About

Vincent Mor is a Professor of Health Services, Policy & Practice and the Florence Pirce Grant University Professor at the Brown University School of Public Health. He has been a faculty member since 1981, initially in the Department of Community Health, which later became the Department of Health Services, Policy and Practice. He was tenured in 1987 and promoted to Professor in 1990. Dr. Mor was a founding member of the department's graduate program in 1986 and directed the Center for Gerontology and Health Care Research for ten years. He served as Chair of the Department of Community Health from 1996 until 2010, contributing to the development of the Brown University School of Public Health. Recognized for his contributions over more than 40 years, he received the Susan Colver Rosenberg Medal of Honor in 2021.

Research topics

• Medicine
• Nursing
• Gerontology
• Internal medicine
• Political Science
• Emergency medicine
• Demography
• Environmental health
• Pediatrics
• Sociology
• Immunology
• Virology
• Medical emergency
• Economics
• Economic growth
• World Wide Web
• Family medicine
• Medical education

Selected publications

• What's in a Number: Do Transfer Rates Reflect Nursing Home Quality?

  Journal of the American Geriatrics Society · 2026-02-24

  article

  BACKGROUND: Hospitalization rates from nursing homes (NHs) have gained traction as pragmatic quality measures that can be derived from claims data. However, claims-based hospitalization measures do not account for clinical complexity and the extent to which they reflect quality of care or quality of transfer decision making is unknown. We aim to examine agreement between a claims-based measure of potentially avoidable hospitalizations and expert clinician review of transfer decision making and care quality. METHODS: We randomly selected 252 hospital transfers across eight Veterans Administration (VA) NHs, known as Community Living Centers (CLCs). Eleven expert clinicians independently completed Structured Implicit Reviews (SIRs) of medical records to assess: (1) whether the transfer decision was appropriate (i.e., hospital was the lowest safe level-of-care given the resident's acute condition); (2) quality of care for evaluation or treatment of the acute change (adequate management of acute change), (3) quality of care for chronic conditions and preventing decline. We used VA Corporate Data Warehouse (CDW) data to determine a claims-based measure of potentially avoidable hospitalization. RESULTS: CDW data were available for 242 VA hospitalizations. The claims-based measure categorized 29 (12%) hospitalizations as potentially avoidable; only 2 of which matched the 20 SIR identified as inappropriate decisions to transfer. Furthermore, the claims-based measure flagged only 5 of 33 cases rated as inadequate treatment of acute decline and 6 of 17 rated as poor quality of chronic disease or preventive care. CONCLUSIONS: In a geographically diverse sample of CLC transfers, independent clinical experts' judgments of transfer decision appropriateness, quality of care for acute decline, and quality of chronic care differ from a claims-based potentially avoidable hospitalizations measure. Findings underscore the need for nuanced clinical consideration of hospitalization metrics for assessing quality and for understanding which aspects of care should be addressed to safely reduce NH transfers to hospitals.

  PublisherDOI

• Untangling Dialysis Received in a Nursing Home from Home Hemodialysis in the Community

  Journal of the American Society of Nephrology · 2026-04-02 · 1 citations

  articleOpen access
  PublisherOA PDFDOI

• Characteristics of the Long‐Term Care Data Cooperative: A New Resource for Research on Outcomes in Long‐Term Care

