01/22/2026

You Asked... We Answered

You Asked: How often must a Braden Scale form be completed?

We Answered: Federal regulations do not require use of a specific pressure injury risk assessment tool like the Braden Scale. However, facilities must assess each resident’s risk for developing pressure ulcers/injuries (PU/PIs) and reassess risk whenever clinically indicated. Facilities identify how they plan to do that through their policy.

Many clinicians use a standardized tool, such as the Braden Scale, as part of this process. Common best practice includes completing a Braden assessment:

• Upon admission
• Weekly for the first four weeks
• Quarterly
• With any significant change in condition 

This frequency aligns with evidence showing that 80% of pressure injuries in skilled nursing facilities develop within the first two weeks of admission, and 96% develop within three weeks, underscoring the importance of close early monitoring.

Risk assessment is not score-driven alone. Surveyors expect clinicians to evaluate all risk factors, even those not fully captured by a standardized tool. These risk factors may include:

• Impaired mobility or functional decline
• Co-morbidities (e.g., diabetes, ESRD, thyroid disease)
• Medications affecting healing (e.g., steroids)
• Impaired blood flow or vascular disease
• Cognitive impairment or refusal of care
• Urinary or fecal incontinence
• Malnutrition, undernutrition, or dehydration
• History of a previously healed pressure injury (especially prior Stage 3 or 4)

Some risk factors are not fully modifiable (such as permanent loss of sensation), while others, like pressure or positioning, can often be addressed immediately. Additional reassessment is expected when a resident experiences an acute illness or condition change (e.g., infection, pneumonia, CHF exacerbation).