Nursing Home Bedsores in New York

Are you or a loved one suffering from painful and debilitating bedsores, also known as pressure ulcers, in a New York nursing home, hospital, or assisted living facility? You are not alone. Bedsores are not simply an unfortunate side effect of aging or illness. In many cases, they are a stark indicator of neglect and inadequate care.

The statistics are alarming. A 2019 report by The Long Term Care Community Coalition revealed that approximately 8.6% of New York nursing home residents were suffering from unhealed pressure ulcers – one of the highest rates in the entire United States. This translates to an estimated 9,000 residents enduring the pain and dangers of pressure ulcers at any given time within New York State alone.

Bedsores are far more than mere bruises or sores. They can cause excruciating pain, open the door to life-threatening infections, and in the most tragic circumstances, contribute to a patient’s death. If you suspect that severe bedsores have developed due to substandard care, it’s important to understand your rights and options.

If you believe that severe bedsores have developed due to inadequate care, consulting an experienced New York bedsore lawyer can help you understand your legal options and seek justice. A lawyer can review the details of your case, explain your rights, and guide you through the legal process to hold the responsible parties accountable.

Bedsores, also referred to as pressure sores or pressure ulcers, are lesions on the skin and underlying tissue caused by prolonged pressure on the skin. They frequently occur among those confined to beds, wheelchairs, or otherwise limited in mobility. Typical sites for bedsores include bony areas such as the hips, heels, shoulders, elbows, and tailbone (sacrum).

Because they develop in stages, early detection is critical. Bedsores can quickly progress from mild skin irritation (Stage I) to severe wounds exposing muscle and bone (Stage IV). Complications from untreated bedsores can include:

• Infections: Open bedsores are highly vulnerable to bacterial infections, including cellulitis (infection of the skin and soft tissues) and sepsis (a life-threatening bloodstream infection). Infections can spread rapidly and become extremely difficult to treat, particularly in individuals with compromised immune systems.
• Osteomyelitis (Bone Infection): Stage 4 bedsores, in particular, can extend down to the bone, leading to osteomyelitis. This is a severe bone infection that can require prolonged antibiotic treatment, surgery, and in severe cases, amputation.
• Sepsis: Sepsis is a systemic, life-threatening condition that arises when the body's response to an infection spirals out of control, causing widespread inflammation and organ dysfunction. Bedsores are a significant risk factor for sepsis, and sepsis from a bedsore can be fatal.
• Pain and Suffering: Bedsores are intensely painful and can significantly impair a person’s quality of life. The pain can be constant, debilitating, and interfere with sleep, mobility, and overall well-being.
• Delayed Healing and Prolonged Hospitalization: Severe bedsores can take months or even years to heal, even with aggressive treatment. This can lead to prolonged hospital stays, increased medical costs, and significant emotional distress for both patients and their families.
• Death: In the most severe cases, particularly when infections like sepsis develop, bedsores can ultimately contribute to a patient’s death.

There are various factors that often lead to bedsores:

• Limited Mobility: Individuals who cannot shift their position on their own—due to paralysis, age-related weakness, or post-surgery immobilization—are especially vulnerable. Prolonged pressure against the same area of the body can compromise blood flow, leading to tissue damage.
• Poor Nutrition: Malnourishment makes the skin more fragile and slower to heal. A facility’s failure to monitor or maintain adequate food intake can drastically heighten the risk of bedsores.
• Insufficient Hygiene: Damp conditions, particularly incontinence that goes unaddressed, will weaken the skin and promote faster breakdown. Proper hygiene protocols—keeping patients clean and dry—are central to bedsore prevention.
• Friction and Shearing: If aides drag a patient across a mattress or wheelchair instead of using proper lifting techniques, friction injuries can occur. Similarly, when parts of the skin are pulled in opposite directions (like sliding down in bed), deep tissue injuries may develop.
• Lack of Staff Training: Caregivers who lack training in turning and positioning techniques or in identifying early-stage pressure ulcers are more likely to miss crucial preventive steps.

Under 42 C.F.R. § 483.25, facilities receiving Medicare or Medicaid funds must maintain or improve a resident’s health status whenever possible. This includes positioning the patient, providing necessary devices for relief, ensuring adequate nutrition, and cleanliness. Any deviation from these federally mandated care standards can lay the groundwork for a negligence or malpractice claim.

