Identifying safety concerns in geriatric health settings: insights from Israel geriatric home inspection reports.

BACKGROUND: In geriatric long-term care settings, safety is a well-established organizational goal, with measures in place to prevent physical injury and psychological harm to residents. However, no study has yet to use official Ministry of Health inspection data to systematically examine whether, and to what extent, these safety goals are achieved in Israeli geriatric long-term care facilities. OBJECTIVE: Identify safety violations in geriatric care facilities and determine whether there is a gap between written safety regulations and documented practices. METHODS: A qualitative content thematic analysis was conducted on 126 audit reports conducted in Israel's geriatric homes between the years 2023 and 2025, selected through sequential analysis until thematic saturation was reached. RESULTS: The thematic analysis of safety inspection reports from geriatric care facilities identified safety violations organized into five major themes of recurring safety concerns: (1) physical environment hazards, including faulty infrastructure, temperature extremes, and sanitation failures; (2) medication management failures, encompassing protocol non-adherence and storage/identification errors; (3) clinical care safety risks, including infection control lapses, fall hazards, pressure ulcer mismanagement, and treatment protocol violations; (4) inappropriate use of physical restraints; and (5) emergency response deficiencies. Despite clear, well-established safety protocols designed to protect residents, it appears that the guidelines are not consistently or effectively enforced. CONCLUSION: The documented safety failures represent preventable, and in some cases recurrent, risks of harm to elderly residents that point to the need for targeted improvements in resources, staffing, regulatory enforcement, and accountability in geriatric care facilities.