During a 22-month period in 1981-82, 250 falls were recorded at a 152-bed acute care specialty hospital in a United States metropolitan area. Rates were highest for patients age 65 years and older and for patients admitted with mental disorders. Patients who had fallen once had a subsequent fall rate of 91.7 per 1,000 patients compared to an overall rate of 18.7 for first falls. Half the falls occurred in or enroute to the private bathroom attached to each room. Only three falls resulted in injury sufficient to prolong hospital stay.