A pressure injury, often called a bedsore or pressure ulcer, forms when a person stays in one position so long that their own body weight cuts off blood flow to the skin. In a nursing home, that is rarely an accident. It is usually a sign that a resident who could not move on their own was left unmoved, and it is one of the clearest pieces of evidence that care broke down.
Why a serious bedsore points to neglect
The medicine here is well settled. A person who cannot reposition themselves needs to be turned regularly, kept clean and dry, fed and hydrated, and checked for early skin breakdown. Federal nursing home regulations expect a facility to prevent pressure injuries unless they were clinically unavoidable, and to treat any that develop so they heal rather than worsen. When a resident enters able-bodied in this respect and leaves with a deep wound, the facility has to explain why.
I have worked the defense side of these cases, so I know how a facility and its insurer will build the story around a pressure injury and how to take that story apart from the wound charting and the turn logs. I represent families, not facilities, and I read those records knowing exactly where a facility hides the days nobody repositioned your loved one. I came up in the courtroom as a public defender, tried numerous cases, and cross-examined witnesses constantly, so I am ready to put a bedsore case in front of a jury, which is often what moves a facility’s insurer to pay fair value. I handle your case personally, from the first call through trial. Learn more about my background.
How pressure injuries are staged
Pressure injuries are graded by how deep the damage goes, and the progression itself tells a story.
| Stage | What it means |
|---|---|
| Stage 1 | Skin is intact but reddened or discolored and does not blanch |
| Stage 2 | The top layers of skin are broken, an open sore or blister |
| Stage 3 | The wound extends through the skin into the fat below |
| Stage 4 | The wound reaches muscle, tendon, or bone |
| Unstageable | Dead tissue covers the wound so its depth cannot be seen |
A wound that climbs from one stage to the next while a resident is in a facility’s care is a sign that the prevention and treatment that should have stopped it did not happen.
When a bedsore turns deadly
A deep pressure wound is an open door for infection, and in a frail resident that infection can spread into the blood as sepsis. Many nursing home wrongful death cases trace back to a pressure injury that was allowed to deepen and become infected until it took a life. A wound that should have been prevented, then should have been treated, becomes the cause of death.
How these cases are proven
The proof lives in the records. The wound photographs and charting show how fast it grew, the repositioning logs show whether the resident was in fact turned, the skin-risk assessments show what the facility knew, the care plan shows what it promised, and the staffing records show whether it had the people to deliver. When the turn logs are empty or the facility was short on staff, the documents make the case.
Common Questions
Are bedsores a sign of nursing home neglect?
Often, yes. Pressure injuries develop when a person stays in one position too long and the weight cuts off blood flow to the skin. With proper repositioning, skin checks, and nutrition, most are preventable, which is why federal regulations expect a facility to prevent them unless they were clinically unavoidable. A serious or worsening bedsore is frequently the first hard evidence of neglect.
How are pressure injuries staged?
They are graded by depth, from a stage one area of unbroken but discolored skin, through stage two and three as the wound opens and deepens, to a stage four wound that reaches muscle or bone. Some are unstageable because dead tissue hides the depth. A wound that climbs the stages while a resident is in a facility's care is a serious warning sign.
What should a facility have done to prevent them?
Assess each resident's risk on admission and regularly after, reposition residents who cannot move themselves on a schedule, keep skin clean and dry, provide proper nutrition and hydration, use pressure-relieving surfaces, and document skin checks. When those steps are in the care plan but not in the chart, that gap is the case.
Can a bedsore be fatal?
Yes. A deep pressure wound can become infected, and that infection can spread into the blood as sepsis, which is life-threatening, especially in a frail, elderly resident. Many nursing home wrongful death cases begin with a pressure injury that was allowed to worsen until it killed.
How do you prove a pressure injury case?
Through the records. Wound photographs and charting, the repositioning or turn logs, the skin-risk assessments, the care plan, and above all the staffing numbers tell whether the facility did what it should have. When the turn logs are blank or the facility was short-staffed, the proof is in the paper.
Related: Nursing home abuse and neglect, Malnutrition and dehydration, Wrongful death in a nursing home, How these cases are proven, Florida nursing home staffing requirements, and What affects the value of a case.
This page is general information about Florida law, not legal advice, and it does not create an attorney-client relationship. Federal pressure injury standards appear in 42 C.F.R. Part 483, and the Florida cause of action to enforce nursing home residents’ rights appears in sections 400.022 and 400.023 of the Florida Statutes. Every case is different, and past results do not guarantee a similar outcome. The hiring of a lawyer is an important decision that should not be based solely on advertisements.
