Fall Prevention for HCBS Participants
Helping More Older Adults Live Safely in the Community
Unlike senior living communities, HCBS participants may spend long periods of time at home without a caregiver physically present. This creates a significant challenge for fall prevention. In 2024, 24% of Medicare beneficiaries living in the community experienced at least one fall, 12% experienced multiple falls, and 17% reported a fall resulting in an injury or other medical issue, according to CMS. Nationally, falls among adults age 65 and older contribute to approximately 3.6 million emergency department visits and 1.2 million hospital stays each year.
For HCBS care teams, a participant's mobility, balance, nighttime activity, bathroom routines, medication use, or overall health can change between scheduled visits without anyone knowing. When a fall occurs while the participant is alone, it may also be unwitnessed, making rapid detection and response especially important.
Zemplee extends the safety net into the participant's home with passive, wearable-free and camera-free monitoring powered by Attentive AI™. Continuous observation of movement, activity, and daily routines can help care teams recognize meaningful changes earlier, respond to potential fall risks, and support participants in remaining safely in their homes and communities.
Where Fall Risk Can Emerge Between Caregiver Visits
- Nighttime movement — increased nighttime activity, repeated bed exits, or changes in sleep routines can create additional opportunities for falls when participants are tired or navigating in low light.
- Bathroom routines — frequent or unusual bathroom visits, particularly overnight, can increase exposure to a high-risk environment and may also signal an underlying change that deserves attention.
- Mobility and activity changes — reduced movement, longer periods of inactivity, or changes from a participant's normal activity pattern may indicate declining function or increasing difficulty with daily activities.
- Transfers and time in bed or chairs — changes in how frequently participants get up, remain seated, or spend time in bed can provide additional context about mobility and functional status.
- Changes following illness or hospitalization — participants returning home after an acute event may experience weakness, medication changes, deconditioning, or altered routines that can increase fall risk during recovery.
Attentive AI™ evaluates these observations against each participant's individual baseline rather than relying only on a single fixed threshold. This helps care teams focus on meaningful changes that may warrant follow-up.
Turning Fall-Risk Signals Into Action
Monitoring only creates value when the information reaches the right person at the right time. Zemplee's smart alerting system helps translate meaningful changes in a participant's patterns into information that caregivers and care teams can act on.
- Potential fall event detected — notify the appropriate caregiver or care team so the participant can be checked promptly.
- Meaningful change from baseline — surface changes in mobility, activity, sleep, bathroom routines, or other daily patterns that may warrant follow-up.
- Increasing risk pattern — help care teams recognize changes over time that can inform fall-risk assessments, care-plan reviews, or additional supports.
- Situational guidance in the home — Zemplee Cue™ can provide reminders, prompts, and guidance that reinforce safer routines and participant engagement.
Zemplee does not replace clinical fall-risk assessment or caregiver judgment. It provides an additional layer of continuous visibility between caregiver visits so care teams have more information—and more opportunities—to intervene earlier.
Why Fall Prevention Matters for Community Living
For an HCBS participant, a fall can trigger consequences that extend well beyond the immediate event. Injury, an emergency department visit, hospitalization, loss of mobility, fear of falling, or a period of skilled nursing care can make it more difficult for an older adult to continue living independently at home.
Preventing falls therefore supports a larger HCBS objective: helping participants remain safely in their homes and communities for as long as appropriate. Earlier visibility into changing risk can give caregivers and care teams more opportunities to address environmental, functional, behavioral, or health-related factors before they contribute to a serious event.
This is also why fall prevention is increasingly a national priority. The National Council on Aging's 2025 National Falls Prevention Action Plan calls for reducing fall-related emergency department visits among adults age 65 and older and highlights technology, evidence-based interventions, partnerships, and improved data as important parts of the national strategy.
Evidence From Real-World Community-Based Care
Zemplee's technology has been evaluated in a real-world program supporting older adults in the community. The results demonstrate why continuous visibility and proactive intervention can matter when organizations are working to keep participants safely supported at home.
These outcomes extend beyond fall detection alone. They demonstrate how a broader safety net—combining passive monitoring, early identification of change, care-team intervention, and participant engagement—can support both safety and well-being in community-based care.
Frequently Asked Questions About Fall Prevention for HCBS Participants
How can Zemplee help prevent falls among HCBS participants living at home?
