PACE: Medical coverage, long-term care and Social Services – All in one

PACE helps seniors maintain independence and health for as long as possible by combining medical coverage with long-term care and social services.

Providence ElderPlace is part of the Program of All-Inclusive Care for the Elderly (PACE), a federally recognized program with over 100 sites operating in 31 states. PACE helps seniors maintain independence and health for as long as possible by combining medical coverage with long-term care and social services.

Long-term Care and In-home Services

Through our contracted partners, you will receive long-term services where you live, be it at home, in a living facility or an adult care home. Services include assistance with personal grooming, housekeeping, medication management, meal preparation and more.

Medical Care

All necessary medical services are covered. This includes doctor visits, hospital and surgical care, medications, medical equipment and supplies as well as physical, occupational and speech therapies.

Social Services

From the care of licensed social workers to the life enrichment activities at our centers, participants receive ongoing social support, enabling each individual to function at the highest possible level of social and emotional wellness.

Program Cost

All services are covered without hidden fees or co-payments. Medicaid covers Medicaid-eligible participants. For those who do not qualify for Medicaid, the ElderPlace premium matches the Medicaid rate.

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Assisted living resources

The following suggestions can help you get started in your search for a safe, comfortable and appropriate assisted living community:

Licensing requirements for assisted living facilities vary by state and can be known by as many as 26 different names including: residential care, board and care, congregate care, and personal care. A complete list of each state’s terminology and state regulations can be found online.

Choosing A Community

A good match between a community and a resident’s needs depends as much on the philosophy and services as it does on the quality of care.

The following suggestions can help you get started in your search for a safe, comfortable and appropriate assisted living community:

  • What are your future needs and how will the community meet those needs?
  • Is the community close to family and friends? Are there any shopping centers or other businesses nearby (within walking distance)?
  • Visit each community more than once, sometimes unannounced.
  • Visit at meal times, sample the food, and observe the quality.
  • Observe interactions among residents and staff and ask questions.
  • Ask about social, recreational, and spiritual activities.
  • Ask about the type and frequency of staff trainings.
  • Review state licensing reports.

These steps should also be considered:

  • Contact your state’s long-term care ombudsman to see if any complaints have recently been filed against the assisted living community you are interested in. In many states, the ombudsman checks on conditions at assisted living units and nursing homes.
  • If the assisted living community is connected to a nursing home, ask for information about it, too. (Information on nursing homes can be found on the Medicare website.


Due to the large number of Adult Foster Homes, not all are listed in this guide.  These links provide a complete list:

By Retirement Connection staff

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Understanding Long Term Care

Awareness Campaign – What is Long-Term Care?

Long-term care is a variety of services and supports to meet health or personal care needs over an extended period of time. Most long-term care is non-skilled personal care assistance, such as help performing everyday Activities of Daily Living (ADLs), which are:

  • Bathing
  • Dressing
  • Using the toilet
  • Transferring (to or from bed or chair)
  • Caring for incontinence and
  • Eating

The goal of long-term care services is to help you maximize your independence and functioning at a time when you are unable to be fully independent.

Who Needs Long-Term Care?

Long-term care is needed when you have a chronic illness or disability that causes you to need assistance with Activities of Daily Living. Your illness or disability could include a problem with memory loss, confusion, or disorientation. (This is called Cognitive Impairment and can result from conditions such as Alzheimer’s disease.)

This year, about 9 million Americans over the age of 65 will need long-term care services. By 2020, that number will increase to 12 million. While most people who need long-term care are age 65 or older, a person can need long-term care services at any age. Forty (40) percent of people currently receiving long-term care are adults 18 to 64 years old.

What Are My Risks of Needing Long-Term Care?

About 60 percent of individuals over age 65 will require at least some type of long-term care services during their lifetime. Over 40 percent will need care in a nursing home for some period of time. Factors that increase your risk of needing long-term care are:

  • Age – The risk generally increases as you get older.
  • Marital Status – Single people are more likely to need care from a paid provider.
  • Gender – Women are at a higher risk than men, primarily because they tend to live longer.
  • Lifestyle – Poor diet and exercise habits can increase your risk.
  • Health and Family History – also impact your risk.

