OBJECTIVES: To evaluate health care resource utilization and costs among diabetes patients residing in long-term care facilities. METHODS: Patients diagnosed with diabetes (International Classification of Diseases, 9^th Revision, Clinical Modification diagnosis codes 250.x0, 250.x2) were identified using the Long-Term Care Minimum Data Set (MDS) linked to 5% Medicare data from 01JAN2009 through 31DEC2010. The initial diagnosis date was designated as the index date. A comparison cohort was created for patients without diabetes, using 1:1 propensity score matching (PSM) to control for age, region, gender and baseline Charlson Comorbidity Index score. The index date for the comparison cohort was randomly chosen to reduce selection bias. Patients in both cohorts were required to be age ≥65 years, have at least two consecutive quarterly assessments documented in MDS data 6 months prior to the index date and have continuous medical and pharmacy benefits for 1-year pre- and post-index date. Health care resource utilization and costs were compared between the diabetes and comparison cohorts. RESULTS: After applying PSM, 783 patients were included in each cohort, and baseline characteristics were balanced. Diabetes patients had a higher percentage of inpatient (31.29% vs. 22.73%, p=0.0001), skilled nursing facility (SNF, 31.55% vs. 22.73%, p<0.001), durable medical equipment (27.46% vs. 16.48%, p<0.0001) and pharmacy visit claims (93.10% vs. 88.76%, p=0.0028) compared to those without diabetes. Patients in the diabetes cohort also incurred significantly higher inpatient ($5,801 vs. $3,071, p<0.0001), SNF ($5,532 vs. $3,244, p<0.0001), carrier claim ($3,118 vs. $2,437, p=0.0002) and pharmacy visit costs ($5,040 vs. $4,275, p=0.0005) than those in the comparison cohort. CONCLUSIONS: Patients diagnosed with diabetes had significantly higher health care resource utilization and costs than those without diabetes.