Although not every instance of bedsores equates to legal negligence, many bedsores are, in fact, avoidable when caregivers follow well-established preventive protocols. Pressure ulcer prevention typically involves:

• Repositioning or turning bedridden patients every two hours.
• Maintaining clean and dry bed linens and clothing.
• Ensuring adequate nutrition and hydration, which helps preserve skin integrity.
• Using specialty mattresses or pressure-relieving devices, such as foam wedges or overlays.

When these measures are consistently followed, the risk of pressure ulcers goes down significantly. In practice, large care facilities often fail to meet these standards because of:

• Understaffing
• Poorly trained aides or nurses
• Cost-cutting measures
• High turnover rates in the healthcare workforce

Because bedsores can escalate from Stage I to Stage IV in as little as days or weeks, a facility that allows a resident to develop severe, unhealed pressure ulcers often fails to meet basic care standards.

A lawsuit can arise if a bedsore develops due to negligence or other legal violations. In New York, negligence can occur when a facility or staff members do not follow recognized procedures. The facility has a duty to maintain a safe environment and to provide care consistent with accepted standards. When a patient experiences harm from a preventable bedsore, legal claims may arise under personal injury law or medical malpractice law.

• Personal Injury Claims: These can involve allegations that the facility or staff failed to provide care, monitoring, and measures to avoid harm. A personal injury claim can seek damages for pain, suffering, and related costs.
• Medical Malpractice: In some cases, bedsores result not only from general negligence but from deviations from recognized medical standards by licensed professionals (physicians, nurses, nurse practitioners). For instance, failing to diagnose a Stage II bedsore promptly or not ordering a specialized bed can be considered malpractice if it deviates from what a competent professional would do under similar conditions. Medical malpractice suits in New York typically require plaintiffs to prove:
  • 1). A departure from accepted practice among similarly situated professionals; and
  • 2). Injury as a direct result of that departure. For bedsores, the question is: Did a medical professional depart from the standard medical protocol for preventing or treating pressure ulcers?
  For example, in O’Connor v. Kingston Hospital (App. Div. 3d Dept, 2018), a 77-year-old patient, Robert O’Connor, developed multiple stage II–IV bedsores during a two-week hospital admission. His estate filed a medical malpractice lawsuit, alleging that the hospital staff failed to turn him every two hours, did not provide a pressure-relieving air mattress, and neglected to recognize and address his high risk for pressure ulcers. An Ulster County jury found the hospital liable for malpractice, determining that these omissions were departures from accepted standards of nursing care, which led to O’Connor’s severe sores and prolonged pain.
• New York Public Health Law § 2801-d: This statute specifically protects residents in nursing homes or other covered facilities by granting them the right to sue if the facility deprives them of any right or benefit conferred by contract, statute, regulation, or a duly approved plan of care. For example, the right to be free from avoidable pressure ulcers falls under the scope of rights that the facility must ensure.
  • A facility that cannot demonstrate that it took “all necessary precautions” may be liable.
  • If liability is established, the resident may recover actual damages, plus attorney’s fees in some instances.
  • Courts sometimes impose a minimum damage amount if a violation is found, even if the resident’s injuries are hard to quantify.

In Rosenblatt v. Center for Nursing & Rehabilitation, Inc. 2021 NY Slip Op 50166(U) (Sup. Ct. Kings Cnty. 2021) the estate of Hercules Smith sued the nursing home for violating the resident’s rights after Mr. Smith (who had dementia) developed an avoidable Stage IV bedsore on his lower back. The jury found that the facility had violated Mr. Smith’s right to “skin integrity” – i.e., his right to be free from avoidable pressure ulcers – and failed to provide necessary treatment to promote healing. Those statutory violations were deemed a substantial factor in causing his injuries, which included infection and pain. Because the nursing home could not prove that it had taken “all necessary care” to prevent the bedsore, it was liable under PHL § 2801-d.

Claims can also reference the Federal Nursing Home Reform Act, 42 U.S.C. §§ 1395i-3, 1396r, which requires facilities receiving Medicaid or Medicare funds to meet standards for care. This includes prevention measures for pressure ulcers.

If a patient has questions about legal rights, consulting an experienced New York bedsore lawyer can be a way to learn about available steps. A lawyer can help gather records, assess care plans, and advise on whether a lawsuit might succeed.

