Bedsores that develop or worsen in a nursing home are often a direct sign of neglect. Illinois and federal law both say so. This guide will walk you through what bedsores are, what the law requires, what warning signs to watch for, and what your family can do right now. If you or your loved one is in a facility in Cook County, DuPage County, Kane County, Lake County, McHenry County, or Will County, the Law Offices of David H. Brinton is available to help,contact us today for a free consultation.
Disclaimer: This article is for general informational purposes only and does not constitute legal advice. You should not act or refrain from acting based on any information in this article without seeking advice from a licensed attorney about your specific situation. Reading this page or contacting our firm through this website does not create an attorney–client relationship.
What Is a Bedsore, and Why Does It Matter Legally?
A bedsore — also called a pressure ulcer or pressure injury — forms when sustained pressure cuts off blood flow to the skin. They develop on bony parts of the body: the tailbone, heels, hips, shoulder blades, and the back of the head. Residents who are bedridden, use a wheelchair, or can’t reposition themselves are most at risk.
There are four main stages, and the stage matters — both medically and legally:
- Stage 1 — Skin is intact but red or discolored; it doesn’t fade when you press on it
- Stage 2 — Skin has broken open; a shallow wound or blister has formed, often painful
- Stage 3 — The wound goes deeper into the tissue beneath the skin; it is a serious and harder-to-heal wound
- Stage 4 — The most severe; bone, tendon, or muscle may be exposed; risk of life-threatening infection is high
- Unstageable — The wound is covered in dead tissue and can’t be accurately measured without medical treatment
If your loved one has a Stage 3 or Stage 4 bedsore, that wound did not appear overnight. It developed over time, meaning it was ignored for a long period.
Are Bedsores Always Preventable?
In most cases, yes. And federal law agrees.
Under CMS Tag F686 (42 CFR §483.25(b)(1)) — the federal standard that every Medicare and Medicaid-certified nursing home must follow — a pressure ulcer is considered unavoidable only if the facility can prove it:
- Assessed your loved one’s skin and risk factors on arrival and regularly after that
- Created an individualized care plan based on those assessments
- Followed through on that plan consistently
- Adjusted the plan when it wasn’t working
Most facilities that allow bedsores to reach Stage 3 or Stage 4 cannot meet it. When a nursing home can’t show that documentation, “unavoidable” becomes very difficult to defend.
What Illinois Law Requires
Illinois nursing homes are governed by the Illinois Nursing Home Care Act, 210 ILCS 45. Under this law, “neglect” is defined as the failure to provide — or the deliberate withholding of — adequate medical care, personal care, or services necessary to prevent physical harm.
Section 1-117 (210 ILCS 45/1-117) specifically lists assistance with movement as part of “personal care.” This is not a technicality. Failing to reposition a resident — one of the most basic, well-established methods of preventing bedsores — can constitute neglect under Illinois law.
The Illinois Department of Public Health enforces these standards. Fines for violations range from $2,200 to $25,000 per violation, and repeat or serious offenders can face license suspension or revocation.
Illinois also incorporates the federal CMS standards by reference. 77 Ill. Adm. Code §300.1210 requires nursing homes to provide adequate nursing care, including skin integrity monitoring and wound care protocols. A bedsore at an advanced stage is treated, under both state and federal law, as evidence of failure.
Why Do Bedsores Actually Happen in Nursing Homes?
Bedsores happen when residents aren’t being moved, monitored, and nourished consistently. That comes down to one thing, most of the time: the staff isn’t doing it, because there isn’t enough staff, or the staff present aren’t being supervised or held accountable.
Common causes of preventable bedsores include:
- Missed repositioning — Immobile residents need to be turned at least every two hours; when staff skip this, pressure builds and skin breaks down
- Skipped skin assessments — Staff should be checking skin condition regularly; a wound caught at Stage 1 is far easier to treat than one caught at Stage 3
- Poor nutrition and hydration — Malnutrition and dehydration weaken the skin and impair healing; these are also independent signs of neglect worth investigating
- Delayed wound care — Once a wound forms, the facility is legally required to treat it promptly and document that treatment; failure to act accelerates the damage
- Understaffing — A facility without enough staff on each shift cannot complete repositioning schedules, assessments, or care plan updates; Illinois began enforcing staffing-based fines in 2025
Bedsores are among the most reported issues in Illinois nursing homes. You can learn how to check nursing home violations in Illinois directly through the IDPH database — and you don’t need an attorney to do it.
