Federal Regulations Covering Nursing Homes State Elder Entering Nursing Home Should Not Develop Decubitus Ulcers, Bed Sores and / or Pressure Sores Unless They Are Clinically Unavoidable

Written by Adam Peck Category: Bed Sores January 26th, 2013 3 min read

Too often, we hear that nursing home residents develop bed sores without really understanding what has happened to them. The terms “bed sore”, “pressure ulcer” and “decubitus ulcer” mean the same thing and are used to describe any skin lesion or wound caused by unrelieved pressure that damages the underlying tissue. The term is one that fails to adequately describe how terrible these wounds are. Left untreated, these injuries can become infected and result in the amputation of a limb, or even death says California Nursing Home Abuse Attorney Steven C. Peck.

Bedsores Can Cause MRSA

These wounds are graded on a scale from I to IV, with a grade I ulcer being a minor reddening of the skin and grade IV being an open wound with exposed muscle or bone. Stage III and Stage IV pressure ulcers have serious health consequences for nursing home residents because they involved major interruptions in the integrity of the skin. This can allow infecting organisms such as MRSA into the body and can cause systemic infections, indicates Los Angeles Nursing Home Lawyer Steven C. Peck.

The term “pressure ulcer” fits because they frequently happen on parts of the body where there is pressure between a bony prominence and another surface such as a bed or a chair. The places where pressure ulcers most typically occur include: the tailbone or sacrum, the buttocks, the hips, and the backs of the heels, although pressure ulcers can also occur on other parts of the body.

There are some common conditions which many nursing home residents suffer from leave them vulnerable to developing bed sores or pressure ulcers. These include immobility, incontinence of bowel or bladder, and poor nutritional status. Even when a nursing home resident suffers from all of these risk factors, that does not mean that they will inevitably develop pressure ulcers.

Federal Regulations put Extensive Responsibilities on Nursing Homes to Prevent and Treat Pressure Ulcers

The federal regulations covering nursing homes state that if a resident enters a nursing home without pressure ulcers, they should not develop them unless they are clinically unavoidable. This means that the nursing home staff must do everything possible to prevent the pressure ulcers from developing. Further, once a resident has a pressure ulcer, the federal regulations require the nursing home to provide care to promote healing and prevent infection.

Because the nursing home staff has such extensive responsibilities to prevent and/or treat pressure ulcers, poor care concerning pressure ulcers may be a viable basis for a claim of violations of the California Elder Abuse Dependent Adult Civil Protect Act (EADACPA) against the nursing home. Some theories might include:

Failure to regularly reposition the resident, leaving one area of the body bearing the pressure of the resident’s weight for long periods.
Failure to provide adequate toileting and clothing changes for residents who are incontinent of bowel or bladder.
Failure to provide adequate nutrition and fluids; if there is malnutrition and dehydration the skin will be less able to resist injury.

An adequate treatment regimen would include:

Regular dressing changes
Application of wound treatments
Use of nutritional supplements
Use of a pressure-reducing devices

When proper treatment is not initiated, bedsores frequently do progress and become infected. A full assessment of the treatment plan and its implementation is an important part of assessing the liability of the nursing home for the resident’s injuries.

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Written by Adam Peck

Expertise: Personal Injury

Adam J. Peck, ESQ is a principal with Peck Law Group, APC. In 2008, Mr. Adam Peck received his Juris Doctorate from Whittier Law School where he graduated Cum Laude. His practice is primarily dedicated to representing Elders, Dependent Adults, along with their loved ones and family members, who have suffered horrific personal injuries.