Background: Falls remain a major health concern impacting function, independence and quality of life for older people in hospitals and residential care. These settings have substantially less research to guide practice compared with the community. Most available research evidence is also derived from large metropolitan health services. This project (funded by Hume Local Health Service Network, Safer Together Program) aimed to evaluate fall prevention practice against best practice guidelines in the Hume region. Methods: Five regional/rural health services across northern Victoria participated. Evaluation included reviewing multiple aspects of practice and outcomes against best practice guidelines and research evidence for hospitals and residential care facilities. This included falls incident data, policy and fall prevention committee document review, falls risk assessment processes, staff and patient education programs and resources, and site visits. Findings: Health services were highly varied. Most had small acute care services (mean number of hospital beds=38/health service, range 14-122), and large residential care units (mean 53 beds/health service, range 11-84). Sites varied in their recent falls and falls injury incidences, current prevention actions, and local initiatives trialled. Network wide and site-specific recommendations to improve outcomes, and a framework for ongoing review and responsive actions, will be presented. Conclusions: There are unique challenges and novel solutions in implementing best practice fall prevention in regional and rural Victoria health services. Each service is implementing recommendations from the evaluation to optimise safety for patients and residents.