Liability for bedsores can involve several parties. The responsibility often starts with the facility, but it can also involve individuals if their acts or omissions contribute to the harm. Possible defendants can include:

• Nursing Home Administration: The facility’s operator must have policies in place to prevent bedsores. Policies should address regular repositioning, nutrition, hygiene, and oversight. A facility can be liable if it does not enforce these policies.
• Hospital Administration: A hospital that admits patients with limited mobility must have care measures to reduce the risk of sores. If staff do not follow protocols, the hospital administration can face liability.
• Staff Members: Individual nurses, aides, or other staff might be liable if they ignore a patient’s requests for help or fail to adhere to care instructions.
• Physicians: In some instances, a physician might fail to diagnose or treat a developing bedsore. If a physician disregards recognized practices, liability may result under a malpractice theory.
• Third-Party Contractors: Some facilities use outside staffing agencies. If an outside provider fails to meet standards, it can share liability.

When exploring liability, consulting an experienced New York bedsore lawyer can help. A lawyer can assess records, discuss facility policies, and examine whether staff members complied with state and federal regulations. This can form the basis of a legal claim seeking damages.

While no two lawsuits are identical, a general roadmap of a bedsore claim in New York looks like this:

You meet with an experienced New York bedsore lawyer to discuss the facts and gather preliminary documents. The attorney assesses whether the injuries are likely a result of negligence or malpractice.

• Obtain medical records, care logs, incident reports, and facility policies.
• Interview witnesses, including family members and staff.
• Engage medical experts to review the care and assess whether it met the standard of care.

Your attorney prepares and files a Complaint in the appropriate court. The defendants typically respond with an Answer.

• Both sides exchange documents, depose witnesses, and consult experts.
• Facility records, staff schedules, and internal policies often become key pieces of evidence.

Courts may hold conferences to explore settlement possibilities or to narrow the issues for trial.

Many defendants’ insurance carriers prefer to settle if the evidence strongly suggests liability. If settlement terms are acceptable, the lawsuit ends here.

If no settlement is reached, your case proceeds to trial, where a judge or jury will determine negligence and, if found, the damages owed.

A verdict for the plaintiff could result in an award of damages. The defense may appeal, and appellate courts can modify or uphold the decision.

Overall, the process can range from months to a few years, depending on the complexity of the case, the court’s schedule, and the willingness of the parties to settle.

Time limits, called statutes of limitations, govern lawsuits. In New York, the applicable limit depends on the legal theory:

• Medical Malpractice: Generally, a claim must be filed within two years and six months from the date of the malpractice. If the matter involves continuous treatment, the time may start once that treatment ends. As seen in Pacio v. Franklin Hospital, 63 A.D.3d 1130 (N.Y. App. Div. 2009), whether a claim qualifies as malpractice or ordinary negligence can drastically affect this deadline. In Pacio v. Franklin Hospital, the plaintiff, Robert Pacio, developed pressure ulcers during his hospitalization and subsequent care. He filed a lawsuit alleging both negligence and medical malpractice. The distinction between these claims significantly impacted the applicable statute of limitations. Under New York law, medical malpractice actions are subject to a 2½-year statute of limitations, while ordinary negligence claims have a 3-year statute. The court emphasized that determining whether a claim constitutes medical malpractice or negligence depends on the nature of the duty breached. In Pacio's case, the court concluded that the hospital's failure to adhere to its own protocols for pressure ulcer prevention was integral to the medical treatment provided. Therefore, the claim was classified as medical malpractice, rendering it subject to the shorter 2½-year statute of limitations. As a result, Pacio's claim was dismissed as time-barred. This case highlights the critical importance of consulting an experienced New York bedsore lawyer who understands the nuanced distinctions between negligence and medical malpractice claims. Such expertise is essential to ensure compliance with the appropriate statute of limitations and to preserve the right to seek legal recourse.
• Negligence: If a claim is not classified as malpractice, the time limit can be three years from the date the injury occurred.
• Wrongful Death: If a person passes away from bedsore complications, representatives of the estate may file a wrongful death claim within two years from the date of death.
• Notice of Claim for Public Entities: If a publicly funded or state-run facility is involved, you may need to file a notice of claim within 90 days of the incident or discovery of the injury.
• Tolling Exceptions. If the victim was mentally incapacitated (e.g., advanced dementia) or a minor, the clock might pause (or “toll”) until they regain capacity or reach adulthood. Fraudulent concealment by the facility may also affect filing deadlines.

