Objectives: To evaluate and compare the predictive accuracy of fall history, staff clinical judgment, the Care Home Falls Screen (CaHFRiS) and the Fall Risk Classification Algorithm (FRiCA). Design: Prospective multicenter cohort study with six months' follow-up. Setting & participants: 420 residents from 15 nursing homes participated. Methods: Fall history, clinical judgment of staff (i.e., physiotherapists, nurses and nurses' aides), the CaHFRiS and the FRiCA were assessed at baseline and falls were documented in the follow-up period. Predictive accuracy was calculated at one, three and six months by means of sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio, Youden Index and overall accuracy. Results: In total, 658 falls occurred and 50.2% of the residents had at least one fall with an average fall rate of 1.57 (SD=2.78, range 0-20) per resident. The overall accuracy for all screening methods at all measuring points ranged from 54.8% to 66.5%. Fall history, FRiCA and a CaHFRiS score of ≥ 4 had better sensitivity, ranging from 64.4% to 80.8%, compared to the clinical judgment of all disciplines (sensitivity ranging from 47.4% to 71.2%). The negative predictive value (ranging from 92.9% at one month to 59.6% at six months) had higher scores for fall history, FRiCA and a CaHFRiS score of ≥ 4. Specificity ranged from 50.3% at one month to 77.5% at six months, with better specificity for clinical judgment of physiotherapists and worse specificity for FRiCA. Positive predictive value ranged from 22.2% (clinical judgment of nurses' aides) at one month to 67.8% at six months (clinical judgment of physiotherapists). Conclusion & implications:No strong recommendations can be made for the use of any screening method. More research on identifying residents with the highest fall risk is crucial, as these residents benefit the most from multifactorial assessments and subsequent tailored interventions.