December 10, 2025 • 19 mins
In this episode of Advice From Your Advocates, Elder Law Attorney Bob Mannor sits down with Jessica Downing of Ascension Living PACE to unpack the Program for All-Inclusive Care for the Elderly, better known as PACE.
Together, they explore how PACE supports senior independence, provides comprehensive healthcare services, and removes some of the biggest barriers aging adults face, including transportation, access to Medicare/Medicaid–covered care, and reliable support for those living with dementia.
Jessica explains how PACE’s wraparound model, featuring 11 healthcare disciplines, helps older adults stay safely in their homes and communities. They also clear up common misconceptions, especially the fear of losing independence, and spotlight the critical role PACE plays in reducing caregiver burnout.
What you’ll learn in this episode:
- What PACE is and who qualifies
- How transportation empowers seniors to stay active and connected
- Why PACE is a lifeline for families caring for loved ones with dementia
- How Medicare/Medicaid interact with PACE services
- What makes the wraparound care model unique
- How PACE supports caregivers and promotes healthy aging
If you support aging loved ones or work in elder care, this is a must-listen episode.
Host: Attorney Bob Mannor, CELA, CDP
Guest: Jessica Downing, Ascencion Living PACE Michigan
Executive Producer: Savannah Meksto
Assistant Producers: Samantha Noah, Shalena Gaul, Alecia Campbell
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ABOUT US:
Mannor Law Group helps clients in all matters of estate planning and elder law including special needs planning, veterans’ benefits, Medicaid planning, estate administration, and more. We offer guidance through all stages of life.
We also help families dealing with dementia, Alzheimer’s disease, Parkinson’s disease, and other illnesses that cause memory loss. We take a comprehensive, holistic approach, called Life Care Planning. LEARN MORE...
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_01 (00:00):
You're listening to Advice from Your Advocates, a
show where we provide elder lawadvice to professionals who work
with the elderly and theirfamilies.
SPEAKER_00 (00:09):
Welcome back to Advice from Your Advocates.
I'm Bob Manner.
I'm a board-certified elder lawattorney in Michigan.
And we have a great show today.
We have Jessica Downing fromAscension Living PACE.
And we've had folks from PACEbefore, and this is a great
topic.
We really want to spread theword about PACE, the program for
all-inclusive care for theelderly.
(00:30):
So, Jessica, welcome.
SPEAKER_01 (00:32):
Thank you so much, Bob.
I'm so happy to be here.
SPEAKER_00 (00:35):
And so tell us a little bit about yourself and
your job, and then we'll getinto the PACE program that you
work for and everything aboutthat.
SPEAKER_01 (00:45):
So my name is Jessica Downing.
I am the marketing and intakedirector here at Ascension
Living Pace, Michigan.
I have actually been in myposition since May of this year,
but I've been with the PACEprogram going on three years
now.
I've worked for Ascension,though, for about 15 years
total.
So this is Wow.
Yeah.
So this is actually a greatopportunity for me.
I do have a husband and sixkids.
(01:07):
So I guess the level of care hasalways been up there for me.
Definitely raising six kids.
SPEAKER_00 (01:12):
So yeah, I've got five kids.
So you got one on so uh let'sspecify a couple things about
pace.
First of all, I understand youyou moved into your new digs,
your new building, and I think Iwas a little uh short on the
uptake.
I had been still talking to Payabout pace and saying that you
were in the old building, butyou guys called me and let me
(01:35):
know that you've moved fullymoved.
And so tell us about the newlocation and the new great uh
space that you have.
SPEAKER_01 (01:42):
Oh yes, I'm happy to.
So we were previously behind theFlint Farm Market, which was a
great location, but we hadoutgrown our facility, honestly.
We were bursting at the sceneswith bringing in participants
left and right.
Right.
So we had to expand toaccommodate.
So we recently moved into ournew building in the middle of
May.
We're actually located off ofthe Dorton Stewart exit off of
(02:05):
475 by the water plant.
We actually are on a privatedrive just off of there.
I'm not sure if you guys knowwhere the the previous Security
Federal Credit Union was.
SPEAKER_00 (02:16):
Okay, right.
SPEAKER_01 (02:16):
Yeah, so we're the old building.
Uh, we've revamped it.
We can accommodate up to 400participants now.
Previously, we were only able toaccommodate about 250.
Um, so this move was definitelya need for us.
But we're absolutely happy to beover here.
It's nice and quiet.
It's a private drive.
The state park across the streetis always nice and well kept,
(02:37):
and it's nice and ready for theparticipants.
SPEAKER_00 (02:40):
And one of the things I always like to point
out about PACE becausesometimes, and we'll get into a
lot of the details on PACE, butthe thing is that the part of
the deal is the for theparticipant, travel is part of
the arrangement that I know youguys have used the term sort of
indoor to indoor.
In other words, they go to wherethey're living and help them
(03:03):
get, you know, situated in thetransportation and then get to
the PACE center and then getthem inside, get them situated,
all of that.
It's not uh the the familiesdon't have to arrange their own
transportation.
SPEAKER_01 (03:15):
Yes, that's correct.
So that seems to be a really bigaspect of the PACE organization,
I have to say.
Transportation, you know, is avery integral part of our
community because a lot ofseniors do not get the privilege
of being able to drive muchanymore, if at all.
