You visit your father and notice a raw, reddened area on his heel. Or a nurse mentions a "small skin issue" on his tailbone during a phone call. A week later, that small issue is an open wound.
Pressure injuries, commonly called bed sores, are one of the clearest indicators of whether a nursing home, assisted living, or group home is providing the basic care a resident needs. In facilities across New Jersey, from Burlington and Camden counties to Mercer, Gloucester, and Atlantic counties, these injuries develop when someone is left in the same position for too long without being repositioned. In a properly staffed facility following its own care plans, most pressure injuries should never happen.
What Causes Pressure Injuries in Long-Term Care
Pressure injuries form when sustained pressure cuts off blood flow to the skin, often over bony areas such as the tailbone, heels, hips, and elbows. Residents who cannot reposition themselves independently depend entirely on staff to turn them on a regular schedule, typically every two hours.
When that does not happen, the damage starts quickly. What begins as reddened skin can progress to an open wound, then a deep crater exposing muscle or bone. Advanced pressure injuries carry serious risks of infection, sepsis, and death. These wounds are painful, slow to heal, and in many cases entirely preventable.
Why Bed Sores Often Point to Failures in Care
Federal regulations are clear: a facility must ensure that a resident who enters without pressure injuries does not develop them unless the resident’s clinical condition makes them unavoidable. That is a high standard, and it is the law.
In practice, pressure injuries often develop because of missed repositioning schedules, inadequate nutrition and hydration, wet or soiled linens left unchanged, lack of proper support surfaces like pressure-relieving mattresses, and simply not enough staff to provide the hands-on care that immobile residents require.
When a facility allows a pressure injury to develop or worsen, it raises a serious question about whether the resident received the care they were entitled to.
What to Watch for During Visits
Families are often the first to catch the early signs. During visits, look at your loved one’s skin, especially the heels, lower back, hips, and any area that bears weight when sitting or lying down. Reddened skin that does not fade when pressed is a Stage 1 pressure injury and should be reported promptly to the facility.
Pay attention to whether your loved one’s clothes and bedding are clean and dry. Notice whether they are in the same position every time you arrive. Ask staff when the last repositioning happened and whether it was documented. If the facility seems reluctant to let you see areas of skin concern or downplays the issue, that is a red flag.
Questions That Come Up After a Pressure Injury
Ask to see the wound and request photographs if the facility will not allow direct observation. If you can photograph it yourself, do so with the date visible.
Request the care plan and repositioning logs in writing. These records show whether the facility was following its own protocols. Ask what stage the wound is, what treatment is being provided, and whether a wound care specialist has been consulted.
Document the timeline. When was the injury first identified? When were you notified? Has it gotten worse? A pressure injury that progresses from Stage 1 to Stage 3 or 4 while a resident is under a facility’s care is a significant concern.
If the facility is not providing adequate answers or the wound is worsening, consider contacting the New Jersey Long-Term Care Ombudsman to report your concerns and speak with a New Jersey attorney who understands long-term care accountability.
Frequently Asked Questions About Nursing Home Pressure Injuries
Pressure injuries can progress rapidly. Without proper intervention, what starts as reddened skin can become an open wound within days. Advanced pressure injuries that reach muscle or bone carry serious risks of infection, sepsis, and death. Early identification and immediate treatment are critical.
Not always, but in most cases, they are preventable. Federal regulations require facilities to prevent pressure injuries unless the resident’s clinical condition makes them unavoidable. When a resident develops a pressure injury while in a facility’s care, it raises serious questions about whether the facility met that standard.
Request the care plan, repositioning logs, wound care documentation, and any wound assessments or photographs. These records show whether the facility was following its own protocols. You have the right to request them in writing.
Stage 3 and Stage 4 pressure injuries are the most serious. Stage 3 involves full-thickness skin loss that may expose fat tissue. Stage 4 involves exposed muscle, tendon, or bone. Both carry high risks of infection and sepsis. A pressure injury that progresses to these stages while a resident is in a facility’s care is a significant concern.
When a New Jersey facility fails to follow repositioning schedules, maintain adequate staffing, or provide proper wound care, and a resident develops or worsens a pressure injury as a result, the facility may be held accountable for those failures in care.
Schall at Law represents families across New Jersey, including South Jersey, from our Moorestown office.
Related Resources
Were you or a loved one a resident of a nursing home, assisted living, or group home and injured due to failures in care?
Better Call Schall® at 856-310-6782 or send a message through our contact form.
Important: Time limits apply. If this happened recently, contact us promptly.
This post is general information, not legal advice.
