SAN ANGELO, TX — A wrongful death lawsuit against Meadow Creek Nursing and Rehabilitation has been settled after allegations that a 75-year-old resident developed severe pressure ulcers that progressed to Stage IV wounds requiring surgical intervention, according to court records filed in Tom Green County District Court.
David Goad, representing the estate of Gerald Lee Goad, filed the lawsuit in December 2022 against CaraDay Meadow Creek LLC and CaraDay Healthcare TX3 LLC, seeking more than $1 million in damages. Court documents indicate mediation resulted in a settlement agreement in September 2025, with the case placed on the dismissal docket for March 19, 2026, as reported by San Angelo LIVE.
Gerald Lee Goad entered Meadow Creek Nursing and Rehabilitation on January 1, 2021, for skilled nursing and rehabilitation services following hospitalization for COVID-19 at Shannon Health System, according to the complaint. Court filings indicate he had a complex medical history including stroke, congestive heart failure, obesity and post-polio syndrome, requiring complete assistance with mobility, toileting, hygiene and bathing.
Ten days after admission, facility staff discovered open wounds on both buttocks, coccyx and gluteal folds accompanied by dark bruising, according to the petition. A consultation at San Angelo Community Medical Center on January 14, 2021, resulted in diagnosis of Stage II painful pressure ulcers on the coccyx and buttocks, court documents state.
The wounds deteriorated rapidly over the following weeks, progressing to deep tissue injury within days and becoming unstageable by late January after transfer to Shannon Health System, as reported in court filings. Following transfer to Park Plaza Nursing Home, the pressure ulcers advanced to Stage IV, requiring extensive surgical debridement of skin, fascia and muscle on February 26, 2021, according to the lawsuit.
The complaint alleged multiple care failures including inadequate assistance with mobility and repositioning, failure to follow physician orders, insufficient monitoring and assessment, delayed communication with physicians, and failure to implement preventive measures. The lawsuit also asserted gross negligence, claiming the facility's actions demonstrated conscious indifference to the resident's safety and welfare.
An expert report submitted with the petition, prepared by Dr. David E. Mansfield, a board-certified family physician with nursing facility experience, concluded that the facility violated established care standards. The expert opinion stated that proper protocols required turning and repositioning every two hours, toileting and hygiene checks every two hours, and daily bathing and cleaning. The report asserted these care violations directly caused the development and progression of pressure ulcers that would have been preventable with appropriate care.
The case was transferred from Hays County to Tom Green County District Court based on venue considerations. Scheduled pretrial proceedings and jury trial dates in October 2025 were canceled following the mediation agreement, with defense attorney Emily J. Davenport noting that final settlement documents awaited resolution of a Centers for Medicare & Medicaid Services lien, according to court records.
CMS Inspection History
Federal inspection data reveals Meadow Creek Nursing and Rehabilitation maintains a 3-star overall rating from CMS, with significant variation across performance categories. The 80-bed for-profit facility received a 2-star health inspection rating, 3 stars for staffing, and 5 stars for quality measures.
CMS records document 39 total deficiencies across 15 inspections since the facility began operations. The most recent health inspection in April 2025 identified five violations including failure to procure and store food according to professional standards, cited at the highest severity level. Inspectors also documented deficiencies in infection prevention and control programs, accommodation of resident needs and preferences, comprehensive care plan development, and maintenance of accident-free environments.
Pressure ulcer prevention represents a fundamental component of nursing home care standards under federal regulations. Federal guidelines require facilities to ensure residents who enter without pressure ulcers do not develop them unless clinically unavoidable, and that existing pressure ulcers receive appropriate treatment and care to promote healing.
The facility's quality measures rating of 5 stars indicates performance on clinical outcomes tracked by CMS, though this data reflects facility-wide statistics rather than individual resident experiences. The 2-star health inspection rating places the facility below the national median for compliance with federal health and safety standards.
Ownership & Operations
Meadow Creek Nursing and Rehabilitation operates under CaraDay Meadow Creek LLC, with CaraDay Healthcare TX3 LLC identified as an affiliated entity in court documents. The facility maintains operations in San Angelo at 4343 Oak Grove Boulevard. CaraDay Healthcare TX3 LLC lists its registered agent at a New Braunfels address, according to corporate filings.
Attorneys from Van Wey, Metzler & Williams PLLC in Dallas represented the plaintiff's estate throughout the litigation.
Resources for Families
Texas families with concerns about nursing home care quality can contact the Texas Long-Term Care Ombudsman at 1-800-252-2412. The ombudsman program provides free advocacy services for residents and families, investigates complaints, and helps resolve care concerns.
Suspected cases of abuse or neglect should be reported to Texas Health and Human Services at 1-800-458-9858. Additional resources and information about nursing home rights are available through the National Long-Term Care Ombudsman Resource Center at 1-800-677-1116 or online at ltcombudsman.org.
Federal regulations require nursing facilities to post contact information for the state survey agency, ombudsman program, and protection and advocacy services in visible locations accessible to residents and visitors.
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