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Reviewed by an award-winning attorney at DALLI MARINO
Salvatore Marino, Esq. is a founding member of Dalli & Marino, LLP, and has been the managing partner since the firm’s inception in 1996, representing clients in New York City, Brooklyn, Bronx, Queens, Staten Island, Nassau County, Suffolk County and Westchester.
Pressure ulcers, often called bedsores, are a serious and often dangerous marker of mortality in older adults. These injuries often occur in tandem with acute illnesses or other end-of-life conditions and are closely associated with neglect, abuse, and poor care.
Quick Answer
Bedsores in nursing homes are often a warning sign that indicates something is not right in the facility. If you notice bedsores on your loved ones, you must take immediate action. Speak to the nursing facility’s management about your concerns and consider contacting a bedsore lawyer to file a nursing home abuse lawsuit.
What Is a Bedsore?
Bedsores, also known as decubitus ulcers or pressure ulcers, are a kind of injury caused by the pressure of one’s body weight focused on an area for a prolonged period. In other words, when someone stays in one place for a long time, their body weight restricts the amount of blood flow and circulation in the area being pressed down, causing repeated chafing that ultimately leads to the breakdown of skin and tissues to form ulcers.
Pressure injuries can develop in anyone, at any time. However, they are most common among older adults residing in nursing homes or long-term care facilities. Individuals confined to wheelchairs or bed rest are particularly prone to bedsores, as are people with circulatory issues, diabetes, former or current smoking habits, malnutrition, or fragile skin. Common pressure ulcer locations include the buttocks, spine, knees, sides of ankles, elbows, and any other spot subject to chafing. You may also spot pressure sores on the toes, backs of ears, or raw patches on the scalp.
Stages Of Bedsores In Older Adults
Pressure ulcers are classified into several stages based on their severity:
- Stage 1: A developing bedsore often appears like a sensitive or raw patch of skin, similar to a bruise with some discoloration. Early signs of bedsores include itchy areas of skin, red spots that don’t “blanch” or whiten when pressed, or a shiny appearance on darker skin.
- Stage 2: At this stage, the bedsore’s “bruise” typically opens into a blistered patch of skin or an abrasion. The edges may be discolored and are likely to be painful to the touch.
- Stage 3: A stage 3 bedsore has a deep, crater-like appearance that may be painful and numb to the touch. The edges may be red, purple, or black. It may also develop a foul smell.
- Stage 4: A stage 4 pressure ulcer causes damage to the surrounding joints, bone, and tissue. It may lead to life-threatening complications such as sepsis or a bone infection (osteomyelitis). The bedsore itself may look blackened or dead, or may be covered in a creamy yellow or white pus-like substance.
How Common Are Bedsores Among Nursing Home Patients in the United States?
Understanding the true scope of bedsores in nursing homes nationwide is challenging because reporting practices vary, residents enter facilities with different levels of health, and some data reflects wounds that developed before admission rather than during care. That said, federal data and long-standing studies do give a useful sense of the extent of the problem.
One of the most commonly cited national snapshots comes from the Centers for Disease Control and Prevention, which found in a 2004 national nursing home survey that more than 1 in 10 residents had a pressure ulcer at the time of the study.
In addition, here are some other key facts about bedsores in nursing homes:
- Stage 2 pressure ulcers are the most commonly reported bedsores across U.S. nursing homes, according to CDC data. They account for about 50% of reported cases, while Stages 1, 3, and 4 make up the remainder.
- Bedsores do not necessarily correlate with higher body weight in nursing home residents. In fact, one study found that about 1 in 5 residents with recent weight loss also had pressure ulcers.
- Other commonly identified factors linked with higher rates of bedsores include recent episodes of incontinence, multiple medications, and reduced mobility.
- Pressure ulcers are most commonly found in newer nursing home residents. Studies suggest residents in their first year of care are at higher risk than those who have been in facilities longer.
- Pressure ulcers appear slightly more often in men (about 13%) than in women (about 10%).
- Black residents of nursing homes are reported to experience more severe pressure ulcers than white residents. Researchers have suggested this may reflect a combination of health disparities and differences in how early skin damage is detected, particularly across different skin tones.
Research has also indicated that bedsores are generally more common in nursing homes than in many other care settings. One study found that older adults admitted to hospitals from nursing homes were more than five times more likely to already have a pressure ulcer than patients admitted from other living situations. One reason for higher rates of pressure ulcers in nursing home settings is that reduced mobility often drives older Americans into nursing care, whereas residents who remain at home may still be able to adjust themselves or lead more active lives.
Are Bedsores Common in NYC Nursing Homes?
New York City is a hotspot for bedsores. In 2019, an exposé from the City University of New York (CUNY) highlighted that nine out of the ten nursing homes in the state which reported the highest incidences of bedsores were located in New York City. Nationally, these ten New York nursing homes were among the worst in the nation for high bedsore rates, ranking in the top 2%.
High staff turnover is in part to blame, leading to a shortage of skilled nurses. In New York, Health Commissioner James McDonald issued an alert for an acute labor shortage in nursing homes statewide from April 2022 onwards. In 2024, it was estimated that approximately 75% of nursing homes in New York were unable to meet minimum staffing requirements set by state law, causing around 400 nursing homes to request waivers of fines due to ongoing trained staff shortages.
New York also has the highest number of beds per nursing home facility in the United States. While the average number of certified nursing home beds per facility in the US is 107, New York has approximately 186 beds per facility, which can lead to overcrowding or short-staffing in nursing homes.
