Bedsores (Pressure Ulcers)

Bedsores, also called pressure ulcers or pressure injuries, form when constant pressure cuts off blood flow to skin and tissue. They usually appear over bony areas such as the tailbone, hips, heels, ankles, and shoulder blades. People at highest risk are those confined to a bed or wheelchair, people who cannot sense pain well, and people who are poorly nourished or incontinent.

Clinicians grade bedsores by depth. Under the CMS coding guide, Stage 1 is intact skin with non-blanchable redness, Stage 2 is partial-thickness skin loss, Stage 3 is full-thickness tissue loss that may show fat, and Stage 4 is full-thickness loss with exposed bone, tendon, or muscle. Some wounds are "unstageable" because dead tissue covers the base, and a deep tissue injury can appear as a purple or maroon area of intact skin.

Bedsores are a common piece of evidence in nursing home and hospital neglect cases. Many can be prevented with regular repositioning, skin checks, pressure-relieving mattresses, good nutrition, and keeping skin clean and dry. A resident who develops a Stage 3 or Stage 4 sore, or whose sore worsens without a change in care, may point to understaffing or ignored care plans. Deep bedsores can lead to serious infections, including bone infections and sepsis.

Photograph wounds with dates, request the facility's care plan and wound records, and report concerns to the state survey agency. Get medical help immediately for any wound that is deep, foul-smelling, or accompanied by fever. See our term page on nursing home neglect and our guides on how to sue a company and class action vs. individual lawsuits.