Bed Sores Should Never Happen – Medicare Won’t Pay If They Do

September 4, 2013

Bed Sores, Decubitus Ulcers, Pressures Ulcers – Whatever You Call Them They Are Never Events


Some years ago, the Centers for Medicare and Medicaid Services placed bedsores on a list of never events.  Never events, simply put, are things that should never happen; they are preventable and generally occur in the face of neglect. The neglect can be a form of nursing home abuse, medical malpractice in hospitals, or failure to take care of a patient properly in home health care.  Not only should never events not happen, but when they include such things as bed sores, items left in patients and other similar preventable mistakes, Medicare and Medicaid will not pay for them. The view is that if a provider causes the harm through its own negligence, it shouldn’t be paid for treating it.

What is a Bed Sore?

Bed Sore - Nursing Home Abuse

Formation of Bed Sores – Click for Full Size


A bed sore is a wound that is caused by a part of the body pushing against a surface for a long period of time.  Essentially, these injuries occur when a person is laying or sitting in the same position long enough that a wound develops.

Bed sores develop in four different stages:

  1. Skin discoloration (blanching) in a specific area. In darker skin the discoloration might not be obvious. Sometimes the area is quite sore and feels different from surrounding areas when touched.
  2. At this point the sore is an open wound. It might be a blister. The skin is damaged or lost. This is quite painful for the patient.
  3. Now the sore is quite deep. Dead tissue might be apparent and a lot of skin in the area is lost. Fat may be visible. At this point you cannot see bone, tendon or muscle. The pain has increased.
  4. The wound is essentially a tunnel into the body. Bone, tendon and/or muscle are visible. The tissue damage is very deep. It probably goes without saying that the pain is extensive.

Preventing Bed Sores

The best way to prevent bed sores is to keep the body from laying or sitting in one place for long periods of time. People who are unable to move themselves need to be moved. The most likely spots to develop pressure sores are on areas where bones protrude, so the heels, tailbone, hips or ankles.  Once pressure ulcers develop they are slow to heal, and if serious enough can cause infection and even death.

When a person is admitted to a nursing home, hospital, or under care at home, she needs to be assessed for her risk of bed sores.  If she is unable to move all or part of her body, then she is at great risk, and needs to be cared for properly. Those who have thinner skin due to medication or for other reasons are also at risk for bed sores. In addition, it is important to make sure the patient has proper nutrition and hydration, since both can assist in the prevention of bed sores.

Contact Us

Bed sores are not always caused by neglect, or malpractice, but frequently they are. If you or a loved one has developed a bed sore due to improper care in a nursing home, hospital, or other medical care situation, please contact the Pennsylvania nursing home abuse lawyers and Philadelphia medical malpractice attorneys of Lowenthal & Abrams.



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