  Journal of the American Geriatrics Society · 2026-02-19 · 1 citations

  articleOpen access

  BACKGROUND: The long-term care (LTC) Data Cooperative is a National Institute on Aging-funded data resource that links skilled nursing facility (SNF) electronic health record (EHR) data with Medicare and Medicaid claims for use in comparative effectiveness and interventional research. Here we characterize the population of residents and SNFs represented in the LTC Data Cooperative and report on the completeness of key data elements. METHODS: We compared facility and resident characteristics between SNF participants in the LTC Data Cooperative in 2023 and all US SNFs. We examined frequencies and variation in documentation of key EHR data elements including resident census data, vital signs, blood glucose readings, medication administration records, and immunizations. RESULTS: The LTC Data Cooperative included 2557 SNFs in 48 states plus D.C. in 2023, or 17% of US SNFs. The LTC Data Cooperative population was generally similar to the national population with small differences including being slightly older (21.3% under age 65 vs. 23.8% in the national population); having fewer females (61.0% vs. 63.2%), fewer Black residents (15.1% vs. 17.5%); and fewer residents with dementia (45.5% vs. 47.2%). Data availability varied across SNFs, however most had relatively consistent documentation of key elements. The number of SNFs with vital sign records available on at least 80% of days ranged from 2248 SNFs for temperature documentation to 2303 SNFs for blood pressure documentation. Approximately 2300 SNFs (90%) had at least some medication administration records available, while 2485 SNFs (97%) had immunization records. CONCLUSIONS: The LTC Data Cooperative offers novel EHR data capturing clinical measures not available in the Minimum Data Set or claims data on a SNF resident population that is comparable to the national population. Studies using these data can generate evidence to inform and improve clinical care and outcomes for older adults in the SNF setting.

  PublisherOA PDFDOI

• Emergency Department Visit Outcomes of a Multicenter Randomized Trial of a Fall Prevention Intervention

  Academic Emergency Medicine · 2026-01-01

  articleOpen access

  BACKGROUND: Emergency department (ED) visits by older adults for falls are an opportunity to initiate fall prevention interventions. The GAPcare II trial tested an effective ED-based fall prevention program at two health systems. Our objective was to assess successful completion of intervention processes across sites including consultation completion rates, time to consultation, consultation duration, and types of recommendations made. PARTICIPANTS AND SETTING: Community-dwelling adults ≥ 65 years old presenting to three EDs (two in Rhode Island, one in Colorado) within 7 days of an accidental fall who were expected to be discharged and were without mobility-limiting injuries. METHODS: GAPcare II was a randomized controlled trial conducted from August 2021 to January 2025. Participants were randomly assigned to intervention (pharmacy and physical therapy (PT) consultations) or usual ED care arms. Pharmacists reviewed medications for fall risk and recommended modifications. Physical therapists performed validated mobility/balance assessments and provided recommendations for assistive devices, outpatient services, and disposition. RESULTS: Of 852 eligible ED patients, 196 were enrolled (96 intervention, 100 control). Participants' median age was 78 years, 68% were female, and 83% were white. In the intervention arm, 93% received pharmacy consultations and 83% received PT consultations. Median time from initial consultation request to bedside evaluation was 24 min (pharmacy) and 47 min (PT). Pharmacists recommended changing medication timing (26%), stopping fall-risk medications (19%), and dose adjustments (18%). Physical therapists recommended assistive devices (66%), outpatient services (36%), and skilled nursing facility admission (25%). ED length of stay did not differ between the intervention and usual care arms (4.6 vs. 4.4 h, p = 0.90). CONCLUSIONS: The GAPcare II trial demonstrated that an ED-based fall prevention program is feasible to implement across two health systems with varied operations, volume, and staffing with similar results. Consultations generated actionable recommendations and did not prolong ED length of stay.

  PublisherOA PDFDOI

• Association of Medicare Advantage Enrollment With Post‐Acute Care Use and Associated Patient Outcomes

