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Pressure Ulcers and Nursing Home Neglect: What Families Need to Know

person laying in hospital bed with back pain symbolized

Pressure ulcers, commonly known as bedsores, are a significant issue in nursing homes, often indicating neglect or inadequate care. If you have loved ones living in a nursing home or assisted living facility, it is crucial to have a comprehensive understanding of your rights and the legal recourse available in cases of pressure ulcers caused or made worse by negligent care.

What Are Pressure Ulcers?

 Pressure ulcers are injuries to the skin and underlying tissue primarily caused by prolonged pressure on the skin. They most often develop on bony areas of the body such as heels, ankles, hips, and tailbone. They can range in severity from mild reddening of the skin to severe tissue damage that extends into muscle and bone.

Causes of Pressure Ulcers in Nursing Homes

  • Immobility: Residents who are bedridden or use wheelchairs are at high risk if not regularly repositioned.  Facilities with inadequate staffing may not be able to reposition your loved one frequently enough to prevent pressure ulcers from developing.


  • Poor Nutrition and Hydration: Inadequate dietary intake can weaken the skin and underlying tissues, making them more susceptible to pressure ulcers.


  • Incontinence: Exposure to urine and feces, without timely attention, can increase skin moisture and promote ulcer formation.


  • Medical Conditions: Conditions such as diabetes and vascular diseases can impair blood flow, increasing the risk of ulcers.


  • Neglect: Failure of nursing home staff to provide adequate care, such as regular repositioning, skin inspections, and prompt treatment of early signs of pressure ulcers.


Pressure ulcers can be fatal. 

 The primary concern is the risk for infection.  If a pressure ulcer becomes infected and is not quickly diagnosed, it can lead to sepsis.  Sepsis is a life-threatening medical condition that occurs when the body's response to an infection spirals out of control.  When the body's immune system overreacts to fight the infection, it can also start attacking its own tissues and organs, leading to widespread inflammation, tissue damage, and potentially organ failure. Sepsis requires prompt medical attention and treatment, often with antibiotics and supportive care, to prevent severe complications or even death.

Recognizing the Signs of Pressure Ulcers

Long-term care residents usually develop pressure ulcers within the first 4 weeks of admission to the senior care facility.  Early detection of pressure ulcers is essential for effective treatment and prevention of further complications. Bedsores have “stages” that can range from very mild with slight redness to the skin to severe where the muscle, fatty tissue and bone are affected. The more serious the bedsore, the higher it's stage.


Stage 1: Reddened area on the skin that does not turn white when pressed. The skin may feel warm and be either firmer or softer than the surrounding area.


Stage 2: Shallow open wound or blister with a pink or red base. The area around the wound may be swollen and painful.


Stage 3: Deep wound exposing fat tissue. The ulcer appears as a crater and may have yellowish dead tissue at the bottom.


Stage 4: Very deep wound exposing muscle, bone, or tendons. The area may be blackened with dead tissue, and there may be significant pain and infection.


Unstageable: Wound covered by dead tissue (eschar) or a yellowish substance (slough) making it difficult to see the depth.


Suspected Deep Tissue Injury: Purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying tissue.


Regulatory Standards in Pennsylvania

 In Pennsylvania, nursing homes are legally obligated to provide a standard of care that ensures residents' safety and well-being, known as their duty of care. A breach of this duty, resulting in harm such as pressure ulcers, can be grounds for a negligence claim. To establish negligence, it must be shown that the nursing home failed to meet the standard of care expected, directly causing the resident's injuries. Pressure ulcers can be a sign of neglect or abuse, and residents or their families may have grounds for a legal claim if they arise due to inadequate care.


Learn more about The Duty of Care to Nursing Home Residents in Pennsylvania


Nursing Home Compliance in Unavoidable Circumstances

There may be some instances when a pressure ulcer is not the result of abuse or neglect. If the nursing home can provide documentation that shows they have followed all appropriate care protocols, including regular repositioning, skin inspections, proper nutrition, and hydration, they may not be liable. Pressure ulcers can result from underlying health conditions or advanced age and extreme frailty that make them particularly susceptible. Some may also develop rapidly due to acute medical events or sudden changes in a resident's condition. If a nursing home can demonstrate that the pressure ulcer appeared quickly and that they responded promptly and appropriately to address it, liability may not be applicable.


If a resident has been recently admitted or transferred to the nursing home and arrives with pre-existing pressure ulcers, the facility may not be held responsible for their initial development. However, the nursing home is responsible for providing adequate treatment to manage and heal the ulcers from the time of admission.


Steps to Take if Pressure Ulcers Are Suspected


1. Seek Medical Attention: Ensure the resident receives immediate medical care to address the ulcers and prevent further complications.


2. Document the Evidence: Take photographs of the ulcers, and keep detailed records of the resident’s condition and any relevant communications with the nursing home staff. Medical records, care plans, and witness testimonies are crucial in establishing neglect. Detailed documentation of the resident’s condition and the care provided is essential for building a strong case.


3. Report the Neglect: File a complaint with the Pennsylvania Department of Health. They will investigate the allegations and take appropriate action.


4. Consult a Lawyer: Contact a law firm specializing in nursing home abuse and neglect to discuss the case and explore legal options.  Our experienced team of injury attorneys can help you understand your rights. 


Compensation and Damages

 Victims of nursing home neglect may be entitled to compensation for:


  • Medical Expenses: Costs associated with treating the pressure ulcers and any related health issues.


  • Pain and Suffering: Compensation for the physical pain and emotional distress caused by the pressure ulcers.


  • Other Related Costs: This can include additional care costs, rehabilitation, or relocation to another facility.


  • Punitive Damages: In severe cases, punitive damages may also be awarded to deter future misconduct by the nursing home.


 Pressure ulcers in nursing homes are often preventable and indicative of substandard care. In Pennsylvania, legal avenues exist to hold nursing homes accountable for neglect that leads to these painful and potentially life-threatening injuries. If you suspect a loved one is suffering from pressure ulcers due to nursing home neglect, seeking legal advice is essential to protect their rights and ensure they receive the care and compensation they deserve.


For more information or to discuss a potential claim, contact our law firm today. We are committed to advocating for the rights of nursing home residents and ensuring they receive the quality care they are entitled to by law.


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