Using Medicaid to Cover Services for Elderly Persons in Residential Care Settings: State Policy Maker and Stakeholder Views in Six States. Dementia Care


A number of respondents felt that the state needed better standards for dementia care. One stated that the industry opposes regulation in this area, but another disagreed:

  • We need regulations for dementia care but the industry is not opposed. They just don't want nursing home style regulations. The better providers are not against regulation. They don't want rotten apples to spoil the barrel.

  • Dementia standards would be a good thing. But the state needs need to figure out its capacity to regulate because there is no point in enacting regulations that can't be enforced. Model standards for dementia would help. The state could encourage the adoption of these standards through incentives. Facilities that operate according to the model standards could advertise that they were certified as meeting the standards. Regulations just set a floor -- they don't get you to a desirable level of care -- they just set a minimum.

One respondent noted that cognitive impairment is a real problem in RCACs, because while the regulations prohibit the admission of people who are incompetent, it's possible to be competent but be incompetent at managing medications.

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