BACKGROUND: Falls among older adults are a pervasive and significant concern worldwide. A practice guideline has been developed to address the prevention of falls and their resulting consequences in hospital and long-term care settings. AIM: The study aimed to assess the fall down rate and preventive tools among older adult patients in nursing homes. METHODS: A cross-sectional study was conducted on randomly selected older adult patients by using a questionnaire with the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) tool in nursing homes at the Ministry of Human Resource and Social Development. RESULTS: Among 323 older adult patients, most of them (73.1%) were male, 23.8% were from Makkah, and the age ranged from 60 to 90 years and older. Results showed that 64.8% had a psychiatric disorder, 41.8% had hypertension, 38.4% had diabetes, 38.1% had movement disorders, 11.3% had heart diseases, and 1.5% had no chronic conditions. The mean STEADI tool score was 3.5 out of 12, and of the 323 older adult patients, 51.7% had a low risk to fall and 48.3% had a high risk to fall. Of the 13 interventions used to prevent falls, the most used intervention was rehabilitative physical therapy, followed by providing patient facilities and muscle strengthening exercises. CONCLUSIONS: The level of falls was markedly low, and a significant correlation was observed between the risk of falling and the participants' region of residence.