Bedsores and Falls in Arizona Nursing Homes and Assisted Living

By Joe Styler, editor (not an attorney). Updated October 17, 2026. Sources checked

Families who visit a parent in a nursing home or assisted living sometimes find a bedsore, or learn about a fall after the fact. Neither one is automatically neglect. Both are also things a facility is expected to work to prevent. This page explains what the federal rules say, what questions to ask, which signs need a doctor right away, and when an injury may become a legal matter in Arizona.

Which rules apply to which facility

Nursing homes that take part in Medicare or Medicaid must meet a set of federal requirements (42 CFR 483.1). Most of what follows comes from those rules. Assisted living centers and homes in Arizona are licensed by the Arizona Department of Health Services under state rules, which are different, so ask the facility which rules it is licensed under. Either way, Arizona’s vulnerable adult law can apply when neglect injures a resident.

What federal rules say about bedsores

Bedsores are also called pressure ulcers or pressure injuries. They can develop when skin and the tissue under it stay under pressure for a long time, which is why people who cannot easily change position are at higher risk.

The federal rule for nursing homes says that, based on a full assessment of each resident, the facility must ensure that a resident “receives care, consistent with professional standards of practice, to prevent pressure ulcers and does not develop pressure ulcers unless the individual’s clinical condition demonstrates that they were unavoidable” (42 CFR 483.25(b)(1)). A resident who already has a pressure ulcer must receive “necessary treatment and services” to promote healing, prevent infection and prevent new ulcers from developing.

Two things follow from that wording. First, the starting point is prevention, not treatment after the fact. Second, the rule itself recognizes that some pressure ulcers are unavoidable because of a resident’s medical condition. Whether a particular sore was avoidable is a medical question that usually needs the records and a qualified opinion.

What federal rules say about falls

The same regulation has a section on accidents. The facility must ensure that “the resident environment remains as free of accident hazards as is possible” and that “each resident receives adequate supervision and assistance devices to prevent accidents” (42 CFR 483.25(d)).

The rule does not say every fall is a violation. It asks whether the hazards and the supervision were what they should have been for that resident. A resident known to be at risk of falling, who was left to get up alone, is a different situation from a sudden fall by a resident with no history of falls.

Questions to ask the facility

Families can ask questions about a resident’s care. Asking calm, specific questions, and writing down the answers, is often the most useful thing a family can do. For a bedsore:

• When was the wound first noticed, and who noticed it?
• What does the care plan say about turning and repositioning, and how often is it done?
• How often is the skin checked, and where is that written down?
• Is a wound care nurse or a doctor following the wound, and what is the treatment plan?
• What has changed in the plan since the wound appeared?

For a fall:

• Was a fall risk assessment done, and what did it say?
• Where were staff when the fall happened, and how long was your family member on the floor?
• Was a doctor told, and were imaging or other tests ordered?
• What is being done to prevent another fall?

Nursing homes in Medicare or Medicaid must report alleged neglect and “injuries of unknown source” to their administrator and to state officials, within 2 hours when there is abuse or serious bodily injury and within 24 hours otherwise (42 CFR 483.12(c)(1)). You can ask in writing whether an injury was reported.

When a bedsore or fall may be neglect under Arizona law

Arizona defines neglect as “the deprivation of food, water, medication, medical services, shelter, supervision, cooling, heating or other services necessary to maintain a vulnerable adult’s minimum physical or mental health” (A.R.S. 46-451). Missed repositioning, wound care that did not happen, or a resident left without needed supervision can fit within that language, depending on the facts.

When neglect injures a vulnerable adult, A.R.S. 46-455 lets the person, or after a death the person’s estate, sue the person or business that was employed to provide care. An ordinary malpractice claim may also be possible, which requires proof that care fell below the expected standard and caused the injury (A.R.S. 12-563). Our page on nursing home neglect and abuse claims explains both paths and their deadlines.

Wondering whether a pressure injury or fall should have been prevented? Request a free case review.

Signs that need a doctor now

An infected wound can turn into a medical emergency. The CDC describes sepsis as “the body’s extreme response to an infection” and “a life-threatening medical emergency,” and it lists the skin among the common places the infections behind sepsis start. If a wound is spreading, draining, smells bad, or your family member has a fever, new confusion or trouble breathing, ask for a doctor to see them right away, and call 911 if it is an emergency. After a fall, new pain, trouble standing or walking, or a hit to the head are reasons to insist on an evaluation.

Our page on sepsis and infection claims explains how a missed or late response to infection is looked at under Arizona law.

What to do this week

1. Take dated photos of any wound or injury, if your family member agrees and it is safe to do so.
2. Write down the answers to the questions above, with dates and the names of the staff you spoke with.
3. Ask for copies of the care plan, wound notes and incident reports, and request the medical records in writing. Our page on getting medical records in Arizona explains how.
4. Report your concern. Our page on how to report nursing home neglect in Arizona lists APS, ADHS and the ombudsman.
5. If the injury was serious or your family member died, talk to a lawyer soon. A claim under the vulnerable adult law generally must be filed within two years after actual discovery of the cause of action (A.R.S. 46-455(K)), and a wrongful death claim within two years of the death (A.R.S. 12-542).

Frequently asked questions

Is a bedsore in a nursing home always neglect?

No. The federal rule says a nursing home must provide care to prevent pressure ulcers and that a resident should not develop them unless the resident’s clinical condition shows they were unavoidable. Whether a particular sore was avoidable is a medical question that depends on the records.

Is a fall in a nursing home always neglect?

No. Federal rules require a nursing home to keep the environment as free of accident hazards as possible and to give each resident adequate supervision and assistance devices to prevent accidents. Whether a fall shows a failure depends on the resident’s known risks and the care that was given.

Does the nursing home have to report an unexplained injury?

Nursing homes in Medicare or Medicaid must report alleged neglect and injuries of unknown source to their administrator and to state officials, within 2 hours if abuse or serious bodily injury is involved and within 24 hours otherwise.

Do the same rules apply to assisted living?

Not exactly. The federal nursing home rules apply to facilities in Medicare or Medicaid. Assisted living facilities in Arizona are licensed by the Arizona Department of Health Services under state rules. Arizona’s vulnerable adult law can apply in either setting.

How long does a family have to bring a claim?

A claim under A.R.S. 46-455 generally must be commenced within two years after actual discovery of the cause of action. A wrongful death claim has two years from the date of death. Sending our form does not stop or pause any deadline.