Achieving better fall risk management is an integral component of quality home care. The current qualitative study uncovers the challenges and opportunities of home health agencies (HHAs) in achieving better fall risk management. A secondary document analysis was adopted to learn from rich contextual information in fall incident reports recorded in a HHA. Poor engagement of patients and caregivers was a contributing factor in many fall incidents. Patients often fell as a result of not understanding or accepting their physical limitations. For better fall risk management, many incidents highlighted a need for providing complete and thorough care, better coordination of care, higher levels of sociocultural awareness, patient engagement, and caregiver involvement. The results provide evidence regarding the challenges and opportunities for improving fall risk management in home care along with insight about how information technology solutions can support improvement initiatives.