How Much Care Might I Need?

It is difficult to predict how much or what type of care any one person might need. On average, someone age 65 today will need some long-term care services for three years. Service and support needs vary from one person to the next and often change over time. Women need care for longer (on average 3.7 years) than do men (on average 2.2 years). While about one-third of today’s 65-year-olds may never need long-term care services, 20 percent of them will need care for more than five years.

If you need long-term care, you may need one or more of the following:

  • Services at your home from a nurse, home health/home care aide, therapist, or homemaker;
  • Care in the community; and/or
  • Care in any of a variety of long-term facilities.

Generally you pay a provider for these services. But most people receiving paid services in their home or community need to supplement these services with help from family and friends.

How Do Care Needs Change Over Time?

Many people who need long-term care develop the need for care gradually. They may begin needing care only a few times a week or one or two times a day, for example, help with bathing or dressing. Care needs often progress as you age or as your chronic illness or disability become more debilitating, causing you to need care on a more continual basis, for example help using the toilet or ongoing supervision because of a progressive condition such as Alzheimer’s disease.

Some people need long-term care in a facility for a relatively short period of time while they are recovering from a sudden illness or injury, and then may be able to be cared for at home. Others may need long-term care services on an on-going basis, for example someone who is disabled from a severe stroke. Some people may need to move to a nursing home or other type of facility-based setting for more extensive care or supervision if their needs can no longer be met at home.

Source: U.S. Department of Health and Human Services, National Clearinghouse for Long-Term Care Information.
Provided by: The Staff at
Copyright © 2008 All rights reserved.

What if the Caregiver Passes Away? Who will provide the care?

What if the Caregiver Passes On?

As caregivers, we cannot assume that we always will be able to provide care. Even if we are able to be active caregivers, it is important to establish both emergency and long-term alternative care plans for our older relative or friend, and to make sure that the necessary legal documents are in place.

Legal Documents and Care Plans That Should Be in Place

Every adult should have at least a power of attorney, a living will or medical directive and a will or trust in place so that his or her wishes can be followed. If your older family member does not have these legal directives, you both should consult an attorney and have the appropriate documents drawn up.

Making Alternative Long-term Care Arrangements

When making alternative long-term care arrangements, you will want to discuss the matter with your care receiver(s), if at all possible, and follow their wishes about the person(s) or facility that would care for them, if you were unable to do so. If your care receiver(s) want to live with another family member or friend, you will, of course, want to discuss this arrangement with the proposed caregiver to ensure that it is agreeable.

If your relative can make informed choices about an alternate caregiver, living arrangement, and other matters, it will be easier to make long-term plans, if you have a power of attorney . If your older relative or friend cannot make informed choices it may be necessary to seek appointment as a conservator and/or guardian. This requires an appointment from the court to act on your care receiver’s behalf regarding matters of care and financial dealings. Whenever possible, discuss your plans for alternative living arrangements or caregiver choice with your older family member or friend and with other close family members as well as the designated caregiver. This will help to avoid opposition in the future that could lead to serious problems.

If you are the only possible informal caregiver, you and/or your relative can appoint a trusted friend or perhaps a committee composed of several friends to oversee your relative’s care, or you may decide that it is best to have a lawyer act as your care receiver’s representative. These arrangements also should be legally established.

Once you have decided on an alternate caregiver(s), it will be necessary to ensure that they, too, have the legal power needed to make decisions, should your care receiver be unable to do so. This may involve a durable power of attorney, a special medical power of attorney, and, in some states, a special power of attorney, if property is to be bought or sold, or a guardianship and/or conservatorship. As stated before, you should ensure that both you and your care receiver have medical directives, living wills and estate wills and/or trusts established, if there are financial resources available for your care receiver.