Zemplee helps HCBS care teams identify changes that may indicate increasing fall risk before a serious event occurs. Attentive AI™ continuously evaluates changes in mobility, activity, nighttime movement, bathroom routines, and other daily patterns against each participant's individual baseline.
When meaningful changes are detected, Zemplee's smart alerting system can notify caregivers and care teams so they can assess what has changed and determine whether additional support or intervention is appropriate. This extends fall-prevention visibility beyond scheduled caregiver visits and helps care teams move from simply responding to falls toward identifying risk earlier.
Can Zemplee detect a fall if an HCBS participant is not wearing a device?
Yes. Zemplee is designed to provide passive monitoring without requiring the participant to wear, charge, or activate a device. Ambient sensors monitor activity and movement in the home, allowing potential fall events and unusual periods of inactivity to be identified even when the participant is unable to press a button or call for help.
Zemplee is also camera-free, providing this additional safety layer without placing video cameras in the participant's home. For HCBS participants who may forget, refuse, or be unable to use a wearable device consistently, this passive approach can provide caregivers and care teams with continuous visibility while preserving privacy and independence.
What happens after a potential fall?
When Zemplee detects a potential fall or other significant safety event, its smart alerting system can notify the appropriate caregiver or care team so the participant can be checked promptly. Because the monitoring is passive, the participant does not need to locate a phone, press an emergency button, or activate a wearable to initiate the alert.
The event also becomes part of the participant's broader activity history, giving care teams additional context about what was happening around the event and whether other changes in mobility, activity, sleep, bathroom routines, or daily patterns may warrant follow-up.
The goal is not only faster awareness of a fall, but also better information to help the care team and emergency responders understand what may have changed, reasons for the fall to help with root cause analysis, and then use that information to reduce the risk of another fall.
Why is rapid fall detection important for an HCBS participant living alone?
When an older adult falls while alone, one of the greatest risks is not only the fall itself but remaining on the floor for an extended period without help. In falls research, remaining on the floor for an hour or longer is commonly described as a “long lie.”

Prolonged time on the floor has been associated with complications including dehydration, pressure injuries, hypothermia, rhabdomyolysis, psychological distress, and loss of mobility.
Zemplee's passive, wearable-free fall detection provides an additional safety net for HCBS participants who may be alone when a fall occurs. Because detection does not depend on the participant pressing a button, reaching a phone, or activating a wearable, Zemplee can alert caregivers or care teams to a potential fall even when the participant is unable to call for help.
Faster awareness can help caregivers check on the participant sooner and reduce the risk of an undetected fall becoming a prolonged long lie.
Why are nighttime and bathroom falls important for HCBS participants living at home?
Nighttime can create additional fall risk for older adults living at home. Getting out of bed while sleepy, navigating in low light, rushing to the bathroom, changes in balance, and frequent nighttime bathroom visits can all increase opportunities for a fall—particularly when no caregiver is physically present.
Zemplee's passive monitoring can provide continuous visibility into nighttime movement, bed exits, bathroom activity, and changes from a participant's normal routine. Attentive AI™ evaluates these patterns against the participant's individual baseline, helping care teams identify meaningful changes that may warrant follow-up.
This allows HCBS care teams to look beyond the fall itself and ask an important prevention question: What changed before the participant's fall risk increased? Earlier visibility can support fall-risk assessment, environmental changes, care-plan adjustments, or other appropriate interventions.
What should happen when fall risk increases?
A change in fall risk should prompt the care team to understand what has changed and why. Zemplee provides additional context from the participant's daily patterns so caregivers and care teams can determine whether follow-up or further assessment is appropriate.
Depending on the participant and the changes observed, follow-up may include reviewing mobility and transfers, medications, hydration, vision, footwear, nighttime routines, bathroom frequency, recent illness, environmental hazards, or changes following hospitalization. The care team can then determine whether the participant's care plan, home environment, caregiver support, or clinical assessment should be adjusted.
Zemplee does not replace a clinical fall-risk assessment or professional judgment. It adds a continuous layer of information between caregiver visits, helping HCBS teams recognize changes earlier and make more informed decisions about when intervention may be needed.
Build a Stronger Safety Net for HCBS Participants
See how Zemplee can help your HCBS program extend visibility between caregiver visits, identify changing fall risk earlier, and support participants more safely in their homes and communities.