PACE Program:
PACE is an optional benefit under both Medicare and Medicaid that focuses entirely on seniors, who are frail enough to meet their State’s standards for nursing home care.
It features comprehensive medical and social services that can be provided at an adult day health center, home, and/or inpatient facilities that offer an alternative to more expensive nursing home care. A team of doctors, nurses and other health professionals assess participant needs, develop care plans, and deliver all services which are integrated into a complete health care plan. PACE is not available in all state; it is available only in those States which have chosen to offer PACE under Medicaid.
How do you know if you are eligible for PACE?
Be at least 55 years of age.
Live in the PACE service area.
Be screened by a team of doctors, nurses, and other health professionals as meeting that state’s nursing facility level of care.
At the time of enrollment, be able to safely live in a community setting.
What specific services does PACE provide?
PACE offers and manages all of the medical, social and rehabilitative services enrolled seniors need to preserve or restore their independence, to remain in their homes and communities, and to maintain their quality of life. The PACE service package must include all Medicare and Medicaid services provided by that State. In addition, the PACE organization provides any service determined necessary by the interdisciplinary team. Minimum services that must be provided in the PACE center include primary care services, social services, restorative therapies, personal care and supportive services, nutritional counseling, recreational therapy, and meals. Services are available 24 hours a day, 7 days a week, 365 days a year.
Generally, these services are provided in an adult day health center setting, but may also include in-home and other referral services that enrolled seniors may need. This includes such services as medical specialists, laboratory and other diagnostic services, hospital and nursing home care.
PACE teams include:
Primary care physicians and nurses.
Physical, occupational, and recreational therapists.
Social workers.
Personal care attendants.
Dietitians.
Drivers.
The PACE team has frequent contact with the enrolled seniors. This helps them to detect subtle changes in the seniors condition and they can react quickly to changing medical, functional, and psycho-social problems.
Who Pays for PACE?
PACE receives a fixed monthly payment per enrolled senior from Medicare and Medicaid. The amounts are the same during the contract year, regardless of the services an enrollee may need.
Persons enrolled in PACE also may have to pay a monthly premium, depending on their eligibility for Medicare and Medicaid.
To find a PACE program near you, search our nationwide service directory.
