Pleasant Law Blog (Insurance Claims, Medical Misakes, and Nursing Home Claims)

When the Nursing Home Claims Pressure Sores are Inevitable or Unavoidable

Often when I am reviewing potential Nursing Home Abuse, Neglect, Injury or Wrongful Death cases, the client tells me that the nursing home involved has told them that (with respect to the particular resident's pressure sores) pressure sores or pressure ulcers are "inevitable" or "unaviodable."  Depending on the severity of the pressure sore (i.e., Stage 3, Stage 4, etc.), this kind of sentiment may or may not carry much weight.  For example, Stage 4 pressure ulcers are almost never unavoidable if proper care is given.  I believe nursing homes inform the family of a resident suffering from pressure sores that those pressure sores are inevitable in order to discourage the family members from realizing that improper care is being given.  The Medicare Regulations applicable to nursing homes actually do make use of the term "unavoidable" in the context of pressure sores.  However, the unavoidability of pressure sores is absolutely dependent upon the nursing home facliity's first having provided and exhausted all possible care interventions before a pressure ulcer can be classified as unavoidable.  If a pressure sore is not unavoidable, there is liability.  So, lawyers examining nursing home claims should pay close attention to the available guidance for nursing home surveyors in this respect.  Again, before a nursing home lawyer can claim on behlaf of his nursing home client that a pressure sore was unavoidable, he must first be sure that all necessary treatment was given.  Until that point, "unavoidability" is not even a factor.  This is true whether the nursing home is in North Carolina or in another state - as long as the facility accepts Medicare Reimbursements, it is subject to the Medicare Regulations, and the previous analysis applies.  A careful analysis of pressure sores in a nursing home cases is very important.  There are pressure sores involved in almost every Nursing Home Neglect or Wrongful Death case I screen, and most often these pressure sores have resulted in serious infections (e.g., sepsis or blood infection).  If you or someone you love is in a North Carolina nursing home and having problems with pressure ulcers, whether in a facility in the Raleigh, Wilmington, Fayetteville, Charlotte, Greensboro, or Winston-Salem area; feel free to contact my office for assistance evaluating your rights.