AL
PACE Enrollment
Program of All-inclusive Care for the Elderly — eligibility, assessment, and site assignment
347
PACE Enrollees
↑ 8 new this month
74
Average Age
Range: 55–98 years
89%
Dual Eligible
310 of 347 duals
92%
NF-LOC Certified
27 pending certification

PACE Eligibility Requirements

Age ≥ 55 — Must be 55 years or older at time of enrollment
NF-LOC — Certified as Nursing Facility Level of Care by State
Medicaid Eligible — Active Medicaid enrollment (most duals qualify)
Residence — Lives within approved PACE service area
Safe Community Setting — Must be able to live safely outside nursing facility
Exclusion — Cannot require 24-hour nursing supervision

Enrollment Timeline (Typical)

Referral / Inquiry Received
Day 0 — Referral from hospital, PCP, or self-referral
Initial Screen
Day 1–3 — Age, residence, and Medicaid eligibility check
NF-LOC Assessment
Day 4–10 — State-certified functional assessment
IDT Comprehensive Assessment
Day 11–21 — Interdisciplinary team (MD, RN, SW, PT, etc.)
Enrollment Agreement Signed
Day 22–30 — CMS required consent and enrollment form
Effective Date / CMS Notification
1st of following month — Enrollment active

New PACE Applicant

PACE Sites — Current Census

SiteCapacityEnrolledWaitlistStatus
Downtown Day Center1501428Near Capacity
Eastside PACE Center120980Open
Northgate PACE10010723At Capacity

Recent Applications

ApplicantAgeADLNF-LOCStatus
Margaret T.784CertifiedIDT Review
Henry C.825PendingAssessment
Rosa M.713CertifiedEnrolled
James P.886CertifiedEnrolled
Sylvia N.662Not MetDenied
AI Assistant

PACE (Program of All-inclusive Care for the Elderly) is a Medicare and Medicaid program that provides comprehensive medical and social services to frail elderly individuals, allowing them to remain in the community instead of nursing facilities.

Nursing Facility Level of Care certification is a State-required assessment that confirms the applicant needs the level of care typically provided in a nursing facility. Required for PACE enrollment under federal regulations (42 CFR 460.150).

Activities of Daily Living score (0–6) reflects the number of ADLs requiring assistance: bathing, dressing, toileting, continence, eating, transferring. Higher scores indicate greater functional impairment.

PACE participants attend the Day Center for comprehensive services. Assignment is based on proximity to the participant's home and site capacity. Waitlists are managed FIFO per CMS guidance.

  • PACE enrollment is continuous — no open enrollment period restriction
  • CMS must be notified of enrollments by the 3rd business day of each month
  • PACE participants disenroll Medicare Part D — PACE covers all drugs
  • CMS capitation is risk-adjusted monthly via MDS 3.0 data