Publications

• Bray Sample Expert Report PUBLIC Version.docx

Geriatric, LTC & Hospice Medicine Expert

Specialties & Experience of this Expert Witness

Additional Information

Steven R. Bray, MD is a board-certified Internal Medicine physician with more than 25 years of clinical experience, over 13 of them devoted exclusively to post-acute, long-term care, skilled nursing, assisted living, memory care, and hospice medicine. He earned his MD from The University of Texas Southwestern Medical Center at Dallas and completed his Internal Medicine residency at Vanderbilt University Medical Center. He is a licensed physician in the State of Texas. Dr. Bray is an active clinician, not a retired or office-based expert. He currently provides direct care to more than 300 patients across skilled nursing, memory care, assisted living, and long-term care settings in the Dallas–Fort Worth area, and serves in multiple medical director and chief medical officer roles across skilled nursing facilities and hospice programs. This contemporaneous, front-line experience gives him current, real-world knowledge of the staffing models, regulatory environment, and clinical realities his opinions address. His clinical and medical-legal focus centers on medically complex, frail, and cognitively impaired older adults, including patients with advanced dementia, chronic cardiopulmonary disease, recurrent falls, pressure injury risk, and end-of-life care needs. Areas of expertise include: falls and fall-related injuries in the frail elderly (avoidable vs. unavoidable analysis, frailty science, sarcopenia, orthostatic hypotension); pressure injuries and wound care (NPIAP staging, Braden Scale, MDS Section M, avoidability determination); dementia, refusal of care, and elopement/wandering; failure to thrive and nutritional decline; polypharmacy and psychotropic medication use (CMS F758); end-of-life care, hospice eligibility, and hospice/SNF overlap; CMS F-tag and MDS 3.0 interpretation; and standard of care across SNF, assisted living, memory care, and hospice settings. Since 2020, Dr. Bray has been retained as a medical expert in more than 33 cases across Texas state and federal courts, with matters in Dallas, Tarrant, Travis, Bexar, Harris, and Collin counties, the Eastern District of Texas, and the State of Oklahoma. His engagements include early medical merit reviews, written expert reports compliant with Texas Civil Practice & Remedies Code Chapter 74, deposition testimony, and trial testimony, including rebuttal of opposing expert reports. Dr. Bray is a published author. His peer-reviewed clinical text, Unavoidable Falls: The Medical Reality of Falls in the Frail Elderly (2026), provides a comprehensive framework for understanding fall risk, frailty, and the limits of prevention in institutionalized populations. He is also the author of What I Would Do If I Had Type 2 Diabetes and The Consult I Never Expected: A Physician, A Husband, A Journey Through Breast Cancer. His approach emphasizes objective, clinically defensible analysis grounded in contemporaneous standards and regulatory context, with clear differentiation between adverse outcomes and negligence, and careful avoidance of hindsight bias. He is known for well-structured written opinions and composed, credible testimony.