Sunday’s story about a new state law that restricts access to nursing home investigation records sparked a lively discussion on

Written by reporter Sarah Karon for the Wisconsin Center for Investigative Journalism, the piece looked in detail at a law passed during the first few months of Gov. Scott Walker’s term that, among other things, makes investigation records generated by state agencies off-limits in lawsuits filed against nursing homes and similar facilities. The bill was framed as “tort reform,” an effort to reduce frivolous lawsuits and therefore make Wisconsin “open for business.”

(Capital Times reporter Steven Elbow’s thorough look from 2011 at the law, which was on a lightning-fast track, is worth a read in light of the new piece.)

The anecdotal lead-in for Sunday’s story was about a 32-year-old man at a group home in Menomonie who had a bedsore that became so bad over the course of four months that he had to be hospitalized. The man’s mother is now suing the care provider, but the records of the investigation by the state health department, which readers can see online, won’t be admissible as evidence in the case.

The large majority of commenters on the story (including those on the Capital Times’ Facebook page) were much opposed to the law, not to mention Walker and his Republican allies who passed it. There was an interesting exchange in a different vein, though, started by “WisconsinLawyer,” who wrote that based on experience working in such facilities, the frequency of lawsuits with or without tort reform won’t affect the incidence of poor care.

“You want to know why patients end up with bed sores? Because nobody gives a damn,” the commenter wrote. “These things can be prevented and people are just lazy and uncaring. Management colludes to hide these problems and/or just turns a blind eye. Most families aren't involved with patients. It stinks. The whole system stinks. And, until we develop better, more empathetic human beings, these incidents will continue to occur (with or without tort reform.)”

That brought a sharp reply from “Badgerman,” who wrote that “I know a great many people working in this industry that care far more deeply for their residents than their own family do. I'm assuming you don't agree with all lawyers being blood-sucking ambulance chasers only interested in lining their own pockets? You want to know why people get bed sores, do some real research and you'll learn it happens for many reasons, many of which nurses and staff can do little to prevent or ultimately cure.”

The Mayo Clinic’s online guide to bedsores does indeed say that “may still develop with consistent, appropriate preventive care,” though it is worth noting that in the case mentioned in the story, state investigators said the care facility did not provide appropriate medical care to the 32-year-old patient.

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Let's not oversimplify these situations. The predisposing factors for skin breakdown/bedsores are often years in developing, starting long before one needs nursing home care and include malnourishment, obesity, being overweight or underweight, chronic illnesses (such as diabetes that may predispose to infection, heart conditions/circulation problems that inhibit healing, skin conditions, etc.) scoliosis and other skeletal deformities, scar tissue or other poorly or incompletely healed wounds, stomas or other causes of drainage, etc. Medications one has previously taken (such as chemptherapy or steroids) or is currently taking are also keys. Please don't forget that nursing home residents also have the right and freedom to refuse treatments, medications, turning and repositioning, eating the prescribed diet, etc.

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