In choosing a long-term care housing arrangement it is a good idea to select one that can provide varying levels of care so that your care receiver will not be forced to move, if his or her medical condition changes.

Short-term emergencies don’t require the same amount of legal planning, but they must be considered. If you are unable to look after your care receiver, you will need to make arrangements with:

  • a relative or friend
  • a facility that provides short-term respite care (many nursing homes and assisted living facilities offer such care)
  • a home care agency
  • a geriatric care manager.

Remember that home care agencies often cannot provide services on short notice, and that you may need to have more than one family member or friend as a backup person.

Provided by: The Staff at
For more information:
Copyright © 2008 All rights reserved.

The FACTS and FICTION of Long-term Care Financing

I will not need long-term care in my lifetime. False. Sixty (60%) of Americans will need some long-term care (LTC) during their lifetime. Family members may be able to provide care in some situations. Or LTC services may be purchased to provide help at home or in a facility setting. The average long-term care stay is two and a half years.

I don’t need LTC insurance; my children will take care of me. Most likely they will. But the physical, emotional, and financial strain of providing care for a loved one can take its toll. LTC insurance plans can be designed to support care provided by the primary family caregiver, thereby preventing you from becoming a burden on your family.

The government will pay for my long-term care? False. Medicare pays primarily for medical care such as doctor and hospital costs and has very limited long-term care benefits, averaging just 23 days IF you meet the qualifying requirements. Medicaid will pay for LTC, but only IF you have limited income and assets less than $2,000. In 2006 Congress restricted Medicaid eligibility to the very poor, sending a message to the American public that they are responsible for paying for their own LTC.

Is LTC insurance my only choice? No, you may choose to pay for care services out of pocket. But with inflation doubling the cost of care every 15 years, many individuals choose to transfer the risk of catastrophic coverage to an insurance company.

LTC insurance will restrict my ability to choose where I want to receive care. False. In fact, the opposite is true. LTC coverage provides you with choices. Close to 70% of individuals who receive benefits from LTC insurance policies today receive care at home or in a community setting.

I’ve heard that LTC insurance isn’t affordable. It is the actual cost of LTC that is expensive, projected to increase to $120,000 per year in the next 15 years. The premiums are just pennies on the dollar.

I’m too young to think about long-term care. False. If you are in your 40s or 50s it is the perfect time to start thinking about your LTC plan. The younger and healthier you are when you start planning, the more options available to you. And when you invest early, your pool of money will have more time to grow before you dip into it to pay for care, maximizing your investment. Youth and good health discounts you may qualify for in your 40s and 50s will remain in place throughout the lifetime of your policy.

I will pay less over time for LTC coverage if I wait until I am older to purchase it. False. LTC premiums are structured so that you pay proportionately more the older you are at the time of purchase. Additionally, you may be required to pay a higher premium or be declined coverage due to existing health conditions at the time of application, leaving you to pay all your LTC costs out of pocket.

I don’t want to be pressured to purchase something that is confusing and expensive. Who can help me? A certified LTC specialist who works as an independent broker can be your best advocate. She can help you identify the level and type of coverage you need, then shop the market on your behalf, comparing plans to find you the best value. Additionally, with many optional riders and choices an experienced professional can tailor the plan to meet the specific needs of her client and their family.

What if I pay for LTCi and never use it? Well, that may happen. But if you are among the 60% of individuals who will need LTC in their lifetime, you and your family will be glad that you are prepared. Building a small plan or sharing coverage with a spouse or partner can maximize use of benefits. And, as with homeowners insurance, you hope you never have to use it. But if advancing age or declining health require you to seek extra care, you can eliminate the financial or emotional burden on your family.

My employer offers coverage through work. Is my employer plan always the best option for me? No. The LTC plan available through your employer isn’t necessarily the best plan for you and your family. Many of the discounts available in individual plans are not available through groups. And, some group plans do not offer the range of benefit choices available on the market. Consult a LTC specialist for a complimentary comparison.

