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There many types of skin injuries that occur in skilled nursing facilities, but pressure sores (also called bed sores) are almost always a clear indicator of neglect or abuse because they always result from a patient being left in bed in one position and not moved for prolonged periods of time.

All of us have bony prominences on our bodies, such as our heels and coccyx. And it is known in the nursing home industry that there are certain areas of our bodies where we would be at risk of developing pressure sores. How are they to prevent them? When a resident is first admitted, a skilled nursing facility has a duty to do a nursing assessment of the resident from head to toe. And when they do that initial nursing assessment, which is a regulatory requirement, they must do a full evaluation that includes doing what's called a Braid and Skin Assessment. In most skilled nursing facilities, they use a "Braden Scale."

When a facility does a Braden scale skin assessment, a nurse determines if a resident is at risk of developing pressure sores. And if the resident is at risk, the skilled nursing facility must, per the federal regulations, develop a Care Plan to prevent the development of pressure sores. Also, both federal and state regulations explicitly state that if someone comes into a skilled nursing facility without a pressure sore, and then they develop one, that facility is in trouble. Skilled nursing facilities have a legal duty to provide all available care and services to prevent a pressure sore from forming because pressure sores are considered "never events," – meaning a preventable event that should never happen.

It would be wrong to say that pressure sores are usually unintentional as if it's a random accident that just happens. Pressure sores are always the product of a facility that is understaffed and thus neglect the resident by failing to provide care and services that the resident needs. And neglect is a form of abuse.

When I see cases involving pressure sores, that raises a red flag for me as an attorney that there's probably issues of neglect, failure to provide care and services, and understaffing. Don’t our parents and seniors deserve better?