You visit your father on Tuesday and notice a red spot on his lower back. By Friday, it's an open wound. The nursing staff tells you it "just happened," but bedsores don't just happen; they develop when someone isn't being turned, cleaned, or monitored. Bedsores are painful, dangerous, and in most cases, completely preventable.
For families across South Carolina, these wounds are often the first visible sign that a loved one isn't receiving the care they were promised. An Anderson nursing home abuse lawyer can help you understand what went wrong and hold the facility accountable.
What Causes Bedsores in Nursing Homes?
Bedsores, also known as pressure ulcers, develop when someone stays in one position too long. Vulnerable areas include the tailbone, heels, hips, shoulder blades, and anywhere bone presses against skin. Without regular repositioning, skin cells die from lack of oxygen and nutrients.
Federal regulations under 42 C.F.R. § 483.25 mandate that nursing homes provide care to prevent pressure ulcers. Specifically, facilities must ensure residents do not develop pressure ulcers unless clinically unavoidable, and if they do develop, facilities must provide treatment to promote healing and prevent infection.
Upon admission and periodically thereafter, nursing homes are required to perform and document a Braden Scale assessment. This standardized tool measures pressure ulcer risk based on factors like mobility, nutrition, moisture exposure, and sensory perception. High-risk residents require more frequent monitoring and intervention.
The Four Stages of Bedsore Progression
Bedsores progress through four stages based on tissue depth:
- Stage I (surface redness). The skin hasn't broken yet, but it won't blanch white when pressed.
- Stage II (shallow open wound). The outer skin layer breaks down, creating what looks like a blister or abrasion.
- Stage III (deep crater). The wound extends through the skin into the fat layer below, presenting what appears to be yellow, dead tissue.
- Stage IV (exposed muscle or bone). The ulcer tunnels down to muscle, tendon, or bone. These wounds can become life-threatening without aggressive treatment.
A Stage I ulcer can progress quickly, sometimes within 24 hours if no one intervenes. The Centers for Medicare & Medicaid Services (CMS) categorizes Stage III and Stage IV hospital-acquired pressure injuries as "never events," meaning they should not occur with proper care.
When Is a Bedsore Legally "Unavoidable"?
A bedsore is legally considered unavoidable only if the facility implemented all appropriate interventions, monitored the resident closely, and documented the care plan. The burden of proof falls on the nursing home to demonstrate that they did everything right.
If your mother develops a Stage III ulcer but her medical records show missed repositioning rounds, incomplete risk assessments, or inadequate documentation, that wound becomes evidence of neglect, not an unavoidable outcome of her medical condition.
Warning Signs Families Should Watch For
Nursing homes sometimes hide developing ulcers from families or downplay their significance. Families have a right to reasonable access to ensure their loved one's well-being, though clinical or privacy considerations may affect how inspections are conducted.
Red flags that inadequate care may be occurring include:
- Unexplained bruising or skin tears, suggesting rough handling or lack of padding
- Resistance when you ask to see certain body areas
- Complaints of pain when sitting or lying down, symptoms that appear before bedsores are visible
- Strong odors that don't go away after cleaning, pointing toward possible infected wounds
Trust your instincts when something seems off. You know your loved one better than anyone.
Bedsores Are More Than Just Wounds
An open Stage III or IV ulcer exposes internal tissue to bacteria. Once infection takes hold, it can spread to the bone (osteomyelitis) or enter the bloodstream (sepsis). Both conditions require hospitalization and aggressive antibiotic treatment.
Imagine an elderly woman with diabetes develops a Stage IV bedsore on her heel. The wound reaches bone. Bacteria colonize the exposed tissue. Within days, she spikes a fever as the infection spreads to her bloodstream. She's rushed to the hospital, where doctors amputate part of her foot to save her life.
Even if a bedsore doesn't turn fatal, the recovery process is brutal. Deep ulcers require months of painful wound care, including debridement to remove dead tissue, specialized dressings, and sometimes surgical flaps to close the wound.
What to Do If Your Loved One Has a Bedsore
If you discover that a family member in a South Carolina nursing home has developed pressure ulcers, document everything and seek guidance immediately.
- Photograph the wound from multiple angles with clear, dated images.
- Request complete medical records, including your loved one's chart, care plans, Braden Scale assessments, incident reports, and wound care documentation.
- Request an Adult Protective Services (APS) investigation, if appropriate. APS can recommend interventions or facility sanctions.
Nursing home residents have specific rights, including the right to be free from abuse and neglect, the right to dignified care that promotes quality of life, and the right to have grievances addressed promptly. When facilities violate these rights, families have legal recourse.
An attorney who focuses on nursing home abuse understands facility defense tactics. They'll argue the bedsore was unavoidable or that the resident's underlying conditions made prevention impossible. We work with medical professionals who can review records and testify about whether care met accepted standards.