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Purpose To estimate functional capability and attendant falls-risk in older institutionalized people after total hip arthroplasty (THA) for femoral neck fractures. Methods The study population comprised 149 consecutive patients (F104, M45; mean age 83.4 years) who were permanent residents of nursing care facilities four weeks after THA for femoral neck fractures. Individual mental and functional capability status was assessed using the Mini Mental State Examination (MMSE), Timed Up and Go test (TUG) and Tinetti's Performance Oriented Mobility Assessment (POMA) which includes sub-scales for balance (B) and gait (G), in conjunction with identifying any concomitant disorders, reviewing individual pharmacotherapy and leisure time activities. Results The subjects’ mean MMSE was 23.1 points, whereas in Tinetti's POMA they scored 19 points on average, which translated into a five-fold greater falls-risk, whereas average TUG scores of 23.9 s effectively corroborated this assertion. Multiple regression analysis effectively highlighted that TUG scores were strongly correlated with the actual number of concomitant disorders, number of regularly taken medications, and usual manner of spending leisure time. Conclusions Institutionalized older people after THA for femoral neck fracture continue to be exposed to high risk of recurrent, possibly injurious falls, which is closely correlated with significantly diminished individual functional capabilities. [ABSTRACT FROM AUTHOR]