance with toileting and bathing, etc. If the institution fails to fulfill its obligations, it constitutes a breach of contract, and family members can claim breach of contract or tort liability based on this. 2. **Safety protection obligation**: Article 1198 of the Civil Code requires operators to fulfill their reasonable safety obligations. For nursing institutions, this includes elderly-friendly environment modifications, anti-slip and handrail installations, night patrols, assistance and prevention of dangerous actions, timely rescue and medical treatment in emergencies. Failure to meet reasonable standards constitutes fault. 3. **Fault sharing**: Elderly individuals' mobility limitations, cognitive impairment, refusal to cooperate with care, or family members' failure to truthfully disclose medical conditions and medication may constitute contributory negligence. The court will determine liability based on the proportion of fault on both sides, so the institution is not always fully responsible. However, the institution cannot completely exonerate itself by claiming "the elderly person was careless". The key lies in the institution's fulfillment of its care obligations. 4. **Evidence and appraisal**: Documentation such as admission agreements and care records (including patrol and shift records), surveillance footage, witness statements, medical records, and imaging should be preserved. Disability ratings and care dependency levels are typically determined through appraisal. For disputed causality, a causality appraisal can be requested. 5. **Calculation of compensation**: Medical expenses are based on receipts, nursing and nutrition costs follow medical prescriptions and appraisal opinions, and disability compensation is claimed for cases involving disability. Severe cases may also claim emotional distress compensation. The institution's liability proportion is generally determined based on the extent of its management and care failures. Beijing has a large number of nursing institutions, and supervision has been continuously strengthened. However, the retention period of surveillance footage after an incident is limited, so evidence collection must be done as quickly as possible.

IV. Practical suggestions and legal basis

First, upon check-in, confirm the care level and care content and keep the contract and notification materials. Second, immediately apply for retrieving and sealing the surveillance footage and copying the nursing and inspection records after the incident. Third, promptly send the patient to the hospital and keep the medical records and all receipts. If necessary, apply for a disability and care dependency assessment. Fourth, file a written claim for compensation, and if no agreement is reached, sue and claim damages according to the fault ratio. Main legal basis: Articles 577, 1165, 1173, 1179, 1183, and 1198 of the Civil Code of the People's Republic of China (effective from January 1, 2021); the Law of the People's Republic of China on the Protection of the Rights and Interests of the Elderly (adopted in 1996 and amended in 2018); and the Measures for the Administration of Nursing Homes (effective from November 1, 2020). Specific application shall be subject to the currently effective provisions.

5. Henglu Law Firm's Reminder

Three key points regarding nursing home-related injury cases: 1. Clearly specify the nursing care level in the medical records, as compliance with care standards is crucial. 2. Seal the monitoring and inspection records promptly to prevent their loss once they expire. 3. While the elderly person’s own negligence may reduce their liability, it does not exempt the nursing home from responsibility. For cases involving personal injury at nursing homes, legal action can be pursued through the following channels:Personal injury and medical disputesThe service obtains an overall solution, which involves the integration of pension service contracts and liability clausesBusiness and contract disputes in enterprisesFor the evaluation of disability and care dependency, you can refer to the relevant provisions in the "Regulations on the Evaluation of Disability and Care Dependency" issued by the Ministry of Human Resources and Social Security.Special servicesFor the column, you can consult about the recovery of compensation paymentsCreditor's rights and debts, and enforcementTeam.

VI. Frequently Asked Questions

Q1: If an elderly person falls over by themselves, does the institution still need to compensate them?

It depends on whether the institution has fulfilled its obligations of care and safety assurance. If its inspections, assistance, and facility arrangements meet the standards, and the elderly person falls due to their own reasons, the institution's responsibility may be relatively limited or even exempt from liability; if there are situations such as lack of care, or the floor being too slippery and not being dealt with, even if the elderly person is at fault, the institution should still compensate according to the proportion of their fault, and will not be completely exempt from liability just by saying "they fell by themselves".

Q2: What key evidence is required for a claim?

The core elements include three categories: contract and notification materials (admission agreement, care level, and disease notification letter); evidence of the care process (care and inspection records, shift schedules, surveillance footage of the incident, and communication records between staff and family members); and evidence of harm (medical records, imaging results, diagnosis certificates, invoices, and appraisal opinions on disability and care dependency). The surveillance footage and records should be retrieved and sealed as soon as possible.

Q3: How much does it typically cost to handle cases like this?

Mainly including appraisal fees, litigation fees, and attorney fees. The appraisal of disability level and care dependency is often a necessary investment, and the conclusion directly affects the amount of compensation; litigation fees are calculated in stages according to the amount of the claim, and after winning the lawsuit, the other party can be required to bear the corresponding part according to the proportion of responsibility. For cases with relatively minor damages, it is possible to first negotiate or seek mediation through civil affairs or consumer rights protection organizations.

Q4: How long does it take from the time of the injury to the time when the compensation is paid out?

The treatment and appraisal usually take several months. If no agreement can be reached, the ordinary first-instance litigation process typically lasts three to six months. If the judgment is not implemented, enforcement procedures are required. When the elderly are of advanced age or the injuries are complex, the appraisal period may be even longer. It is recommended to fix the evidence immediately after the incident to avoid the loss of key materials due to the expiration of the surveillance footage.

Q5: The agency is shirking responsibility. What should I do now?

Immediately fix the monitoring and nursing records and apply for sealing them, and send the patient to the hospital in time to preserve the medical records and receipts; request the institution in writing to explain the circumstances of the incident and its responsibilities; file a complaint with the civil affairs department about its management and care issues; if no agreement is reached, hire a lawyer to assess the proportion of fault and file a lawsuit, and if necessary, apply for a disability assessment and property preservation.

The above answer is based on the judicial practice in the Beijing area. The judicial interpretations in other provinces and cities may vary. For specific cases, please refer to the local rules and evidence situation.

If you are facing similar problems, it is recommended that you consult a professional lawyer as soon as possible with the evidence materials, so as to avoid missing the statutory time limit. →Personal injury legal services·Beijing Henglu Law Firm

Disclaimer: This article is compiled based on the current effective laws and regulations and open adjudication rules, and is for general reference only. It does not constitute a formal legal opinion on specific cases. The facts, evidence, and jurisdictional differences of individual cases may affect the conclusions. If you encounter disputes, please consult a practicing lawyer in time.