Programs of All-Inclusive Care for the Elderly (PACE) PACE Quality Data Monitoring and Reporting (10525)

The PACE program is a unique model of managed care service delivery for the frail elderly, most of whom are dually-eligible for Medicare and Medicaid benefits. To be eligible to enroll in PACE, an individual must: be 55 or older, live in the service area of a PACE organization (PO), need a nursing home-level of care, and be able to live safely in the community with assistance from PACE. POs are responsible for providing all required Medicare and Medicaid covered services, and any other service that the interdisciplinary team (IDT) determines necessary to improve and maintain a participant’s overall health condition. The IDT is responsible for providing as well as coordinating the care and services for each participant enrolled in the program based on his or her individual needs with the goal of enabling older individuals to remain in their community. Because PACE organizations are both an insurer and health care provider, it is vital that CMS have a mechanism to monitor POs performance and identify areas for quality improvement and the need for technical assistance. Therefore, POs must comply with the quality monitoring and reporting requirements outlined in the regulatory citations listed on this form. POs are also required to report certain unusual incidents to other Federal and State agencies. POs have been collecting and reporting PACE Quality data to CMS and State administering agencies (SAA) since 1999.

The latest form for Programs of All-Inclusive Care for the Elderly (PACE) PACE Quality Data Monitoring and Reporting (10525) expires 2023-12-31 and can be found here.

PACE Quality Data Without RCA

Federal Enterprise Architecture: Health - Health Care Services