  Journal of the American Geriatrics Society · 2026-04-06

  articleOpen access

  IMPORTANCE: Enrollees in Medicare Advantage (MA) receive less intensive post-acute care (PAC) than those in traditional Medicare, but the implications of this lower intensity, particularly for patients with complex needs, remain poorly understood. OBJECTIVES: To estimate the association of MA enrollment with PAC use and patient outcomes for hospitalized beneficiaries with hip fracture or stroke. DESIGN, SETTING, AND PARTICIPANTS: A quasi-experimental difference-in-differences analysis leveraging the geographic expansion of MA from 2012 to 2017. The study included 148,396 stroke and 126,046 hip fracture hospitalizations, representing quasi-exogenous hospitalization events in high MA-growth counties. MAIN OUTCOME MEASURES: Initial PAC setting, 30-day all-cause hospital readmission, and 30- and 90-day all-cause mortality. RESULTS: MA enrollment was associated with fewer discharges to inpatient rehabilitation facilities (stroke: -8.9 pp; 95% CI, -9.88 to -7.92; hip fracture: -14.4 pp; 95% CI: -15.38 to -13.42). While 30-day readmissions were modestly lower for MA enrollees in both cohorts, MA enrollees experienced a 7.1% relative increase in 30-day mortality for stroke (0.6 pp; 95% CI: 0.01 to 1.19) and an 11.9% relative increase in 90-day mortality for hip fracture (1.3 pp; 95% CI: 0.52 to 2.08). This adverse mortality effect was concentrated in markets with high baseline IRF use (> = 33.3% of discharges, top tercile), where MA enrollment was associated with an 18.0% relative increase in 90-day mortality for stroke (2.0 pp; 95% CI: 0.82 to 3.18) and a 22.3% relative increase in 90-day mortality for hip fracture (2.3 pp; 95% CI: 0.93 to 3.67). CONCLUSIONS: MA enrollment was associated with lower IRF use, modestly lower readmissions, and a higher mortality risk for hip fracture and stroke. These findings suggest that MA's strategy of shifting patients to lower-cost settings may carry unintended adverse consequences for clinically complex patients.

  PublisherOA PDFDOI

• Unmet Needs and Associated Factors among Community-living Older People with Disability in China: 2005–2014

  2025-05-29

  book-chapter

  Based on the Chinese Longitudinal Healthy Longevity Survey from 2005 to 2014, this study estimated the prevalence and examined risk factors of under-met needs and completely unmet needs for assistance in activities of daily living (ADLs) among community-living older people with disability in China. As of 2014, over 50% of community-living Chinese elders with disability experienced under-met needs, and nearly 5% had completely unmet needs. From 2005 to 2014, the proportion with completely unmet needs doubled for all disabled elders. Significant risk factors of under-met needs included lower per capita annual household income, more ADL limitations, living alone, and fewer living children, and those of completely unmet needs included less ADL limitations and living alone. More policy attention should be paid to address the gap between long-term care services for older persons with severe disability and supportive services for those who are relatively healthy, toward ultimately establishing a care continuum for the elderly at all stages of their life course. In addition, family care for elders with severe functional impairments should be supplemented by professional long-term care services to best meet their needs.

  PublisherDOI

• Medicare Advantage Enrollment in Nursing Homes: 2010–2023

  Journal of the American Geriatrics Society · 2025-11-14

  articleOpen access

  BACKGROUND: Medicare Advantage (MA) plans now cover 54% of all Medicare beneficiaries. However, MA is understudied in the nursing home population. We analyzed MA enrollment trends and resident and facility characteristics from 2010 through 2023. METHODS: We calculated the point prevalence of MA enrollment for long-stay nursing home residents, short-stay residents, and all other Medicare beneficiaries from 2010 to 2023, and compared variation in MA growth at the state level between long-stay residents and the general Medicare population. We analyzed how the composition of Traditional Medicare- and MA-enrolled long-stay residents changed over time, changes in special needs plan (SNP) enrollment, and nursing home quality for MA enrollees. We also tracked monthly MA enrollment rates among nursing home residents before and after they became long-stay. RESULTS: MA enrollment among long-stay residents increased from 12.9% in 2010 to 36.5% in 2023, a 183% increase, outpacing the growth rate among the overall Medicare population. There was substantial geographic variation in MA growth between long-stay residents and others across states. Enrollment in Institutional SNPs grew substantially, accounting for about 35% of MA enrollment among long-stay residents. Dual-Eligible SNP enrollment also accounted for a substantial proportion among MA long-stay residents, ranging between 12% and 20% across years. Long-stay residents covered by Traditional Medicare and MA showed comparable clinical characteristics and had similar shares residing in high-quality nursing homes. Disenrollment from MA sharply increased as beneficiaries entered nursing homes for long-term care. CONCLUSIONS: The substantial growth in MA enrollment among long-stay nursing home residents, coupled with the notable geographic variation and disenrollment, underscores the importance of recognizing that not all beneficiary groups experience MA in the same way. Targeted monitoring is needed to ensure that MA plans adequately address the care needs of this high-risk population.

