Objective To explore the status and expectations of fall management in elderly care institutions and provide reference for fall prevention. Methods A total of 11 administrators from 4 elderly care institutions in Changsha received semi-structured interviews. The grounded theory procedure was employed to gather and analyze relevant data. Results Two principle themes emerged: fall management status (fall risk assessment, fall prevention and fall management); and expectations (personal quality, theoretical knowledge and practical competence）. Conclusion Fall management in elderly care institutions is at stage of frequent observation and valuing experience. Caregivers lack the knowledge and skills for fall management. Managers hope to improve the practical competence of caregivers in the short term and achieve knowledge acquisition in the long term through training.