Keeping "PACE" with American Health Care: Introducing a new partnership role for WOC Nurses

Health care is changing dramatically in the US!  As the Federal government attempts to balance budgets for Medicare and Medicaid, and as the older population grows at an unprecedented rate, proven models for dual eligibles are growing.  PACE (Program of All-inclusive Care for the Elderly), is one such program.  Under PACE, the goal of care is to keep elderly individuals, otherwise eligible for nursing home care, safe in the comfort and dignity of their own homes. The traditional rules and requirements of Medicare and Medicaid for supplies, products and services do not apply to this comprehensive program as the interdisciplinary team can authorize additional services beyond what Medicare and Medicaid provide.  

     The wound care needs in a PACE are significant, as the program is designed to care for registered participants in a variety of settings, including the PACE Center which includes a diagnostic and treatment center and a day health center, at home, in medical and/nursing clinics  and when necessary, hospitals and nursing home. The presence of venous stasis, arterial, diabetic and mixed etiology ulcers are prevalent in this population.  Even when participants are in the hospital or nursing home, the PACE is held responsible for the outcomes. Unstagable and Stage 3 and 4 pressure ulcers are reportable events to CMS that must be tracked.  Prevention, early detection and treatment of these are a major goal.  When participants cannot afford proper footwear or hosiery, for example, the PACE interdisciplinary team is empowered to authorize and supply whatever is necessary.   In all cases, the need for both staff and participant education is extensive.

     This poster will present a summary of the numerous opportunities for a WOCnurse working within a PACE, and will share both successful approaches used by one WOC nurse and ongoing challenges encountered in this unique and new system.