Introduction A nursing home is a place that offers residential care to people who require continuous nursing care [1]. In recent years, the number of elderly Americans over the age of 65 living in nursing colleges is more than 1.4 million and is expected to increase due to the aging of the baby boom generation and the aging of the population. 6% of the nation's healthcare spending is spent in 15,500 nursing homes in the United States. The growing population requiring nursing homes and rising expenses suggest an urgent need for quality measures in nursing homes. Despite numerous clinical and regulatory efforts and enormous expenses, the poor quality of nursing homes is still a major problem. Falls among nursing home residents occurred frequently and repeatedly. Every year, 50% to 75% of nursing home residents fall. This is double the rate of falls for people living in the community. Although 5% of adults aged 65 years and older live in nursing facilities, nursing home residents account for approximately 20% of fall-related deaths in this age group [3]. Falls represent a significant cost to nursing homes. Fall-related injuries to the elderly population account for 6% of all medical expenses in the United States. Among the nursing home population, $11,719 is the average patient cost with a hip fracture [4]. Quality measures can provide information to guide nursing facilities to improve their quality and help patients' family make a better decision on choosing a satisfactory nursing service. home for the patient. Risk factors can be identified by monitoring quality measures. Evidence-based suggestions would help reduce the incidence of falls.Measure selectionTo access the fall rate in care homes, an outcome measure is selected from the National Quality Measures database in this study C...... half of the document .. ....the elf organization requires management practices that change the way people relate to each other. In particular, management practices that promote the speed of information flow through the system, the nature of connections between people, and the diversity of cognitive schemas are related to better outcomes for residents. Management practices that support constructive self-organization can lead to better outcomes. A variety of management practices are needed to ensure a lower resident fall rate in nursing homes. Using the key concept of coevolution, the management process asks individuals to adapt to new situations, such as new patients with unusual health conditions. Individuals continually learn to adapt to changes in the environment and evolve with the environment, thus improving their ability to care for residents and reducing accidents, such as falls.