What questions should I ask to begin putting my own LTC plan in place? Ask yourself these questions to get started: If you live a long life and need care, where would you like that care to be delivered? Who would provide your care? What impact will the need for LTC have on your spouse, children, and family or friends? How will you pay for that care?

I can’t afford financially to put a long-term plan in place. In fact, you can’t afford NOT to. Consultation with a LTC professional is complimentary. You owe it to yourself and your family to find out IF long-term care coverage makes sense for you. Armed with information, you can make an informed decision that is right for you and your family.

For more information about planning for your long-term care, check out these websites:

Use the Long Term Care savings calculator to see how much money you would have to save to accumulate enough to pay for your future long-term care. Click on Can I Save on My Own for LTC?

Provided by:Becky Wehrli, CLTC,,, 503-758-5725, toll-free 1-888-778-4164
Copyright © 2008 All rights reserved.

About the Long Term Care Ombudsman Program

What is the Long Term Care Ombudsman Program?

Long-Term Care Ombudsmen are advocates for residents of nursing homes, board and care homes, assisted living facilities and similar adult care facilities. They work to resolve problems of individual residents and to bring about changes at the local, state and national levels to improve care. While most residents receive good care in long-term care facilities, far too many are neglected, and other unfortunate incidents of psychological, physical and other kinds of abuse do occur. Thus, thousands of trained volunteer ombudsmen regularly visit long-term care facilities, monitor conditions and care, and provide a voice for those unable to speak for themselves.


Begun in 1972 as a demonstration program, the Ombudsman Program today is established in all states under the Older Americans Act, which is administered by the Administration on Aging (AoA). Local ombudsmen work on behalf of residents in hundreds of communities throughout the country.

Long Term Care Ombudsman Results

In 2005, about 13,800 volunteers, 9,187 of whom were certified to investigate complaints and 1,277 paid ombudsmen served in 572 localities nationwide. Ombudsmen investigated over 300,000 complaints made by 186,000 individuals and provided information on long-term care to another 306,000 people. The most frequent nursing home complaints involved lack of resident care due to inadequate staffing.

Residents’ Rights

Ombudsmen help residents and their families and friends understand and exercise rights that are guaranteed by law, both at the federal level and in many states. Residents have the right to:

  • be treated with respect and dignity;
  • be free from chemical and physical restraints;
  • manage their own finances;
  • voice grievances without fear of retaliation;
  • associate and communicate privately with any person of their choice;
  • send and receive personal mail;
  • have personal and medical records kept confidential;
  • apply for state and federal assistance without discrimination;
  • be fully informed prior to admission of their rights, services available and all charges; and be given advance notice of transfer or discharge.

The Ombudsman Program Assists Older Adults by empowering adults as they age with reliable information and access to the care they need. The program enables individuals who are at high risk of nursing home placement to remain at home. Another aspect of the program is building disease prevention into community living through the use of low-cost, evidence based programs.

The AoA recognizes the importance of making information readily available to consumers, professionals, researchers, and students. Their website provides information for and about older persons, their families, and professionals involved in aging programs and services.

For more information about AoA, please contact: US Dept of Health and Human Services, Administration on Aging through their website at

Ombudsman Responsibilities are:

Ombudsman responsibilities outlined in Title VII of the Older Americans Act include:

  • identify, investigate and resolve complaints made by or on behalf of residents;
  • provide information to residents about longterm care services
  • represent the interests of residents before governmental agencies and seeking administrative, legal and other remedies to protect residents;
  • analyze, comment on and recommend changes in laws and regulations pertaining to the health, safety, welfare and rights of residents;
  • educate and inform consumers and the general public regarding issues and concerns related to long-term care and facilitate public comment on laws, regulations, policies and actions;
  • promote the development of citizen organizations to participate in the program;
  • provide technical support for the development of resident and family councils to protect the well-being and rights of residents, and
  • advocate for changes to improve residents’ quality of life and care.

Source: US Dept of Health and Human Services, Administration on Aging,,

Provided by: The Staff at
Copyright © 2008 All rights reserved.