Am reading this late, but in LTC the occurrence of pressure ulcers is SUPER CLOSELY monitored for statistical reports that the DOH checks when doing its surveys.
Besides the reasons OP gives, the in-house development of pressure ulcers is to be AVOIDED UPON PAIN OF DEATH TO LTC STAFF (serious stuff if one occurs). That's because I believe that the facility has to absorb the cost of treating the ulcers because of the regs that govern reimbursement by CMS. Major financial burden for the facility!!
I'm fuzzy on all this as I wasn't directly involved with the monitoring, treatment & reports, etc. That usually fell to the DON or ADON (or other designee) or a Wound Team. As UM, I do remember completing a form for survey that counted wounds. As supervisor, I would often be responsible that care plans
were updated for interventions for ANY residents identified at risk. And I know that MDS monitors wounds also with quarterly wound risk assessments.
So I doubt that the average staff nurse has any in-depth knowledge of info OP seeks. Information from CMS may be the info you seek.
When survey occurs, the survey team usually would zoom in on a pressure ulcer pt and would like to see the wound for themselves and to assess wound care tx skills, like med pass, by staff. They would fine-tooth comb the med record for RD consult recommendations, pertinent lab work, physician involvement, PAIN MANAGEMENT, prescribed wound tx, out-pt wound care center consultation PRN, care plan interventions (BIG MONITORING), etc. Family involvement at quarterly care plan meetings also. I mean, we're talking that they scrutinize care. So it BEHOOVES all concerned disciplines to be on the top of their game.
Also, the pt admission (and readmission) assessment process is SUPER thorough to check for community-acquired (hospital or home) occurrences.
To SICUmurse - please know that while many NH/LTC facilities have serious staffing problems, it should NEVER EVER be acceptable to excuse lack of preventative and interventional pt care tasks, such as freq repositioning & turning, to staffing inadequacies. While not perfect, most places do try. I will concede that yes, there are poor facilities, but pressure ulcers as a quality indicator is a PRIORITY if they want to be paid (and stay open).