When a loved one in a nursing home or an assisted living community develops a wound, the person treating it may not be on the facility’s in-house staff. That care may come from a mobile wound group: an outside provider that travels from site to site. Families may have little involvement in selecting that provider. When a facility arranges for outside wound care, choosing a qualified provider and coordinating that care are important parts of its responsibility to residents.
The Post-Acute Wound & Skin Integrity Council (PAWSIC), a nonprofit professional group focused on wound care in post-acute settings, has published the Mobile Wound Group Checklist, 2026 Edition. The checklist was written by a multidisciplinary team of clinicians, including physicians, nurses, a pharmacist, and physical therapists. I was asked to serve as a reviewer, bringing the perspective of an attorney who represents nursing home residents and their families.
Why mobile wound care deserves a closer look
Pressure injuries and other chronic wounds can cause serious harm. Proper assessment, prevention, and timely treatment are essential to reducing that harm. In my practice, the same questions come up again and again. Who was watching this wound day to day? When did it actually start? Who was told when it got worse? Did anyone explain the treatment and obtain appropriate consent?
Bringing in an outside wound group does not relieve a nursing home of its own care obligations. Federal regulations, 42 C.F.R. § 483.70(f)(2)(i)–(ii), require outside-service arrangements to specify in writing that the facility assumes responsibility for obtaining services that meet applicable professional standards and for the timeliness of those services. The facility must continue to oversee the provider’s care and to address the resident’s needs between the provider’s visits.
Maryland assisted living programs also have continuing obligations. Under COMAR 10.07.14.28, each resident’s service plan must identify the services to be provided, when and how often they will be provided, and how and by whom they will be provided. The regulation specifically addresses monitoring, intervention, and oversight for pressure ulcer risk, prevention, and treatment. COMAR 10.07.14.14H also requires on-site nursing personnel to work with the delegating nurse and program staff on resident assessment, medical-service planning, and oversight of nursing activities. Visits from an outside wound provider do not replace these responsibilities.
Choosing a wound provider, coordinating treatment, and continuing to oversee the services the facility has arranged are part of the facility’s job. The checklist gives facilities a structured way to evaluate a provider at the start and to keep reviewing the provider’s work.
For a free legal consultation, call,
(888) 585-2188
What the checklist covers
The framework starts with Core Standards that apply across care settings, then adds a section tailored to where the care is delivered: a skilled nursing facility, a home health agency, or an assisted living or independent living setting. Each item is scored from 0 (Absent) to 3 (Best-in-Class), with space to record findings and the evidence reviewed. Items carrying elevated regulatory or clinical risk are identified as Critical.
The checklist covers provider qualifications, clinical practices, documentation, communication, financial incentives, and coordination with facility staff. It is intended to help providers improve their programs, help healthcare leaders evaluate wound care services, and give patients and responsible parties a reference for understanding those services.
What this means for patients and caregivers
You do not need to be a clinician to ask useful questions about wound care. The checklist brings attention to issues families should understand when a loved one is receiving treatment.
Consent. The checklist asks whether consent is obtained for procedures such as sharp debridement, which removes damaged or dead tissue, and biopsy. Residents should understand the proposed treatment and participate in decisions. When a resident cannot provide consent, the process should involve the legally authorized representative, as appropriate.
Communication. It asks how the provider communicates with patients and families, and how changes in condition, treatment orders, and concerns are reported.
Financial incentives. It asks whether clinicians’ pay is tied to the volume of debridements or skin substitute products, and whether anyone in the group holds an ownership stake in a product or supplier.
Accurate records. It asks whether the chart distinguishes the date a wound began from the date the wound group first saw it. That distinction matters when a family is trying to understand what happened.
Escalation. It asks about emergency escalation protocols and immediate reporting when a patient’s condition changes or an infection worsens.
Comfort and dignity. It asks about pain management and whether treatment reflects palliative or hospice goals.
If someone you love is being seen by a wound provider, these are useful questions to ask the facility or agency:
- Who is the wound provider, what are the clinician’s credentials, and how did you evaluate those qualifications?
- How often will the provider visit, and who cares for the wound between visits?
- How will you obtain informed consent from the resident or, when appropriate, an authorized representative before a procedure?
- How will you keep the resident and designated family contacts informed about treatment and changes in the wound?
- Does the provider or its clinicians have a financial interest in the products being used?
- If the wound worsens, who will respond, and what is the plan?
Complete a Free Case Evaluation form now
Why I said yes
My career has been devoted to helping people who have suffered serious personal injuries. Much of my work representing nursing home residents and their families begins after the harm has occurred. Reviewing this checklist was a chance to contribute to prevention. I see case after case where wound care breaks down: delayed notification, inadequate care plans, treatment that is not carried out, incomplete records, and families left out of decisions. I wanted that experience to inform a tool that facilities and providers could use before someone is harmed.
I also believe residents are better served when the people who litigate these cases and the people who deliver the care are willing to sit at the same table. Those conversations can help identify problems and improve care.
The checklist is a practical guide. It does not replace facility policies or federal, state, and local requirements, and it should not be treated as a standalone statement of the legal standard of care. Completing it, or hiring a provider that scores well on it, does not relieve a facility of its own obligations to residents. Its value is practical: it gives facilities specific questions to ask, and to keep asking.
Call or text (888) 585-2188 or complete a Free Case Evaluation form
Download the checklists
Start with the Core Standards, then read the add-on for the setting where your loved one receives care.
- Download Core Standards PDF
- Download Skilled Nursing Facility Add-On PDF
- Download Assisted Living and Independent Living Add-On PDF
- Download Home Health Add-On PDF
You can also access the documents through PAWSIC after registering for a free membership. Visit the checklist download page to learn more and access the documents. I encourage administrators, directors of nursing, wound providers, and families to read it.
If you have concerns about wound care that a family member received in a nursing home or assisted living community, Jenner Law is available to talk with you. Contact us at 410-412-2155.
This post is for general information only. It is not legal or medical advice, and reading it does not create an attorney-client relationship.