Program of All-Inclusive Care for the Elderly (PACE)

Enrollees in the Program of All-Inclusive Care for the Elderly (PACE) benefit from a comprehensive health care plan that consolidates all of their services.

The PACE program for the elderly enables those seniors to remain in the community rather than in a nursing facility as long as it is safe for them to do so. The program targets seniors who are at least 55 years of age with an acceptable level of independent living skills.

An individual enrolled in this Medicaid and Medicare program works with a case manager who coordinates his or her care. The case manager works with a team of healthcare professionals who administer services to the enrollee. The PACE program for seniors includes primary care visits, nutritional counseling, meals, recreational activities and restorative therapy. Potential program recipients can keep reading for more information on PACE services and how to apply for the program.

What is the Program of All-Inclusive Care for the Elderly (PACE)?

Through the Program of All-Inclusive Care for the Elderly (PACE), elderly seniors receive comprehensive health and social services in a combined program. PACE elder care services are aimed at reducing independence on nursing home care by allowing individuals to live on their own when able.

PACE organizations are non-profit or public entities that primarily provide PACE program services. The program targets frail individuals who would benefit from an all-inclusive program to manage their daily care needs. These organizations provide services in an adult day health setting. Seniors also receive supplemental in-home care as needed.

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The program is facilitated by an interdisciplinary team that coordinates the senior’s care. The patient’s care team includes a variety of specialists which include a primary care physician, registered nurse, social worker, physical therapist, occupational therapist, home care coordinator and transportation driver.

Most PACE participants meet both Medicaid and  . Once enrolled, PACE becomes the patient’s sole source of Medicaid and Medicare services. Given that, the PACE program for elderly provides all Medicaid and Medicare services. The program also offers additional services such as therapy and social services, as needed. Enrollment in the program is voluntary, and participants may disenroll at any time. Services continue until death or the participants voluntary opt out of the program.

Services Provided by the PACE Program for Seniors

The Program of All-Inclusive Care for the Elderly (PACE) provides patients with a comprehensive package of services designed to simplify patient care. Each PACE healthcare enrollee is assigned a case manager who coordinates all services for the senior. Once enrolled in the program, the senior’s case manager allocates a care team to administer any services the individual requires. The care team develops what is known as a care plan for each program participant. The plan outlines the types of services required, medication needs, recreational activity plan and other items dependent on the senior’s needs. Specific services the program offers include the following:

Primary Care

Individuals enrolled in PACE services receive health care services through a primary care physician assigned to their care team. The physician handles all patient health care needs including routine checkups, labs, medications and preventive medicine services such as health screening.

Restorative Therapies

PACE services also include therapies such as physical therapy. Through physical therapy, seniors work to increase their mobility. The program also administers occupational therapy aimed at improving tasks related to the senior’s daily living skills such as dressing or bathing.

Nutritional Counseling & Meals

Through nutritional counseling, PACE program for the elderly enrollees receive a meal plan designed for their specific healthcare needs. The counselor evaluates a person’s health situation and makes recommendations on appropriate foods best suited to the senior. Seniors in the program also receive daily meals during their time at the day health care center.

Recreational Therapy

The program helps seniors remain active by providing a range of recreational activities. Such activities include games, puzzles and gardening.

Services Provided Through PACE Healthcare

As most PACE services enrollees are dual eligible for Medicaid and Medicare, the program administers health services covered under both plans. With PACE healthcare, individuals receive a comprehensive range of services which include:

  • Inpatient hospital services.
  • Outpatient services.
  • Medications.
  • Primary health services.
  • Mental health services.

Individuals who require end-of-life care through hospice receive those services through the PACE program. Services include medical, pharmaceutical and counseling. Program participants may elect another hospice facility for their care. However, they must voluntarily disenroll from PACE. The senior’s care team would then work with the outside hospice facility to transfer care.

PACE Eligibility Requirements

Those interested in PACE elder care must meet set qualifications to enroll in the program. The eligibility requirements exist to ensure the PACE program for seniors serves the needs of the individuals who most need it. Those mandates include the following:

Age

Applicants must be at least 55 years of age. The program recognizes that many patients are dually eligible for Medicare and Medicaid and that each has different age requirements. However, applicants to the program are only required to meet the age requirement for PACE.

Nursing Care

The program works to decrease the dependence on nursing facilities for a patient’s care. As such, those seeking admission to the program must require a level of care.

Location

The PACE program serves the needs of the local community in which it operates. Given that, individuals applying for PACE services must live in a PACE organization’s service area.

Independent Living Skills

PACE elder care aims to enable seniors to remain in their community if they can safely do so. This goal is accomplished through utilizing adult day health care for a senior’s daily living needs. However, they must be able to carry out essential life skills outside of program hours. Therefore, applicants must demonstrate an acceptable level of independent living skills to qualify to receive PACE services.

How to Apply for the Program of All-Inclusive Care for the Elderly (PACE)

Those seeking PACE elder care must contact the organization servicing their area. Enrollment in PACE services requires an application. Once the center receives the form, it will schedule an assessment for the senior. Often, the evaluation is conducted at the senior’s home. The assessment helps determine if the senior meets eligibility criteria and if the individual would receive benefit from the program’s long-term care plan. The program may also require the senior to visit the PACE center for further assessment and to allow the applicant to determine if they wish to continue the application process.

Once accepted into the program, the senior must sign an enrollment agreement. The agreement outlines the start date for services, the types of benefits and services provided and explanation of plan premiums. The PACE services enrollment agreement also specifies the plan for emergency care.

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