Falls are a serious health risk for older people. For many older adults, a fall is a life-changing event that can lead to disability, loss of independence or even death. Fall reduction in any organization requires an organized, consistent approach to facilitate change and achieve sustainable outcomes. The honest reporting of fall circumstances, performing root cause analysis that involves the interdisciplinary care team and the patient’s family, and identifying and analyzing trends must go beyond the paper compliance level. In addition, any fall interventions that are used must be matched to each individual’s risk factors and initiated before the fall occurs. Educational and research focus on the creation of sustainable change in senior citizen facilities is needed to create safer environments for our elders.