​I conduct applied health services research to inform policies and practices that secure better health and quality of life outcomes for individuals who are aging and disabled, particularly those who require long-term services and supports (LTSS). Broadly, my research focuses on the organization and delivery of LTSS, with an emphasis on measurement and quality. Funded by the U.S. Department of Veterans Affairs, the Agency for Healthcare Research and Quality, the National Institute on Aging, and various foundations, I have led research projects related to the quality of long-term care and the role of home- and community-based services in preventing or postponing nursing home placement. I have 12 years of long-term care research experience and am an expert in using large administrative datasets (e.g., the nursing home Minimum Data Set, the home health Outcome and Assessment Information Set, Medicare claims, and Medicaid Cost Reports) to ask and answer policy-relevant questions. 

Ongoing Research Support

National Institute on Aging: 1R21AG059120-01 - Thomas (PI)

09/01/2018-06/30/2020

Innovative Approaches to Examine Post-Acute Care Outcomes of Older Adults with Traumatic Brain Injury

This grant merges multiple sources of data using probaliistc matching to examine functional and cognitive improvement during post-acute (PAC) rehabilitative care among older patients age 65+ years with traumatic brain injury (TBI). Working with an experienced interdisciplinary team with statistical and clinical expertise, this project has two specific aims: 1) To create a national longitudinal database that follows older patients with TBI across multiple healthcare settings and 2) To identify patient characteristics that predict community discharge and functional improvement during the PAC rehabilitative episode.

Role: Principal Invesgitagor

National Institute on Aging: 1R01AG057746-01 - Thomas (PI)

01/15/2018-12/31/2020

Do State Regulations Affect the Outcomes of Assisted Living Residents with Dementia? 

This grant examines states’ assisted living (AL) policy environments, applies our novel methodology to identify AL residents, and together with Medicare claims will enable greater understanding of how AL residents’ outcomes are impacted by states’ regulatory decisions. We hypothesize that in order to survive, AL providers adhere to state licensing requirements and respond to changes in the regulatory environment which ultimately impact residents’ outcomes. Our specific aims are to 1) characterize how states regulate AL as it relates to the care of residents with ADRD; 2) test the effect of regulations likely to influence ADRD care in AL on providers’ response and outcomes of AL residents with ADRD over a 10-year period; and 3) compare outcomes between residents with ADRD who reside in AL communities licensed to provide specialized dementia care to residents in non-specialized AL communities.

Role: Principal Investigator

National Institute on Aging: R21AG057451-01- Mor (PI)                                    

09/15/17 – 08/31/18                      

METRIcAL – Music & Memory: a Pragmatic Trial for Nursing Home Residents with Alzheimer’s Disease

This study will standardize the introduction and implementation of Music & Memory (M&M) during a one-year R21 pilot then test the impact of implementing M&M on nursing home residents’ behavioral and psychological outcomes during a four-year R33 pragmatic trial. 

Role: Co-Investigator

National Institute on Aging: R03AG054687-01 - Rahman (PI) 

09/01/17 – 08/31/19                               

Disparity in Incidence and Health Outcomes Between Rural and Urban Patients with Alzheimers Disease and Related Disorders

The goal of this proposed research is to examine the rural-urban disparity in the prevalence and incidence of an ADRD diagnosis and Medicare beneficiaries’ subsequent health outcomes. Our results will help policy development and improve care practice to reduce the rural-urban disparity.

Role: Co-Investigator

Advance – CTR Pilot Projects Program: U54GM115677 - Thomas (PI)

07/06/17 – 07/05/18                  

Merging National Hospital Trauma Registry Data with Medicare Claims and Post-acute Care Patient Assessments to Examine Predictors of Functional Improvement among Older Adults with Traumatic Brain Injury

The objective of this study is to merge multiple sources of data to examine predictors of successful outcomes, particularly the ability to return home following post-acute (PAC) rehabilitative care, among older patients age 65+ years with TBI.

