Healthcare facilities exposed to pressure injury litigation too often fail to defend patient malpractice claims because they cannot prove that caregivers provided reasonable turning and repositioning to prevent skin breakdown and deterioration. The modern defense of pressure injury claims focuses upon demonstrating that a patient’s comorbid health conditions and risk factors alone resulted in unavoidable skin impairment. The problem with the defense strategy as currently implemented is that facilities often fail to prove that caregivers provided reasonable turning and repositioning in response to the heightened needs of patients prone to pressure injuries. Peer-reviewed and regulatory standards require facilities to prove the implementation of reasonable care in response to comorbid risk factors to demonstrate that a wound was clinically unavoidable. However, too often facilities fail to meet the standard of establishing the provision of reasonable care by failing to routinely, systematically, and accurately document turning and repositioning consistent with a patient’s needs.