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John Dalli, founding partner of Dalli & Marino, recently discussed bedsores and nursing home liability on the Dearie Law Podcast with John Dearie, a leading attorney and founder of The Dearie Law Firm. With nearly two decades of experience handling elder abuse and nursing home negligence cases, Dalli has tried hundreds of matters involving falls, bedsores, medication errors, and other injuries in nursing homes, assisted living facilities, and hospitals.
During the conversation, Dalli offered insight into what causes bedsores, how families can help prevent them, and when litigation may be necessary.
What Was Covered: Key Questions and Answers
What causes bedsores?
A bedsore is a wound that occurs on what’s known as a bony prominence, such as the sacrum, heels, elbows, or even the ears. They are caused by unrelieved pressure on those areas. As the pressure builds, circulation decreases, nutrients can’t reach the tissue, and the skin begins to break down.
Who is most at risk?
The risk depends on two main factors: mobility and nutrition. People who cannot move on their own and rely on staff to reposition them are much more vulnerable. Poor nutritional status, particularly low protein levels, makes it harder for wounds to heal. Diabetes and other health conditions also increase risk. Age plays a role, but mobility is more important than whether a resident is 60 or 85.
How can families help prevent bedsores?
Families should look at their loved one’s skin daily, especially on the back and heels, to catch the earliest signs of breakdown. It’s also important to make sure staff are turning and repositioning residents who cannot move on their own. Families should speak directly with the administrator, director of nursing, and supervisors to understand what is in the care plan, and ask specifically about staffing on overnight shifts when residents may otherwise go unmonitored.
Where do bedsores most often develop?
Bedsores can develop in hospitals and other facilities, but they are most often seen in nursing homes. In long-term care settings, residents may not be getting regular physical or occupational therapy, and understaffing means they are not being moved frequently enough.
When does a bedsore become a legal case?
Under New York’s Public Health Law, nursing homes are required to provide all reasonable and necessary care to meet each resident’s needs. A bedsore should not occur unless it is truly unavoidable. From a litigation standpoint, stage one and two sores are not actionable, and stage three sores usually are not. It is typically stage four bedsores, particularly when they involve infection, osteomyelitis, or sepsis, that form the basis of a case.
Where are these cases filed?
These cases are usually filed in New York State court, either where the nursing home is located or where the estate’s executor or administrator resides. They are not typically brought in federal court, since discovery rules there tend to favor the defense.
Are some nursing homes worse than others?
Yes. Certain facilities repeatedly appear in cases. For example, Cold Spring Hills in Nassau County has been the subject of lawsuits and investigations for both neglect and misuse of funds. The patterns usually reflect ownership decisions about how money from Medicaid, Medicare, and private insurance is being used, whether it is going back into staffing and resident care or diverted elsewhere.
What other types of nursing home liability cases are common?
Falls and fractures are now as common as, or even more common than, bedsores. Many residents need two aides to help them move safely, but if there is only one available, they fall and suffer broken hips, femurs, or arms. Medication errors are also frequent, especially when prescriptions are not properly carried over from hospitals. Other cases involve physical or sexual abuse by staff or assaults between residents, often tied to a lack of supervision.
What defenses do nursing homes raise?
Facilities often claim that residents were simply too old or too sick, and that the staff did the best they could under the circumstances. They may also bring in doctors to argue that a sore was unavoidable. But elderly residents are in nursing homes precisely because they need this level of care, and claiming that illness or age excuses neglect does not hold up.
What damages are available in these cases?
New York’s Public Health Law allows recovery under several categories: pain and suffering; damages for the violation of the statute itself; death as an injury if the sore or its complications contributed to a resident’s passing; and, in rare cases, punitive damages for reckless or willful neglect.
Dalli & Marino Helps Families Take Action Against Nursing Home Neglect
Bedsores and other preventable injuries in nursing homes are serious indicators of neglect, and they can have lasting effects on residents and their families. At Dalli & Marino, we help families identify these issues, investigate the circumstances, and hold facilities accountable when care falls short. If your loved one has suffered from neglect or abuse, contact us today to understand your options and ensure they receive the protection and care they deserve.
