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A Partnership To Help You

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Polypharmacy. Personal assistance with ADL's and IADL's ... Polypharmacy. Needs personal assistance with at least 3 ADL's or IADL's ... – PowerPoint PPT presentation

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Title: A Partnership To Help You


1
  • A Partnership To Help You
  • Keep Your Residents Longer
  • Joy Cornelius, MS, PACE 916-446-3100
  • Mark John Crews, CSA 916-224-6688

2
High Maintenance assisted living client
  • Polypharmacy
  • Personal assistance with ADLs and IADLs
  • Pays 1500 to 4000 per month for assisted care
  • Pays for health insurance and prescriptions out
    of pocket (100 to 1000s per month)
  • Frequent utilization of ER, physician, and other
    health services
  • Needs transportation to and from medical
    appointments
  • Has medical needs that cannot be taken care of in
    the Assisted Living Facility
  • Doesnt want to go to a nursing home but might

3
Typical PACE participant
  • Polypharmacy
  • Needs personal assistance with at least 3 ADLs
    or IADLs
  • Has an income from 200 to thousands per month
  • Frequent utilization of ER, physician, and other
    health services
  • Needs transportation to and from medical
    appointments
  • Medical appointments as often as needed
  • Doesnt want to go to a nursing home

4
Asst Living Facility services
Polypharmacy
Client pays for health needs insurances
ADLs IADLs
Frequent medical visits
ALF provides Transportation to medical
Client pays for assisted care
Room, Bed Meals
Has additional medical needs
5
PACE services WRAP AROUND
Adult Day Care Environment
Majority of clients have 0 cost
At least 3 ADLs IADLs
Medical visits as needed
Eliminated
Geriatrician MD Dr to client 1100 Complete TEAM
of Professionals
Provides transportation
Provides, Rx, Dental, Vision, Rehab
6
PACE eligibility
  • Live in our 21 zip code service area
  • (or move to an RCFE in service area)
  • Be 55 years of age or older
  • Be at a Skilled Nursing or Intermediate Care
    Facility level of care
  • Be able to live safely in the community with the
    help of PACE services

7
PACE - dispelling the myths
  • None of the criteria has anything to do with
    income.
  • Unlike popular belief, PACE is not only for low
    income seniors.
  • Our mission is to keep frail seniors in the
    highest level of care possible and prevent
    nursing home placement for as long as possible
    through quality coordinated health care.

8
Partnering at its best!
  • Assisted Living Facility provides the personal
    care needs for the client as well as a safe
    living environment
  • PACE provides all-inclusive medical services
    (Medical, Rx, Vision, Hearing, Therapy, etc)
    through a multidisciplinary staff, an adult day
    health center, transportation, and coordinated
    health services to work to maintain a person in
    his or her current living environment
  • The services are complementary

9
Why work with PACE?
  • PACE will help your residents stay with you
    longer.
  • PACE provides a interdisciplinary team of
    doctors, nurses, social workers, therapists,
    pharmacist, nutritionist, and others who will
    work with the Asst Living Facility to personalize
    and complement the care issues of your resident.

10
continued
  • The PACE Adult Day Health Care is a place where
    your more frail and difficult residents go and
    allows your staff to spend more quality time with
    the residents who are in your facility
  • With PACE coordinated, comprehensive services,
    your residents will be more stable and balanced
    because they receive health care as frequently as
    they need it.

11
Can your residents afford PACE?
  • PACE is regulated by the Center for Medicare and
    Medicaid Services in Washington DC
  • We receive capitated funds from Medicare and
    Medi-cal for each PACE participant through which
    we provide the health services they need
  • If a person uses all of their income for rent in
    assisted living, there is no cost to your
    resident to be a PACE participant. If they use
    part but not all of their income for rent, then
    there is a partial share of cost for the program.
  • Medi-Cal provides a waiver for residents in a RCFE

12
Continued
  • A Partnership with PACE can
  • Reduce a clients costs (Rx, medical co-pays
    premiums, etc) allowing them to stay longer!
  • Keep a client healthier, allowing them to stay
    longer!
  • Reduce stress on RCFE staff because client is at
    PACE 1-5 days a week
  • Reduce RCFEs costs
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