PACE and Social Managed Care- Alternatives to Nursing Home Care

Alternatives to Nursing Home Care

Nursing Homes serve as permanent residences for people who are too frail or sick to live at home or as a temporary facility during a recovering period. However, many people need a nursing home level of care but would prefer to remain in their own home with the help of their family and friends, community services, and professional care agencies. The Medicare program offers limited access to two unique programs for certain beneficiaries who need a comprehensive medical and social service delivery system.

The two programs currently available are:

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

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.

Social Managed Care Plan

A Social Managed Care Plan is an organization that provides the full range of Medicare benefits offered by standard Managed Care Plan’s plus additional services which include care coordination, prescription drug benefits, chronic care benefits covering short term nursing home care, a full range of home and community based services such as homemaker, personal care services, adult day care, respite care, and medical transportation. Other services that may be provided include eyeglasses, hearing aids, and dental benefits. These plans offer the full range of medical benefits that are offered by standard Managed Care Plan’s plus chronic care/ extended care services. Membership offers other health benefits that are not provided through Medicare alone or most other senior health plans.

Summary

There are some people, however, who require less than skilled care, or who require skilled care for only brief periods of time. In most communities, people can choose from a variety of living arrangements that offer different levels of care. Before deciding on a care setting, talk to a doctor or maybe a social worker about your care needs. Most people want to stay in their home for as long as possible. If you are considering staying at home make sure you know the amount of responsibility and work involved. If you cannot live independently, but don’t want to live in a nursing home, you may want to consider some of the other alternatives available.