Enrollment

There are four (4) steps to enrolling to Riverside 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:

Intake – Intake usually starts when you or someone in your family, or even someone from an agency, calls Riverside 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:

  • About the Enrollment Agreement;
  • How the Riverside 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 Riverside PACE; and,
  • An estimate of your monthly cost, if any.

After this visit, if you are interested in becoming a participant in Riverside PACE, a member of the Personal Care Team will discuss your health care needs with other Team members and set up a visit for you at our PACE Center.  Usually this means that you will go to the Riverside PACE Center for a couple of visits so you can get to know us and we can get to know you and learn about your special needs.  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.

Assessment - Within two weeks, after each Team member has reviewed your records, the entire Personal Care Team will meet to talk about what kind of care you need.  At this meeting, they will create a plan of care just for you.

Scheduling the Family Conference - After we have an opportunity to discuss your needs, a staff member will call you and your family, or someone close to you, to set up a meeting to discuss the best kind of care for you.  If the Team agrees that you are eligible, and if you like the Riverside PACE Center after your visits, it will be time for you to officially enroll in the program.

Enrollment (Family) Conference and Preliminary - A Personal Care Team member will meet with you to talk about enrolling in Riverside PACE.  You can choose to have your family or a caregiver attend this meeting. We will discuss:

  • The plan of care the Personal Care Team feels you need and how your family will be a part of  it;
  • Your monthly costs, if any;
  • If you decide to be a Riverside PACE participant, we will ask you to sign the Enrollment Agreement signature sheet.

Approval – The Nursing Facility Pre-admission Screening Team will determine whether you meet the level of care criteria required to be eligible for PACE.  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 thirty (30) days of receipt of your decision letter.


 

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