A bedsore, also called a pressure ulcer or pressure injury, is an injury to the skin and tissue caused by too much pressure on one area for too long. The pressure reduces blood flow, which can damage the skin and the tissue underneath it. Bedsores commonly develop over bony areas such as the heels, hips, ankles, back, and tailbone (MedlinePlus, 2024).
People in nursing homes and rehabilitation facilities may be at higher risk because they are often in bed or a wheelchair for long periods of time or cannot change positions without help. Poor nutrition, fragile skin, poor circulation, and problems controlling the bladder or bowels can also increase the risk (MedlinePlus, 2024).
Bedsores are generally divided into four stages based on how much damage has occurred:
Stage 1: The skin is not broken, but there is redness or discoloration that does not go away when pressed. The area may also be painful or feel warmer, cooler, firmer, or softer than the surrounding skin.
Stage 2: The top layers of skin have been damaged. The area may look like an open sore or blister.
Stage 3: The wound has become deeper and extends into the tissue beneath the skin. It may look like a deep hole or crater, and body fat may be visible.
Stage 4: The wound is very deep and may cause damage to muscles, tendons, joints, or bones.
Some bedsores are considered unstageable because dead tissue covers the wound, making it difficult to determine how deep it is. A deep tissue pressure injury occurs when there is damage underneath the skin and may first appear as a dark red, maroon, or purple area (MedlinePlus, 2024).
Many bedsores can be prevented with proper care. Prevention may include regularly changing a person's position, checking the skin for early signs of damage, keeping the skin clean and dry, managing incontinence, providing proper nutrition, and using special mattresses or cushions to reduce pressure (AHRQ, 2025; MedlinePlus, 2024).
Federal regulations require nursing homes to provide care consistent with professional standards to help prevent pressure ulcers. If a resident already has a pressure ulcer, the facility must provide necessary treatment to promote healing, prevent infection, and help prevent additional sores from developing (CMS, 2024).
Treatment depends on how serious the bedsore is. It may include taking pressure off the affected area, regularly repositioning the person, cleaning and covering the wound, removing dead tissue when necessary, treating infection, and making sure the person receives adequate nutrition. Serious wounds may require specialized wound care or surgery (MedlinePlus, 2024).
Finding and treating a bedsore early can make a significant difference. Stage 1 and Stage 2 sores are often easier to treat, while Stage 3 and Stage 4 wounds can be much more difficult and take longer to heal. Untreated bedsores can also lead to serious infections, some of which can become life-threatening (MedlinePlus, 2024).
Not every bedsore means that a nursing home or rehabilitation facility provided improper care. Some pressure injuries may develop even when appropriate precautions are taken.
However, problems may arise when staff fail to recognize that a resident is at risk, regularly reposition someone who cannot move independently, monitor changes in the skin, provide appropriate pressure relief, or properly treat a developing wound. In these situations, a preventable bedsore may develop or an existing wound may become much more serious.
If you or someone close to you has been in a hospital, nursing home, rehabilitation center or other care facility and suffered a bedsore that you believe could have been prevented, or was not properly cared for, call our injury team at the Law Offices of Judy Greenwood, for a FREE CONSULTATION at 215-557-7500.
Agency for Healthcare Research and Quality. (2025). Skin Under Pressure: Preventing Pressure Injury.
https://www.ahrq.gov/hai/tools/mrsa-prevention/mdro-ltc/pressure.html
Centers for Medicare & Medicaid Services. (2024). State Operations Manual: Appendix PP – Guidance to Surveyors for Long Term Care Facilities. https://www.cms.gov/medicare/provider-enrollment-and-certification/guidanceforlawsandregulations/downloads/appendix-pp-state-operations-manual.pdf
MedlinePlus. (2024). How to Care for Pressure Sores. U.S. National Library of Medicine.
https://medlineplus.gov/ency/patientinstructions/000740.htm
