Medicaid patients appear to be losing out on dementia care, government statistics show. 

A little bit more than 17 percent of the nation’s residential care centers offered specialized dementia care to their residents, the U.S. Department of Health and Human Services (HHS) found in a 2013 report, “Medicaid in Residential Care.” But fewer than 14 percent of Medicaid centers offered that kind of care.

More than 20 percent of non-Medicaid centers offered specialized dementia care, the report found.

That means that an even 20 percent of Medicaid patients were able to access specialized dementia care in their care centers, compared with more than 40 percent of non-Medicaid patients, the report found. The report’s authors guessed that some of the care gap may be “indicative of the younger age of Medicaid residents who are less likely to have dementia.”

Medicaid Communities Take Higher-Acuity Residents

At the same time, though, the report authors found that “a larger proportion of Medicaid communities admit individuals who need skilled nursing care, including daily monitoring for a health condition, or have a substance abuse problem,” the report says. 

“A smaller proportion of Medicaid [residential care communities] admit residents who are unable to leave the [community] in an emergency without help, are regularly incontinent, and have moderate to severe cognitive impairment,” the report said. 

Medicaid residents in residential care communities were more likely to be under the age of 65 and to have severe mental illnesses or intellectual and/or developmental disabilities; non-Medicaid residents were more likely to be 65 years or older and to have Alzheimer’s disease or other dementias, the report found. 

For all of that, more than two out of every five residential communities served at least one Medicaid resident, and almost one out of every five residents in residential care depends upon Medicaid to pay the bills, the report said.

Residental Care Less Expensive

HHS investigators also found that, while residential care communities charged much less than skilled nursing centers, on average, non-Medicaid residential communities charged much more than Medicaid-based communities. 

A one-bedroom apartment or a single room in a non-Medicaid residential community cost about $3,500 per month and $2,993 per month, respectively. In a Medicaid residential community, the apartment or private room cost $2,912 and $2,587 per month, respectively, the authors found. 

“Similarly, the average total charge to non-Medicaid residents in the month prior to the survey is significantly higher than that charged to Medicaid residents, with non-Medicaid residents paying approximately $1,200 per month more,” the HHS report says.

—B​ill Myers​