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A bedsore that progresses from a patch of redness to an open wound exposing muscle or bone does not happen overnight. It is the result of days or weeks of missed repositioning, skipped skin assessments, and inadequate wound care by staff who were either untrained, understaffed, or indifferent. At The Elder Justice Firm, we represent Los Angeles families whose loved ones developed pressure ulcers in nursing homes and skilled nursing facilities. We investigate what the facility did and failed to do, and we pursue full compensation under California's elder abuse statutes when neglect is responsible.
Pressure ulcers, also called bedsores or decubitus ulcers, form when sustained pressure cuts off the blood supply to the skin and underlying tissue. The affected area begins to die within hours of unrelieved pressure, which is why clinical standards require nursing home staff to reposition bedridden residents at least every two hours and to conduct daily skin assessments. The CDC National Center for Health Statistics reports that approximately 11 percent of nursing home residents have pressure ulcers at any given time. That prevalence rate reflects a population-level failure: the medical community classifies Stage 3 and Stage 4 pressure injuries as "never events," meaning they should not occur when facilities provide proper care.
Certain residents are at higher risk than others. Those who are bedridden, have limited mobility, suffer from diabetes or vascular disease, or are malnourished are particularly vulnerable. But elevated risk does not reduce a facility's legal obligation to prevent these wounds. It increases it.
The skin remains intact but appears persistently red in lighter-skinned residents, or darker or discolored in those with darker skin. The affected area may feel warmer or firmer than the surrounding tissue. A Stage 1 wound is an urgent warning that pressure is causing damage. A facility that documents a Stage 1 finding and fails to immediately intensify repositioning and protective measures has created the conditions for the wound to progress.
The outer layer of skin has broken down, creating a shallow open wound or fluid-filled blister. Stage 2 wounds are painful and require documented wound care. The presence of a Stage 2 wound in a nursing home resident who was at known risk raises immediate questions about whether the facility was following its own care plan and repositioning schedule.
Tissue damage has extended through all skin layers into the fat beneath. The wound may show dead tissue and drainage. Stage 3 pressure ulcers are classified as serious preventable harm. Facilities are required to report them. When a resident reaches Stage 3, the question for a legal investigation is not just how the wound got there, but what the facility knew weeks earlier at Stages 1 and 2 and what it failed to do.
The wound has reached muscle, tendon, or bone. Stage 4 pressure ulcers provide a direct pathway for bacteria into the deep tissue and bloodstream. Sepsis, the body's dangerous systemic response to infection, is a common and frequently fatal complication of Stage 4 wounds in elderly patients. When a nursing home resident dies from sepsis that originated in an untreated bedsore, the family may have both a wrongful death claim and an elder abuse claim against the facility.
Pressure ulcers are almost always preventable. When they develop inside a nursing home, specific failures by the facility or its staff are generally responsible. Common causes include:
Under California Health and Safety Code Section 1276.5, skilled nursing facilities are required to provide a minimum of 3.5 direct care service hours per resident per day. This staffing floor exists precisely because adequate hands-on care time is the foundation of bedsore prevention. Facilities that fall below this standard, or that meet it only on paper, are at elevated risk of producing the kind of care gaps that allow pressure injuries to develop.
Federal regulations under 42 CFR Part 483 require nursing homes to ensure that residents who are admitted without pressure ulcers do not develop them, and that residents admitted with existing wounds receive care to promote healing. Failure to comply with these federal standards can support findings of regulatory deficiency, which in turn is relevant evidence in a civil elder abuse case.
California's Elder Abuse and Dependent Adult Civil Protection Act, Welfare and Institutions Code Section 15600, provides civil remedies specifically designed for nursing home neglect cases. When a facility's failure to prevent or treat a bedsore reflects reckless disregard for resident safety, the Act allows recovery of attorney's fees and enhanced damages in addition to compensation for medical expenses, pain and suffering, and other losses. The legal definition of neglect under Welfare and Institutions Code Section 15610.57 expressly includes failure to provide proper hygiene and medical care, both of which are directly implicated in bedsore cases.
When a family contacts The Elder Justice Firm about a loved one's pressure injury, our investigation focuses on reconstructing the precise timeline of care and identifying the specific failures that allowed the wound to develop or worsen. We request and review:
We work with wound care experts and physician reviewers who can explain to a jury exactly how these wounds form, what the standard of care required at each stage is, and how the facility's failures allowed preventable harm to occur.
No. A resident's pre-existing vulnerability to pressure injuries does not relieve the facility of its legal duty to prevent them. It actually heightens that duty. The standard of care requires facilities to identify high-risk residents at admission, document that risk in the care plan, and implement specific protocols, including more frequent repositioning and daily skin assessments, to address it. When a high-risk resident develops a pressure ulcer, the investigation focuses on whether those elevated protocols were followed.
Yes. California elder abuse claims do not require proof that the pressure ulcer was the only cause of harm, or that the resident would otherwise have been in good health. They require proof that the facility's negligence or recklessness caused or contributed to the development or worsening of the wound. Even in cases where a resident has a serious underlying illness, a Stage 3 or Stage 4 pressure ulcer that develops inside a nursing home is strong evidence that the facility failed to meet its standard of care.
Under California Code of Civil Procedure Section 335.1, personal injury and elder abuse claims must generally be filed within two years of the date the harm occurred or was discovered. The delayed discovery rule may extend this period when the facility concealed the injury or when the resident lacked the capacity to recognize what was happening. Consulting an attorney as soon as possible preserves evidence and protects your legal options.
If your loved one developed bedsores in a Los Angeles nursing home or skilled nursing facility, you deserve to know whether the facility failed them and what legal options are available to your family. At The Elder Justice Firm, we investigate pressure ulcer cases with rigor, working with wound care experts and reviewing every relevant record to build the strongest possible case. We handle all cases on contingency, meaning no fees unless we recover for you. Contact us today for a free, confidential consultation.
We have won multi-million-dollar cases against public and private facilities on behalf of our clients. As a result, many institutions and their insurance companies opt to settle with us, based on our attorneys’ reputations.
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