  PublisherOA PDFDOI

• Incidence of Long COVID Diagnoses in 3.6 Million U.S. Medicare Beneficiaries With COVID-19

  The Journals of Gerontology Series A · 2025-05-15 · 2 citations

  articleOpen access

  BACKGROUND: Long COVID incidence and risk factors in older adults need to be better characterized to identify risk mitigation strategies. Our aim was to quantify the incidence of Long COVID in a population-based sample of older adults and to describe the association between COVID-19 vaccination and Long COVID risk. METHODS: This cohort study included Medicare fee-for-service beneficiaries ≥ 66 years diagnosed with COVID-19 between October 1, 2021, and March 31, 2023 (index date). Long COVID diagnoses were identified from Medicare Part A-B claims based on ICD-10-CM code U09.9. We measured the number of COVID-19 vaccine doses administered prior to the index date using Medicare Part B claims and pharmacy records. Kaplan-Meier estimators, Cox proportional hazards, and Fine-Grey regression models were used to estimate the 1-year cumulative incidence and relative rate of Long COVID. RESULTS: We identified 3 588 671 Medicare beneficiaries diagnosed with COVID-19. Overall, 3.89% of beneficiaries were diagnosed with Long COVID over 1 year. A gradient in the 1-year cumulative incidence of Long COVID was observed according to the number of prior COVID-19 vaccine doses. Beneficiaries with 4 or more COVID-19 vaccine doses had a 39% lower adjusted rate of Long COVID relative to beneficiaries without a prior dose (adjusted hazard ratio = 0.61, 95% CI = 0.60-0.62). CONCLUSIONS: Long COVID diagnoses in Medicare claims were common in a large sample of older adults with COVID-19, and we observed a gradient in Long COVID risk across the number of prior COVID-19 vaccine doses. Promoting continued vaccination may be an effective strategy to mitigate the burden of Long COVID in older adults.

  PublisherOA PDFDOI

• Effects of Medicare Advantage Growth in Nursing Homes on Care Quality and Resident Outcomes: Using Shift-Share IV

  Innovation in Aging · 2025-12-01

  articleOpen access

  Abstract Medicare Advantage (MA) now covers 54% of all Medicare beneficiaries. MA growth has expanded to nursing home (NH) setting, covering 37% of short-stay patients and 32% of long-stay residents in 2021. The impact of MA growth in NHs remains understudied. Using a shift-share instrumental variable (SSIV), we estimated effects of MA growth in NHs on care quality. We identified MA enrollment of Medicare-enrolled NH residents using the Medicare enrollment file (2015-2019). NH quality measures included CMS five-star overall and staffing ratings and health deficiencies. Population-specific outcomes, derived from claims, included proportion of short-stay residents with 30-day rehospitalization and death, and the quarterly rate of hospitalization and death among long-stay residents. The main explanatory variable was high MA share in NHs (top quartile NH MA share annually). We used a SSIV, leveraging an exogenous shift—the annual national MA contract growth—linked to baseline NH contract share. We estimated a two-stage least squares (2SLS) regression with NH and year fixed effects, adjusting for NH and county characteristics and clustering standard errors for NHs. Among 18,711 NHs (83,215 observations over five years), 31% had high MA share. The first-stage F-statistic was 528.7 (Coef. 0.12, P < 0.001), confirming IV strength. In 2SLS results, high MA share in NHs was associated with a 0.6 increase in staffing ratings (95% CI 0.4-0.9; P < 0.001), an 18.8% relative increase, but not with overall star-rating, deficiencies, or population-specific outcomes. Although these results suggest MA growth has improved staffing levels at NH, the mechanisms underlying these findings warrant further investigation.

