Enrollment
The enrollment process is designed to make sure that you or your loved one can continue to live safely in their own home while utilizing PACE services.
The Enrollment Specialist will meet with you and your family or caregiver in your home to provide a detailed understanding of our program. We will also make sure that if you need help applying for Medicaid, the stress and burden is taken off of you and your loved ones.
The Enrollment Specialist will
do an assessment of your eligibility and schedule a visit to the PACE Center where
you will meet our staff and complete the rest of the needed assessments. Once
the care plan has been approved by both our staff and the potential
participant, along with the remaining enrollment paperwork, enrollment will
then be completed and submitted to CMS (Centers for Medicare and Medicaid
Services) for final approval. Enrollment is voluntary and you may leave the
program at any time.
A copy of the enrollment agreement can be viewed here.
The following steps lay out a more comprehensive look at the
enrollment process:
Pre-Screen
- Enrollment Specialist (ES) will go through a list of pre-screening questions to help determine if individual will qualify for PACE.
- If the individual meets certain criteria, a home visit by the ES will follow.
Enrollment Specialist Home Visit
- The ES will do a home visit to continue the screening process and complete a level of care.
- If a caregiver is involved regularly with the individual, the meeting should include them as well.
Home Care Coordinator/Occupational Therapist Home Visit
- During this visit, the individual is assessed by both the Home Care Coordinator and the Occupational Therapist to determine the needs of the individual and if they can live safely in their environment while they are enrolled in the PACE program.
Tour of Facility and Last Assessments
- During the time the individual comes in for their tour, additional assessments will be completed.
- Assessments from Dietary, Physical Therapy, Recreational Coordinator, the Provider, Master's Level Social Worker, and the Clinic Nurse will need to be completed.
- In the event the individual is unable to complete those assessments during visit, a future clinic date or in home date will be scheduled.
Preliminary Plan of Care/Finish Enrollment
- Based on the assessments, a preliminary plan of care is developed and presented to the individual for approval.
- If approved, the agreement to enroll is signed and everything is submitted to CMS for approval.
- Participation in the PACE program starts on the 1st of the month.