PACE Enrollment

You’ll take four steps to enroll in Sentara PACE. As soon as you have completed all four steps, your medications, care from a doctor or nurse, and other services described in this Enrollment Agreement are covered. The four steps are:

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1. Intake

Intake usually starts when you or someone in your family, or even someone from other agencies with your consent, calls PACE to talk about your medical needs. This call tells us that you might be eligible to be a participant. We will come to your home to talk to you and explain our program. We will also look at your medical needs and decide the best way to meet them. During this visit, you will learn:

The Enrollment Agreement includes:

How the PACE program works, the services we offer, and the answers to any questions you may have about us;
That if you enroll, you must agree to get all your health care from PACE; and,
That you must pay all monthly premiums (if applicable)

After this visit, you will sign a consent form if you are interested in becoming a participant in Sentara PACE, and then a member of the Interdisciplinary Team (IDT) will discuss your health care needs with other Team members and set up a visit for you at one of our PACE centers. Usually this means that you will go to the PACE center nearest to you for a visit so you can get to know us and we can get to know you and learn about your special needs. Members of the IDT will consist of a Physician, RN, Social Worker, Physical Therapist, Occupational Therapist, Recreational Therapist, Activity Coordinator, Personal Care Attendant, Dietitian, Facility Manager, Transportation/Driver and Home Care Coordinator. We will also ask you to give us permission to obtain your medical records from doctors you have seen so we can get a complete picture of your health condition.

2. Assessment

The Interdisciplinary Team (IDT) will review your medical records and afterward, the entire IDT will meet to talk and discuss your special needs.

Virginia Uniform Assessment Instrument

A Virginia Uniform Assessment Instrument (UAI) is a form used by acute care hospitals, the Department of Social Services and the local Department of Health to assess an individual's need for nursing facility level of care.

3. Scheduling the family conference

After we have an opportunity to discuss your needs, a staff member will call you and your family to obtain you and your family's input into your plan of care. If the team agrees that you are eligible, and if you like what the program offers, it will be time for you to officially enroll in the program.

Enrollment (Family) Conference and Preliminary

An IDT member will meet with you to talk about enrolling in Sentara PACE. You can choose to have your family or a caregiver attend this meeting. We will discuss:

The plan of care the IDT feels you need and how your family will be a part of it
Your monthly costs, if any
If you decide to be a PACE participant, we will ask you to sign the enrollment agreement signature sheet.

4. Approval

The nursing facility pre-admission screening team will determine whether you meet the level of care criteria required to be eligible for the program. If you do not agree with the decision by the pre-admission screening team, you may appeal the decision by writing to the Appeals Division, Department of Medical Assistance Services, 600 East Broad Street, Richmond, Virginia 23219 within 30 days of receipt of your decision letter.

Disenrollment

Enrollment

Last updated 10/23/20