Role: Principal Investigator

Veterans Health Administration Health Services Research and Development: CDA14-422 - Thomas (PI)

10/01/2016-09/30/2021

Evaluating Cash Benefits for Veterans’ Long-Term Care

This is a VA HSR&D Career Development Award to focus on understanding the role of participant-directed (PD) cash benefit programs provided by VA to meet the growing need for LTSS. This research seeks to (1) use administrative data to determine which eligible Veterans being served by which Medical Centers enroll in VA’s PD cash benefit programs, (2) explore reasons for variation in enrollment PD programs across VAMCs with interviews of VAMC personnel (3) conduct interviews with Veterans to describe their experiences with the VA’s PD cash benefit programs and (4) establish the effectiveness of the VA’s PD cash benefit programs in controlling healthcare costs by using sophisticated methodologies to compare Veterans’ healthcare utilization to that of Veterans receiving traditional LTSS.

Role: Principal Investigator

Veterans Health Administration Health Services Research and Development: 1I01 HX002376-01/SDR 16-194                                                  Thomas, Rudolph, Sperber (Co-PIs)

10/01/2016-9/30/2019

Evaluation of Veteran-Directed Home and Community Based Services

Working closely with the VHA's Office of Geriatrics and Extended Care and the Administration for Community Living, this award will evaluate the impact of the VD-HCBS program on Veterans and their caregivers, as well as the program’s implementation, through a randomized stepped wedge national roll-out of the program.

Role: Co-Principal Investigator

National Institute on Aging: R21AG047303 - Thomas (PI)   

1/15/2015-1/15/2019

Identifying a Cohort of Assisted Living Residents

This grant aims to validate a methodology to identify assisted living residents using CMS data. Specifically, we are using 1) a national list of licensed residential care facilities; 2) the Medicare denominator file; 3) the Home Health Outcome and Assessment Information Set (OASIS); 4) a 20% sample of Medicare Part B/carrier file claims to compile a finder file of 9-digit ZIP codes that we have validated as representing assisted living facilities. In addition, this grant is examining the effect of assisted living market changes on the private-pay nursing home market using Medicare claims, the Medicare enrollment record, and the Minimum Data Set.

Role: Principal Investigator

National Institute on Aging: 2P01AG027296 - Mor (PI) 

01/15/2014-1/31/2019

Changing Long Term Care in America: Policies, Markets, Strategies, and Outcomes

This Program Project grant studies the effects of Medicare policy changes on the use and outcomes of Medicare’s post-acute care benefit and how those policies interact with long term care provider markets and states’ Medicaid policies. Specific aims of Core C include 1) Assemble project data and develop methods for tracking and cleaning projects’ longitudinal data. 2) Create uniform, core measures for use in project analyses 3) Develop novel methods of evaluating functional status across post-acute settings.

Role: Investigator on Core C 

2006    Phi Beta Kappa

2007    The Harold L. Sheppard Endowed Memorial Scholarship, USF

2008    The Everett and Anne Lee 2008 Gerontology Award

2010    University of South Florida’s Distinguished Graduate Student Achievement Award

2010    Provost’s Commendation for Outstanding Teaching by a Graduate Student, USF

2011    Richard L. Thorpe Fellowship, American College of Health Care Administrators

2011    Laurence G. Branch Doctoral Student Research Award Funded by the Retirement Research Foundation, Honorable Mention, American Public Health Association

2011    Carroll L. Estes Student Research Award, Social Research, Policy, and Practice (SRPP) Section, Gerontological Society of America

2011    Douglas Holmes Award for Quality of Life/Quality of Care, Research in Quality of Care (RESQCARE) Interest Group, Gerontological Society of America

2013    Zimmer New Investigator Research Award, Honorable Mention, American Public Health Association

2015    Providence VA Medical Center’s Research Week Poster Award Winner

2016    Salomon Award, Brown University Office of the Vice President for Research

2016    2015 Top Cited Article in Public Policy and Aging Report

2016    Carroll L. Estes Rising Star Award, Social Research, Policy, and Practice (SRPP) Section, Gerontological Society of America

2018    Dean's Award for Excellence in Mentoring, Brown University, 2018

Gerontological Society of America

AcademyHealth

American Public Health Association