How Are Bed Sores Treated in Nursing Homes? 

Pressure ulcers, also called pressure sores or decubitus ulcers, are some of the most preventable yet dangerous conditions affecting nursing home residents. 

These injuries develop when blood flow is restricted to the skin due to prolonged pressure, typically over bony areas like the hips, back, or heels. Left untreated, even a mildest stage sore can progress into a deep tissue injury, increasing the risk of life-threatening infections such as sepsis or osteomyelitis.

In many cases, open sores directly result from poor care and lack of attention. Nursing homes are legally required to prevent and treat pressure ulcers through appropriate wound care, repositioning, and infection control. When facilities fail to follow these basic practices, it may indicate elder neglect, and families could be entitled to compensation.

This guide explains how pressure sores are treated in nursing homes, what good care looks like, and when families should seek support from a nursing home pressure injury lawyer.

What Proper Pressure Sore Treatment Should Look Like in Nursing Homes

Effective care for pressure sores involves a combination of daily attention, skilled observation, and the ability to respond quickly when a sore begins to form. Once a wound is discovered, staff should immediately begin treatment, adjusting care based on the wound’s stage and location.

Here’s what proper pressure sore treatment should look like:

1. Repositioning and Pressure Relief

The most basic yet most critical part of care is to change positions frequently. The clinical guidelines committee recommends repositioning bedbound residents at least every two hours and wheelchair-bound residents every 15 minutes. The goal is to reduce pressure on bony areas like the hips, sacrum, heels, or back—spots most vulnerable to skin breakdown.

Nursing homes should use foam cushions, pressure-relieving mattresses, and other support tools to help reduce pressure on the skin. When residents aren’t repositioned regularly, sores not only develop, but they also worsen fast.

2. Cleaning and Dressing the Wound

Each sore must be cleaned with mild soap and warm water to avoid further tissue irritation. Harsh chemicals such as hydrogen peroxide may delay wound healing by damaging healthy cells. Once cleaned, the sore should be covered with a sterile dressing suited to the depth and drainage level.

Dressings may need to be changed daily or more often. Failure to keep the area around the sore clean and dry increases the risk of infection and may reflect substandard care.

3. Removing Dead Tissue (Debridement)

Advanced sores, especially those in stage III or stage IV, often contain dead tissue or necrotic material. This material must be removed to promote blood flow and allow healing. This process is called debridement and may be done surgically or chemically by trained medical staff.

If dead skin is left in place, the risk of spreading infection increases dramatically. Untreated decubitus ulcers with necrosis often signal a lack of oversight and could be grounds for a neglect claim.

4. Nutritional Support

Wound recovery is directly tied to nutrition. Malnourished residents or those with chronic conditions like diabetes need protein, fluids, and micronutrients to support tissue repair. Nursing homes must assess a resident’s nutritional needs and provide supplements or adjusted meals as part of a comprehensive care plan.

Ignoring nutritional support can prevent even a well-dressed wound from healing properly, particularly in residents with fragile skin or other risk factors.

5. Monitoring and Infection Control

As part of ongoing wound care, nursing homes must watch for signs of infection, including:

• Foul odor from the sore;
• Redness, swelling, or warmth around the sore;
• Pus or discharge;
• Fever or confusion;
• Increasing wound depth.

These symptoms require urgent treatment with antibiotics and possibly hospitalization. If a sore progresses to sepsis, it can be fatal. Pressure sores that become infected often indicate that a facility ignored key responsibilities.

If a nursing home fails to follow any of the steps above, or fails to act at all after noticing a sore, it may be liable for elder neglect. These failures often violate not only medical standards but also federal and state laws designed to protect residents in care facilities.

Legal Standards Nursing Homes Must Follow in Pressure Ulcer Care

Federal regulations require that pressure sores must be prevented unless they are clinically unavoidable, and if a sore does develop, it must be properly treated.

According to the Centers for Medicare & Medicaid Services (CMS) under 42 CFR §483.25(b)(1):

“A resident who enters the facility without pressure sores does not develop pressure sores unless the individual’s clinical condition demonstrates that they were unavoidable; and a resident having pressure sores receives necessary treatment and services to promote healing, prevent infection, and prevent new sores from developing.”

This means nursing homes must follow clear clinical guidelines to minimize pressure, assess residents routinely, and ensure adequate staffing for wound care.

Failure to comply with these requirements may violate both federal law and state elder protection statutes. If a facility doesn’t take basic steps, such as repositioning, cleaning the wound, or identifying signs of infection, this may be grounds for a legal claim for elder neglect, especially if the injury worsens to a stage 4 ulcer.

When to Contact a Lawyer for Pressure Sore Neglect

Families often feel powerless when they see a loved one suffering from a pressure sore, especially when staff offer vague explanations or insist the injury was inevitable. But the truth is: most pressure sores are preventable. When they are not treated properly, legal action may be the only way to hold the facility accountable.

You should consider contacting a nursing home neglect lawyer if:

• The sore worsened quickly with little explanation.
• The facility failed to change positions regularly.
• You weren’t told about the sore until it was advanced.
• There’s no record of wound care in the medical chart.
• The sore became infected, required hospitalization, or led to death.

If you suspect that your loved one’s pressure ulcer was caused or worsened by poor care in a nursing home, it’s essential to act quickly. The earlier you document the issue, the stronger your case may be.

1. Photograph the Wound

Take dated photos of the open sore, noting the size, depth, and condition of the surrounding skin. Photographic evidence can show progression and may counter attempts to minimize the severity later.

2. Request Wound Care Records

Ask for copies of the wound care plan, treatment logs, and any documentation that details how often the resident was repositioned. Look for gaps, vague language, or inconsistencies in care.

3. Document Delays and Communication Breakdowns

Note any missed treatments, delays in seeing a doctor, or poor communication about the injury. If the facility avoided explaining how the sore developed or blamed the resident’s condition without evidence, this may indicate neglect.

4. Speak with a Nursing Home Abuse Lawyer

Consulting a lawyer experienced in nursing home neglect cases can help you understand your legal rights. An attorney can investigate care failures, review medical records, and pursue a claim for compensation related to medical costs, pain and suffering, or even wrongful death in severe cases.

At Nursing Home Law Center, we help families hold facilities accountable when residents suffer preventable harm. Whether the sore was ignored, worsened without explanation, or never properly treated, our team is here to help.

We offer free consultations and work on a contingency basis, meaning there are no fees unless we win your case. With millions recovered for families across the country, we’re committed to getting justice for those harmed by nursing home abuse and neglect.

Call us at (800) 926-7565 or fill out our contact form to speak with a pressure sore injury attorney today.