Bedsores in Nursing Homes: When Pressure Injuries Become Neglect

Last Updated: September 14, 2026

In Illinois your family proves a bedsore neglect claim by showing the care the nursing home missed, such as the turning or skin checks in the care plan, and that the missed care caused the wound. The wound by itself does not prove neglect. A nurse or physician who reviews the chart usually supplies that opinion.

“Dad has a sore on his tailbone. Does that mean the nursing home neglected him?” The question comes up after a visit, when a son or daughter sees a wound on a parent’s heel or tailbone and wants to know what it means. In Illinois the answer turns on proof: the family shows the care that was missed and that the missed care caused the wound.

Under the Illinois Nursing Home Care Act, neglect is a facility’s failure to provide, or willful withholding of, adequate care that a resident needs to avoid physical harm, mental anguish, or mental illness. That care includes medical care, personal care, and help with the activities of daily living (210 ILCS 45/1-117). This article explains how pressure injuries develop and are staged, what a care plan covers, and which records answer the question. It ends with what to do after a visit like that one, whether the facility is in Peoria or anywhere else in central Illinois.

How Does a Bedsore Develop?

A bedsore forms when skin and the soft tissue under it press against a harder surface, such as a bed or a chair, for a prolonged time. The pressure reduces the blood supply to that spot, and without enough blood the tissue can become damaged or die (MedlinePlus, Preventing Pressure Injuries). Bedsores commonly form where bone is close to the skin: the heels and ankles, the tailbone, the hips, the elbows, the shoulder blades and the back of the head. MedlinePlus lists the residents who are more likely to develop one (How to Care for Pressure Sores):

residents who spend most of the day in a bed or a chair with little movement;
residents who cannot move without help;
older adults, and residents with fragile skin;
residents who cannot control bladder or bowels;
residents who do not get enough nutrition.

Repositioning, mattresses and cushions that relieve pressure, skin care, daily skin checks, and enough food and water are the measures MedlinePlus lists to prevent them.

What Are the Stages of a Pressure Injury?

Pressure sores are grouped into four stages by severity (MedlinePlus, How to Care for Pressure Sores):

Stage 1: a reddened, painful area that does not turn white when pressed; the skin may be warm or cool, firm or soft.
Stage 2: the skin has blistered or formed an open sore.
Stage 3: an open, sunken sore, a crater, with damage to the tissue below the skin; body fat may be visible.
Stage 4: a sore so deep that it has damaged muscle and bone, and sometimes tendons and joints.

Two other types do not fit the stages. A sore covered in dead skin, which hides how deep it goes, is called unstageable. A deep tissue injury starts in the tissue below the skin, may look dark purple or maroon, and can quickly become a Stage 3 or Stage 4 sore.

Advanced sores are slow to heal, and Stage 3 and Stage 4 sores are harder to treat and can take a long time to heal. A pressure sore can also cause a serious infection, and some of those infections are life-threatening (MedlinePlus, Pressure Sores). Advanced bedsores in a nursing home resident are a reason to ask what the facility did to prevent them. The firm’s page on the warning signs that a facility may be failing a resident lists the other signs to watch for.

Does a Bedsore Mean the Nursing Home Neglected My Parent?

The answer is in the resident’s care plan and in whether the facility followed it. Prevention lives in that plan: how often the resident is turned and repositioned, the mattress or cushion in use, nutrition and hydration, skin care, and how often the skin is checked. The turning schedule comes from the plan and differs from resident to resident. Federal nursing home rules, 42 CFR 483.25(b)(1), require a facility to give each resident care to prevent pressure injuries, so that the resident does not develop one unless the resident’s clinical condition made it unavoidable. That care is based on the facility’s assessment of the resident, and a resident who has a pressure injury receives treatment to promote healing, prevent infection and prevent new ones.

In an Illinois lawsuit the federal quality-of-care rule is evidence of what adequate care looks like; the family still proves what the facility failed to do and that the failure caused the wound. The care plan is the measuring stick: a facility that wrote a turning schedule and skin checks into the plan and then skipped them has left the gap in its own records. Staffing records answer the next question, how many aides were on the floor for how many residents during the days the wound developed.

What Evidence Does a Bedsore Neglect Case in Illinois Rest On?

A bedsore neglect case is built from records:

the medical chart showing when the wound appeared and how it changed;
the turning and repositioning logs;
the nutrition assessments;
the wound care notes;
the staffing records for the days in question.

Dated photographs of the wound show what the chart describes.

Expert medical testimony is often essential in these cases to establish that the bedsores resulted from inadequate care rather than unavoidable medical conditions. Understanding who is legally responsible for the neglect helps families identify all potential defendants, including the facility, its parent company, and any management organizations.

How Does a Nursing Home Defend a Bedsore Claim?

One defense a facility raises is that the resident was so frail or ill that the wound would have formed under any care. The federal quality-of-care rule allows that answer only where the resident’s clinical condition made the wound unavoidable. In an Illinois lawsuit the family carries the proof, and the records test the facility’s answer: any risk assessment done when the resident arrived, the care plan written from it, and the daily notes showing whether the plan was followed. A nurse or physician who reviews the chart usually supplies the opinion that connects the missed care to the wound.

What Should I Do After Finding a Bedsore on My Parent?

If you find a bedsore on a parent in a nursing home, start with the nurse on duty. Ask how the wound started, what treatment it is getting, what is being done to prevent more, and whether your parent’s doctor has been told. Write down the answers and the date, and with your parent’s agreement photograph the wound. Request a copy of the care plan and any wound assessment records. If the facility does not answer or the wound is getting worse, a Peoria nursing home injury attorney can request the records for you.

Call 309-673-0069 and describe what you saw and what the staff told you; you can call before the facility hands over any records. Robert Parker reviews nursing home injury claims as part of the firm’s Peoria personal injury practice and personally handles every case the firm accepts.

Need a lawyer? This article is part of our Peoria Nursing Home Injury Lawyer practice area. Call Parker & Parker at 309-673-0069 for a free consultation.

Frequently Asked Questions

Does a bedsore prove nursing home neglect in Illinois?

A pressure injury does not by itself prove neglect in Illinois, so the wound is where the questions start. Your family proves two things: the care the facility failed to give, and that the failure caused the wound. A nurse or physician who reviews the chart usually supplies the opinion that ties the missed care to the wound.

Is there a two-hour turning rule for Illinois nursing home residents?

The federal quality-of-care rule, 42 CFR 483.25(b)(1), requires care to prevent pressure injuries based on the facility’s assessment of each resident and sets no turning interval. The turning and repositioning schedule for each resident is written into that resident’s care plan and differs from resident to resident. In a case the question is whether the facility followed the plan it wrote.

What records should I ask an Illinois nursing home for after finding a bedsore?

Ask for the care plan, the skin assessments, the wound care notes, the turning and repositioning records, and the nutrition assessments. With your parent’s agreement, photograph the wound, and write down the date and what the staff said.