Warning Signs to Look for During Your Next Visit
Nursing homes don’t always call families when a wound develops. Some facilities hope it heals before anyone notices. Watch for these signs when you visit:
- Your loved one mentions pain, soreness, or a burning feeling in areas that press against the bed or wheelchair
- They are always in the same position and don’t appear to have been moved
- You notice an unusual odor from beneath clothing or bedding — this can signal an infected wound
- They develop an unexplained fever or sudden confusion, which can be signs of a wound-related infection like sepsis
- Staff are vague or defensive when you ask about bandages or wound dressings you notice
- You see redness, blistering, or open wounds on the tailbone, heels, hips, or shoulders when helping your loved one change or bathe
These are among the most common nursing home complaints that Illinois families report, and they are often the first clue that something more serious has been going on.
What to Do Right Now — Step by Step
If you find or suspect a bedsore, do these things in order:
- Take photos immediately — Date and time stamped; photograph the wound and its location on the body
- Write everything down — What you saw, when you saw it, which staff members were present, and exactly what they said when you asked about it
- Request the care plan and wound assessment records in writing — You have a legal right to your loved one’s medical records under Illinois law; put the request in writing so there is a record you asked
- Ask directly about the repositioning schedule — Is it written in the care plan? Is there a log showing staff followed it? The answers — or the absence of answers — matter
- File a complaint with IDPH — Call the Nursing Home Hotline at 1.800.252.4343 or file online at https://www.idph.state.il.us; you can do this anonymously
- Call a nursing home abuse attorney — An attorney can access records families cannot, identify what the facility was supposed to be documenting, and tell you quickly whether you have a claim
What Compensation May Be Available
If a nursing home’s neglect caused or worsened your loved one’s bedsores, you may be able to recover compensation for:
- All medical expenses — wound care, hospitalization, surgery, antibiotics, specialist visits
- Future healthcare costs if the injuries require ongoing treatment
- Pain and suffering your loved one endured
- Emotional distress
- If your loved one passed away, a wrongful death claim may be available under common law negligence
Injury claims for nursing home abuse and neglect in Illinois are commonly brought under the Illinois Nursing Home Care Act, which allows for attorney’s fees and costs on top of compensatory damages. In many cases, you do not pay legal fees unless your attorney wins.
How Can a Chicago Nursing Home Abuse Lawyer Help?
If you suspect your loved one is being abused in a nursing home, an attorney can help protect them and ensure they receive justice. A lawyer can investigate the situation, collect evidence, file lawsuits against the responsible parties, and negotiate with insurance companies to secure compensation for any medical expenses or pain and suffering endured by your loved one. A lawyer can provide important legal guidance and protect your loved one’s rights during this difficult time.
By seeking the help of an experienced attorney, you can help put a stop to nursing home abuse and ensure that those responsible are held accountable for their actions. It is important that we all take a stand to protect our elderly loved ones and help ensure they are living in an environment of safety and respect.
Please contact the Law Offices of David H. Brinton, LLC. You can call 312.445.4908 or contact us to set up your free consultation.
FAQ: Bedsores in Illinois Nursing Homes
Are bedsores automatically proof of neglect in Illinois?
Not automatically — but they are treated as strong evidence of it. Under 210 ILCS 45 and 42 CFR §483.25(b), a bedsore is presumed avoidable unless the facility can document it followed every required assessment, care plan, and intervention protocol. Most facilities that allow wounds to reach Stage 3 or 4 cannot produce that documentation.
My loved one was admitted with an existing wound. Is the nursing home still responsible?
Yes. The facility was still legally required to treat the existing wound and prevent it from getting worse. If a wound worsened under their care, that is still evidence of inadequate treatment — and it can still form the basis of a claim.
What is the difference between a “pressure ulcer” and a “pressure injury”?
They refer to the same condition. In 2016, CMS updated its terminology to “pressure injury” to cover both open wounds and intact skin damage. For legal purposes in Illinois, both terms fall under the same regulatory standards and the same obligations.
How fast can a bedsore develop?
A Stage 1 wound can begin forming within hours of sustained, unrelieved pressure — especially in residents with poor circulation, low body weight, or fragile skin. Progression to Stage 3 or 4 can happen within days if it isn’t caught and treated. This is exactly why daily skin assessments and regular repositioning aren’t optional, they’re legally required.
The nursing home told us the bedsore was “unavoidable.” What do we do?
Ask them to show you the documentation. “Unavoidable” under federal law has a specific clinical meaning — the facility must prove they assessed the risk, created an individualized plan, followed it consistently, and updated it when it wasn’t working. If they can’t produce that paper trail for every step, their defense is weak. An attorney can help you request and review those records.
Can family members file an IDPH complaint, or does it have to be the resident?
Anyone can file — family members, visitors, staff, or the resident themselves. You can call 1.800.252.4343 or file online. Complaints can be made anonymously.
How long does our family have to file a lawsuit in Illinois?
Illinois law imposes strict deadlines on nursing home neglect and negligence claims, and those deadlines can vary depending on how the case is filed. Do not wait for IDPH’s investigation to finish before consulting an attorney. The sooner you call, the more options your family has.