Nursing Homes
Program of All-Inclusive Care for the Elderly (PACE)
PACE is unique. It is an optional benefit under both Medicare and Medicaid that focuses entirely on older people, 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. For most patients, the comprehensive service package permits them to continue living at home while receiving services, rather than be institutionalized. 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 available only in States which have chosen to offer PACE under Medicaid.
Eligibility
Eligible individuals who wish to participate must voluntarily enroll. PACE enrollees also must:
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Be at least 55 years of age.
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Live in the PACE service area.
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Be screened by a team of doctors, nurses, and other health professionals as meeting that state's nursing facility level of care.
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At the time of enrollment, be able to safely live in a community setting.
Services
PACE offers and manages all of the medical, social and rehabilitative services their enrollees 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 enrollees may need. This includes such services as medical specialists, laboratory and other diagnostic services, hospital and nursing home care.
An enrollee's need is determined by PACE's medical team of care providers. PACE teams include:
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Primary care physicians and nurses.
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Physical, occupational, and recreational therapists.
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Social workers.
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Personal care attendants.
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Dietitians.
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Drivers.
The PACE team has frequent contact with their enrollees. This helps them to detect subtle changes in their enrollee's condition and they can react quickly to changing medical, functional, and psycho-social problems.
Payment
PACE receives a fixed monthly payment per enrollee 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.
Current Sites
For a listing of PACE organizations nationwide, please visit the following website:
http://www.cms.hhs.gov/pace/pacesite.asp
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