A large part of the blame, however, lies in nursing home ownership. Many nursing facility owners move money from their facilities through corporate arrangements, paying themselves handsomely while residents are left in deplorable conditions. New York nursing homes are required to spend at least 70% of their revenue on direct resident care. However, the law is criticized for being weakly enforced and has been recently challenged in court.
Are Bedsores a Sign of Nursing Home Neglect?
Yes, bedsores in nursing homes can be a strong sign of neglect. Federal regulations and accepted standards of care require nursing homes to regularly assess residents for bedsore risk, assist with repositioning and mobility, maintain proper hygiene, monitor for early signs of skin breakdown, ensure adequate nutrition and hydration, and provide timely medical treatment when sores begin to develop.
When those steps are followed, most pressure ulcers can be prevented or caught early before they become serious. For that reason, a developing or worsening bedsore often suggests that something went wrong in a resident’s day-to-day care, whether that is missed repositioning, delayed attention to warning signs, or a failure to properly monitor a vulnerable patient.
Can I Sue a Nursing Home for a Bedsore?
Yes. In many cases, families can pursue a legal claim when a nursing home resident develops a preventable bedsore. But the success of a case depends on more than just showing that the injury happened. You must be able to prove that the nursing home failed to provide the accepted standard of care and that this failure led to harm.
These cases often rely on medical records, care logs, staffing information, and expert review to show what happened and whether the injury could have been prevented.
If a claim is successful, compensation may be available for:
- Medical expenses related to treating the bedsore and complications
- Pain and suffering
- Additional care or rehabilitation needs
- Hospitalization costs or long-term care increases
- Wrongful death damages, in cases where a preventable bedsore contributes to a resident’s passing
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How a Nursing Home Bedsore Lawyer Can Help
When a nursing home resident develops a bedsore, families are often left trying to understand what happened while also managing care decisions and concern for their loved one. A nursing home bedsore lawyer can take on the investigation and legal process so the family is not left carrying the burden alone.
A lawyer can help:
- Obtain and review complete medical and nursing home records
- Consult medical experts to evaluate the cause of the bedsore
- Identify gaps in care or breakdowns in treatment
- Gather evidence related to staffing, supervision, and facility practices
- Calculate the full extent of damages, including medical costs and long-term care needs
- Negotiate a settlement with the nursing home or file a lawsuit if necessary
With a lawyer involved, the family has someone pushing the case forward, demanding answers, and working to hold the facility accountable. This allows families to focus on their loved one, knowing the legal process is being actively managed on their behalf.
How Common Are Bedsores in Nursing Homes: FAQs
What Are the Risk Factors for Bedsores?
Bedsores are most likely to develop when a resident is unable to move or change position on their own for long periods of time. Other common risk factors include limited mobility due to illness or injury, incontinence, poor nutrition or dehydration, advanced age, and serious underlying medical conditions that affect circulation or healing. Residents who are bedridden or spend most of their time in a wheelchair are generally at the highest risk of developing bedsores.
What Do Bedsores Look Like?
At first, bedsores may appear reddened on light skin or as blue/purplish patches on dark skin. The area may feel sensitive or sore to the touch. It can also feel warm or itchy at the start. As bedsores worsen, they may look more like a blister or a crater in the skin. They may seem spongey or infected. At advanced stages, bedsores typically look blackened and have a bad smell.
What Are the Symptoms of Bedsores?
Early symptoms often include skin that feels warm, tender, or unusually firm in one area. Residents may also report pain, itching, or discomfort before any visible skin breakdown appears. As the condition progresses, symptoms can include open sores, drainage, swelling, and signs of infection such as redness spreading beyond the original area, fever, or increasing pain.
How Are Bedsores Treated?
Treatment depends on how advanced the bedsore is. Early-stage sores are often treated by relieving pressure on the affected area, keeping the skin clean and dry, and closely monitoring the condition. More advanced bedsores may require wound dressings, specialized cleaning, antibiotics for infection, and, in some cases, surgical treatment to remove damaged tissue. Consistent repositioning and ongoing care are essential to prevent worsening.
What Are the Possible Complications of Bedsores?
If not treated properly, bedsores can lead to serious complications. These may include deep tissue infections, sepsis (a life-threatening infection that spreads through the bloodstream), prolonged hospitalization, and permanent tissue or bone damage. In severe cases, complications from infected bedsores can contribute to a significant decline in overall health or even death.
How Do You Prevent Bedsores?
Prevention focuses on reducing constant pressure on the skin. This includes regularly repositioning residents who cannot move on their own, using pressure-relieving mattresses or cushions, maintaining good skin hygiene, and ensuring proper nutrition and hydration. Nursing staff are also expected to monitor the skin closely so that early signs of breakdown can be addressed before they become serious.
What Should You Do If You Notice a Bedsore in a Nursing Home?
If you notice a bedsore, it should be reported to nursing home staff immediately and documented. Ask how it is being treated and whether a medical provider has evaluated it. It is also important to monitor whether the condition is being properly addressed over time. If the sore is worsening, untreated, or not being explained clearly, families may want to seek outside medical or legal advice to better understand whether appropriate care is being provided.
Have Concerns About Bedsores? Contact an Experienced Attorney at Dalli & Marino For Help
At Dalli & Marino, our New York City nursing home abuse and neglect attorneys have won our clients over $1,300,000 in bedsore lawsuit settlements. We stand up for residents and families when nursing home neglect leads to unnecessary pain, suffering, and tragedy.
No one should have to suffer the abusive and degrading circumstances that often precede the formation of an advanced-stage bedsore. If your loved one has suffered harm in a New York City nursing home, our attorneys are available for a free consultation to discuss your case and explain how we may be able to help.