Because of these complex legal rules, consulting an experienced New York bedsore lawyer can provide insight into how the statute of limitations applies. A lawyer can also help gather documentation and meet necessary deadlines.

New York law allows various forms of compensation. The nature of the damages will depend on the harm. Possible categories of recovery can include:

• Medical Costs: This can involve expenses related to treatment of the sores, surgeries, medication, and therapy. Documentation of bills is relevant in these claims.
• Pain and Suffering: Bedsores can cause physical harm, infections, and other harm. A lawsuit can seek monetary damages for these losses if they result from negligence or malpractice. In O’Connor v. Kingston Hospital, O’Connor, developed severe bedsores during a two-week hospital stay. His estate sued, alleging inadequate preventive care. The jury found the hospital negligent, leading to O’Connor's prolonged pain. They awarded $500,000 for pain and suffering over the two months before his death. The appellate court upheld this award, finding it reasonable given the severity of his condition.
• Lost Wages: If a person had to leave work or lost income because of a bedsore-related condition, compensation can be pursued.
• Future Costs: Some injuries require on-going treatments. A claim may include projections of future expenses linked to the condition.
• Punitive Damages: In limited instances, if the conduct is very egregious, courts may permit punitive damages. This category is not common, but it arises if there is evidence of reckless conduct.

Under N.Y. Public Health Law § 2801-d, courts may award damages for injuries linked to violations of resident rights in nursing homes. The facility must provide a safe standard of care. If a resident was deprived of that, damages may include attorney fees and costs in some cases. A court may impose a minimum award under certain circumstances.

Reviewing medical records, speaking with witnesses, and studying the facility’s policies are steps to determining possible damages. Consulting an experienced New York bedsore lawyer can guide a person through these tasks.

Insurance coverage can reduce out-of-pocket costs for an individual. In some lawsuits, a facility or an insurer might argue that a plaintiff’s damages should be offset by what insurance already covered. This concept arises under rules that try to prevent a person from recovering the same costs twice.

In New York, there is a principle under CPLR 4545 referred to as “Collateral Source” setoff. Under this rule, if a plaintiff receives compensation from a collateral source like an insurance plan, a court can reduce the verdict by amounts covered by that plan. However, the application of this rule involves a process to verify the source of the payment and the actual amounts covered.

If a case involves the offset rule, a court may review each category of damages. Costs that insurance did not pay may be recoverable in full. There can also be questions about the nature of coverage, whether future costs will remain covered, and whether reimbursement claims from insurers must be satisfied.

Claimants often need guidance about how insurance may interact with a settlement or verdict. Consulting an experienced bedsore attorney in New York can help a person understand how these offsets might apply and how to address any liens placed by insurance carriers.

Q. How long do bedsore lawsuits take?

A. The timeline varies. Factors include the complexity of medical records, the number of parties involved, and the scheduling of court proceedings. Some settle at an early stage, while others continue for a longer period.

Q. Is a bedsore always a sign of negligence?

A. Not in every instance. Some medical conditions can cause wounds despite adequate care. However, many bedsores are preventable with regular monitoring, repositioning, and treatment. A review of records and expert opinions can clarify whether negligence was present.

Q. Who pays if I win my case?

A. Facilities typically carry liability insurance. In most cases, the insurance carrier pays. In some instances, the facility itself may be self-insured or partially self-insured.

Q. Should I report a bedsore complaint to any government agency?

A. You can file a complaint with the New York State Department of Health if a nursing home or other facility is involved. The Department may conduct inspections or investigations. This process can occur alongside any legal action you choose to pursue.

Q. Does having a pre-existing medical condition affect a bedsore claim?

A. Pre-existing conditions can influence how easily someone develops bedsores, but they do not negate possible liability. If the facility did not follow recognized preventive measures, a claim may still be possible, regardless of underlying health issues.

For over 20 years, Stephen Bilkis & Associates has advocated for the rights of injured New Yorkers, including residents of nursing homes and hospitals who suffer harm due to inadequate care. If you or a loved one suffered a severe bedsore while residing in a nursing home or receiving care at a health care facility, consulting an experienced bedsore attorney serving New York is an important step toward protecting your rights. Contact Stephen Bilkis & Associates at 800.696.9529 to schedule a free, no-obligation consultation regarding your case. We serve nursing home abuse victims and their families in the following locations: Westchester County, Suffolk County, Staten Island, Bronx, Brooklyn, Long Island, Manhattan, Nassau County, and Queens.