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:
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.
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:
Primary care physicians and nurses.
Physical, occupational, and recreational therapists.
Social workers.
Personal care attendants.
Dietitians.
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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