  PublisherOA PDFDOI

• Recombinant vs Egg-Based Quadrivalent Influenza Vaccination for Nursing Home Residents

  JAMA Network Open · 2025-01-02 · 3 citations

  articleOpen access

  Importance: Influenza vaccination remains the most important intervention to prevent influenza morbidity and mortality among nursing home residents. The additional effectiveness of recombinant influenza vaccine vs standard dose vaccines was demonstrated in outpatient older adults but has not been evaluated in nursing home populations. Objective: To compare hospitalization rates among residents in nursing homes immunized with a recombinant vs a standard dose egg-based influenza vaccine. Design, Setting, and Participants: This pragmatic cluster randomized trial assessed nursing home residents 65 years or older residing in a US facility for 100 or more days before the start of influenza season (October 1). The study was conducted across the 2019 to 2020 and 2020 to 2021 influenza seasons and randomly assigned nursing homes 1:1 within blocks categorized by proportion of Black residents and prior resident hospitalization rates. Medicare claims data were used to evaluate resident-level hospitalization outcomes. Enrollment and allocation to treatment groups began on July 20, 2019. Data analysis began on January 1, 2021, with primary end points finalized June 30, 2024. Intervention: Nursing homes were cluster randomized to vaccinate all residents with recombinant quadrivalent influenza vaccine (RIV4) or standard egg-based quadrivalent inactivated influenza vaccine (IIV4). Main Outcome and Measures: The primary outcome was respiratory-related hospitalization. Secondary outcomes included death and hospitalization due to any cause. Results: A total of 144 565 person observations (mean [SD] age, 77.4 [13.1] years; 63.0% female) at 1078 nursing homes were included, with 72 005 residents in nursing homes randomized to provide RIV4 and 72 560 residents in nursing home randomized to provide IIV4. In total, 85.6% of the residents received influenza vaccination. Baseline resident characteristics were comparable across treatment groups. For the primary end point of respiratory-related hospitalizations, there were 1387 hospitalizations (1.9%) in the RIV4 group vs 1424 (2.0%) in the IIV4 group (hazard ratio, 1.01; 95% CI, 0.62-2.17). Hospitalization rates by vaccine were similar for other hospitalization outcomes and death, overall, and by season and subgroups (gender, race, and comorbidities). Conclusions and Relevance: In this cluster randomized trial of nursing homes, there was no significant difference between recombinant or standard dose vaccine for reducing hospitalizations associated with influenza illness. However, the COVID-19 pandemic restricting influenza activity along with poor vaccine match to circulating strains substantially limits the conclusions. Trial Registration: Clinicaltrials.gov Identifier: NCT03965195.

  PublisherDOI

Recent grants

• Ethics and Regulation Core (C)

  NIH · $68.6M · 2019–2030

• NIH Grant R01CA046331

  NIH · $1.0M · 1989

• METRIcAL - Music & MEmory: a Pragmatic TRIal for Nursing Home Residents with ALzheimer's Disease

  NIH · $571k · 2017–2018

• NIH Grant T32HS019657

  NIH · $860k · 2013

• NIH Grant R01HS018462

  NIH · $896k · 2013

Frequent coauthors

• Amal N. Trivedi

  Providence VA Medical Center

  375 shared

• Pedro Gozalo

  Providence College

  297 shared

• Stefan Gravenstein

  Brown University

  269 shared

• Kali S. Thomas

  Johns Hopkins University

  245 shared

• Momotazur Rahman

  Brown University

  223 shared

• Susan L. Mitchell

  Harvard University

  214 shared

• Andrew R. Zullo

  Brown University

  186 shared

• Zhanlian Feng

  RTI International

  179 shared

Education

• Ph.D.

  Brown University

• M.S.

  Brown University

• B.A.

  Brown University

Awards & honors

• Susan Colver Rosenberg Medal of Honor (2021)
• Distinguished Investigator Award from AcademyHealth (2011)
• John Eisenberg Excellence in Mentoring Award from the Agency…
• Distinguished Researcher Award from the National Hospice and…
• Elected to the National Academy of Medicine (2015)