It was also a departure from good practice not to provide passive range of motion in the lower extremities, given that passive range of motion helps to improve circulation and thereby promotes wound healing.  The staging of the ulcer should have been changed when it grew in size and eschar was seen, which would have mandated that adjustments be made to the plan of care. NEW YORK SUPREME COURT APPELLATE DIVISION December 3, 2015

  The eighty-one year-old patient was transferred back and forth between the hospital and the nursing home for problems with her skin and other issues.  After her passing the family sued. The New York Supreme Court, Appellate Division, turned down the defendants' petition for dismissal of the lawsuit.

  The family's expert geriatrician pointed out that the documentation was spotty as to the patient being turned and repositioned every two hours.  An immobile patient on a ventilator is more challenging, but still can be given pressure relief with pillows, wedges and other devices used as positioning aids.  Only when accepted standards for skin care can be proven to have been fully met is it appropriate to relate the patient’s skin breakdown solely to her co-morbidities and not to lapses by the patient's caregivers, the family's expert went on to state. Pichardo v. Hospital, __ N.Y.S.3d __, 2015 WL 7766864 (N.Y. App., December 3, 2015).

http://www.nursinglaw.com/decubitus3.htm