OBJECTIVES: To evaluate health care resource utilization and costs of patients diagnosed with Alzheimer's disease (AD) and residing in long-term care facilities.  METHODS: A retrospective database analysis was performed using the Minimum Data set (MDS) linked to 5% Medicare data from 01JAN2008 through 31DEC2011. AD patients were identified using International Classification of Disease, 9^thRevision, Clinical Modification (ICD-9-CM) diagnosis code 331.0. The first diagnosis date was designated as the index date. A comparison cohort was created for patients without an AD diagnosis, using 1:1 propensity score matching (PSM) to control for baseline characteristics (age, region, gender, index year, baseline Charlson Comorbidity Index [CCI] score). For the comparison cohort, the index date was randomly chosen to reduce selection bias. Patients in both cohorts were required to be age ≥65 years, with at least two consecutive quarterly assessments in MDS data in the 6 months pre-index date and 1-year continuous medical and pharmacy benefits enrollment pre- and post-index date. Study outcomes (health care costs and utilizations) were compared between the cohorts.  RESULTS: After 1:1 matching, a total of 2,158 patients were identified for the disease and comparison cohorts, and baseline characteristics were balanced. The AD cohort had a higher percentage of inpatient stays (33.73% vs. 24.93%, p<0.0001), outpatient visits (92.22% vs. 89.99%, p=0.01) and skilled nursing facility (SNF) (32.53% vs. 28.41%, p<0.01) and hospice admissions (11.03% vs. 7.14%, p<0.0001) than the comparison cohort. The AD cohort also incurred higher inpatient ($5,442 vs. $4,001, p<0.001), SNF ($5,679 vs. $4,523, p<0.01) and hospice stay costs ($3,164 vs. $2,047, p<0.001) as well as carrier claim ($2,907 vs. $2,686, p=0.03) and pharmacy costs ($5,043 vs. $4,722, p=0.01), compared to the comparison cohort.  CONCLUSIONS: AD was associated with higher health care resource utilization and a significantly higher economic burden.