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Bedsore Lawsuit: When a Pressure Ulcer Is Neglect
If you're wondering whether a loved one's bedsore reflects poor care and could support a bedsore lawsuit, the federal nursing home rules offer a starting point: homes must provide care to prevent pressure ulcers and treatment for residents who already have them. Federal rules say a resident should not get a pressure ulcer unless their medical condition made it unavoidable. A pressure ulcer, sometimes called a bedsore, is injury to the skin and the soft tissue beneath it, most often over a bony area like the tailbone or heel.
- Can you bring a claim?
- Often, yes. Often, if a resident was hurt because the home did not give the care it owed. The resident, a legal representative or, after a death, the estate or the family that state law names can act.
- What it costs
- The fee is a share of any recovery; case costs are handled on their own. The fee is usually a contingency fee: part of whatever money is recovered, often about a third, and no fee is owed if there is no recovery. Costs for records, experts, and the like are separate; the written agreement spells out who pays them when the case is lost.
- Your deadline
- Set by each state, and it can be short. Each state sets its own. Injury claims often allow two or three years, some claims less, and the clock can start on the day of the injury. See the deadline in your state
Think a resident was hurt or neglected?
Call 1-833-892-8135Calls go to a law firm that advertises on Nursing Home Violations.In danger right now? Call 911. To report the home, see how to report abuse.
In the Federal Inspection Records
| Rule | Citations | Homes cited | Harm-or-danger citations |
|---|---|---|---|
| F686: Pressure Ulcer (Bedsore) Care | 8,386 | 5,500 | 1,881 |
Harm or danger counts the citations lettered G to L, part of the citation total. A citation is an inspector's finding against the home, not a lawsuit. It can support a claim but does not prove one.
The Care Standard a Nursing Home Has to Meet
The federal quality of care regulation, 42 CFR 483.25, says a resident should not develop pressure ulcers unless their clinical condition shows they could not have been avoided. The only exception is when the resident's own medical condition shows the sore could not have been prevented. Even then, the home still had to give care that met professional standards.
The home has to provide care that prevents sores, and that care has to meet professional standards of practice. This duty grows out of the home's full assessment of every resident.
When someone comes in with a sore already there, the home must deliver whatever treatment is needed to help it heal, keep infection away, and stop new sores from forming. The same regulation also calls for enough food and fluids to maintain a healthy weight and good hydration, and nutrition is one thing that shapes how well skin holds up under pressure.
Is the Case About the Sore Itself or the Care?
The wound itself counts, but what the home did or failed to do around it also matters. A sore that was caught early, treated, and checked again tells one kind of story. A sore that showed up, got deeper, and turned infected with no documented plan tells a very different one.
That is why the medical record carries so much weight. A resident has the right to see their own chart within a day of asking, weekends and holidays not counted, and the home must provide copies given two working days' notice.
What the Stages of a Bedsore Mean
Clinicians group pressure injuries into stages, following the national staging system. The higher the stage, the deeper the damage.
| Stage | What is seen |
|---|---|
| Stage 1 | Skin still intact, with a red spot that stays red when pressed; it can look different on darker skin |
| Stage 2 | Part of the skin is gone and the layer beneath shows; it can resemble a blister filled with clear fluid |
| Stage 3 | Skin is gone all the way through and fat shows, though muscle, tendon, and bone remain covered |
| Stage 4 | Skin and tissue are gone, and muscle, tendon, cartilage, or bone is exposed or can be felt in the wound |
| Unstageable | Dead tissue hides the bottom of the wound, so its depth is unclear; once cleaned it proves to be Stage 3 or 4 |
| Deep tissue | A lasting deep red, maroon, or purple patch that stays dark when pressed and can get worse fast |
Stage 2 is not the right label for skin broken down by moisture, and a wound from a medical device tends to mirror that device's outline. An open sore can hurt.
Inspection Records in a Bedsore Case
Each home listed here, which you can find by name, city or ZIP with the site's search, comes with an inspection record built from the CMS Care Compare files and refreshed each month. Inspectors cite failures in pressure ulcer care under the tag F686, which tells homes to give proper pressure ulcer care and keep new ulcers from forming.
Nationwide, F686 shows up 8,386 times across 5,500 homes in the current files, which span roughly three rounds of inspections. Out of those citations, 1,881 involved inspectors concluding that residents had truly been hurt or placed in immediate danger, and 249 reached the immediate danger level. Immediate danger, sometimes called immediate jeopardy, is the gravest finding there is. It means a resident's life or health was at serious risk.
| Tag | Citations | Homes cited | Harm or danger found | Immediate jeopardy |
|---|---|---|---|---|
| F686 care for pressure ulcers | 8,386 | 5,500 | 1,881 | 249 |
| F692 adequate food and fluids | 5,099 | 4,046 | 610 | 50 |
| F684 care following orders | 16,456 | 8,337 | 2,071 | 737 |
Past citations at a home cannot prove what happened to any one resident, but they do show whether inspectors have run into the same kind of failure there before. Survey reports and complaint investigations covering the past three years have to be kept at the home where anyone can review them on request.
What to Do in the First Few Days
- Ask the home for the resident's medical records; the resident has the right to see them and to get copies with two working days' advance notice.
- Take a dated photo of the sore, because a deep tissue injury can get worse fast and the stage can shift.
- Ask to look at the home's survey and complaint reports covering the last three years, and note the contact for the State Long-Term Care Ombudsman that the home must post.
- Send a complaint to your State Survey Agency, the body responsible for inspecting nursing homes and looking into complaints, usually housed in the state health department; 1-800-MEDICARE can give you its contact information.
You can file that complaint without giving your name, and no home may try to talk a resident out of reaching out to government officials. Residents can speak up about concerns without fear of retaliation.
Losses a Claim Can Cover
- Medical and hospital bills caused by the harm
- Pain, suffering and loss of dignity
- The cost of extra care the harm made necessary
- After a death: funeral costs and the family's loss
Some states cap parts of these awards, so a lawyer licensed in the state can say what applies.
Records Worth Keeping
- Dated notes of what you saw and who you spoke with
- Photos of injuries, the room and the bed
- The care plan and any incident reports you were given
- Hospital and doctor records since the injury
- The admission papers, including any arbitration agreement
- The home's federal inspection record
Check the home's federal record
You can look up any Medicare or Medicaid certified home here: its inspection findings, any federal fines and its star ratings. Search a home by name, city or ZIP, or open the flagged homes in your state.
Want to talk about what happened?
Call 1-833-892-8135Calls go to a law firm that advertises on Nursing Home Violations.Questions People Ask About Bedsore Lawsuits
How Much Does a Bedsore Lawsuit Usually Pay?
Inspection records do not include settlement amounts, so this site cannot offer an average. What the records can tell you is whether a home got cited over pressure ulcer care and whether inspectors documented harm to residents.
Can a Hospital Be Sued for Bedsores?
The rule and the records described here cover nursing homes that Medicare and Medicaid certify, not hospitals.
Do Stage 4 Bedsores Ever Heal?
The staging system tells you how deep a sore goes, not whether it will get better, and it does not say whether a particular sore will close. Even so, the federal rule still obliges the home to provide treatment that promotes healing and prevents infection, whatever the stage.
Does a Stage 4 Bedsore by Itself Prove Neglect?
No one stage proves neglect on its own, since the rule leaves room for wounds that were clinically unavoidable. Stage 4 means skin and tissue have been lost, leaving muscle, tendon, cartilage or bone exposed or felt directly in the wound, and that alone does not show how the injury developed or what care was given.