So we provide those services toand from our PACE facility and
to and from outside appointmentsas well.
(03:36):
And like you had mentioned, theyare a door-to-door service.
So we'll go right to the door topick up your loved one, take
them to our bus.
We have lift systems for anykind of assistance medical
devices that your loved onemight have, whether it be a
walker, cane, or wheelchair.
So our buses can assist justabout an array of anything you
can think of to be able to getthem safely to and from our pace
(03:56):
center and to and from theirappointments.
SPEAKER_00 (03:58):
Now, it sounds like with the numbers that is about
double or more than double thethe uh volume that you're
allowed that you can get that asmany that many people now that
you can serve.
SPEAKER_01 (04:08):
We're almost double.
We were at about 250, we're at400 now that we can potentially
bring in.
Yeah, but after we get closer to400, we get to be reevaluated,
so we might even be able tobring in more as we reach that
cap as well.
SPEAKER_00 (04:21):
Okay.
Yeah.
So for those that don't reallyknow about PACE, I'd like you to
kind of give an explanation ofhow PACE works, how people, you
know, the the participants'contribution towards it, if they
as far as what insurances theyneed and things like that.
So if you can uh just kind ofgive us a background on how PACE
works.
SPEAKER_01 (04:42):
Absolutely.
So it's kind of an extensiveprocess to kind of go from start
to finish.
So to start up, to get anindividual into our program,
they do need to have Medicareand Medicaid to be in our
program completely free ofcharge.
We do have out-of-pocket costsfor those that cannot qualify
for Medicaid.
So that is an option.
But we are an all-inclusive careprogram.
Pay stands for program ofall-inclusive care for the
(05:04):
elderly.
Um, so we service those 55 andolder who are struggling to
remain independent in theirhomes and in the community.
We just offer that little bit ofassistance to keep them living
independently in the communitywith, you know, safeguards in
place that we are helping themwith and their caregivers with.
So that way they can remainindependent in their homes and
in the community.
SPEAKER_00 (05:23):
And that's what it seems like most people would
really want, you know, that theywant to stay independent as much
as possible.
They'd like to stay home or inthe community.
And so I understand that pacecould work with someone who's at
home, maybe living at theirdaughter's home.
They could be an independentliving.
And then there's othersituations that can be advanced
(05:44):
to later.
But basically, where you live isyour home.
And so it doesn't have to be,you know, in your own home.
It could be your daughter'shome, it could be independent
living.
SPEAKER_01 (05:54):
Yes, that's correct.
So we service a bunch ofdifferent living situations for
participants in our program.
Absolutely.
SPEAKER_00 (06:00):
Now tell me about, and this is something I've
always found fascinating.
The 11 different, I don't knowif you want to call them
specialties, there are 11different areas where they come
up with the plan of care for theparticipant.
SPEAKER_01 (06:14):
So there are 11 different disciplines that come
into play.
It's kind of a wraparound careprogram, is how we like to
describe it.
So the wraparound is the 11different disciplines come in to
kind of cater to eachindividual's health care needs
to assist them in livingindependently and safely in the
community.
So they each play an integralrole in each participant's
health care needs.
(06:34):
It could be your social workerthat's just kind of reaching out
to make sure that your Medicaidredetermination is taken care of
as it's coming up.
And that takes a little burdenoff of those potential
participants or caregivers totry to scramble and figure that
out.
Or it could be, you know, simplyjust our receptionist answering
the phone to take a referralfrom you regarding your
neighbor.
So it's all kinds of aspectsjust kind of coming together to
(06:58):
help with their healthcareneeds.
SPEAKER_00 (07:00):
One of the things that I think is unique about
PACE, so for our clients, weoften have clients that really
it's really important that thefan to the family that their
loved one continue to getphysical therapy, occupational
therapy.
Well, under Medicare andtraditional insurance, that
usually is for a set period oftime.
(07:22):
But if you're part of the PACEprogram, they're not going to
put a limit on that.
If if it's part of the plan ofcare.
And if, you know, so forexample, we have families that
have a loved one with a stroke,and they feel like, boy, they
made such great progress whenthey were getting therapies,
physical therapy, occupationaltherapy, maybe even speech
therapy.
And the idea that, you know, itgets cut off after a set period
(07:44):
of time based on the insurances,and that's one of the unique
things about PACE is that youdon't have those types of
limitations because you've gotthe physical therapists and all
that right there at the PACECenter.
SPEAKER_01 (07:56):
Yes, that's correct.
We do have physical therapy andoccupational therapy on site
here.
So we actually have expanded ourfootprint for our services with
our therapy department from ourprevious building.
We've actually tripled thatdepartment by three times.
So we're able to accommodatemore participants with the need
of therapy services by havingthat extra room here in this new
(08:17):
building.
But they also do, you know, gointo the homes to help people
who are more bedbound orhousebound, those that can't
come into our center, they do goin there just to make sure that
everybody is getting the carethat they need.
SPEAKER_00 (08:28):
Now we've worked with the pace, especially
Ascension Living PACE, a lotbecause, you know, ideally the
participant has Medicare andMedicaid, and that's something
that we help people with.
And so often they might not be,you know, currently eligible for
Medicaid.
And we can look at theircircumstances and see, you know,
what would be necessary to getthem eligible.
(08:50):
So that's one of the ways thatwe've worked pretty closely with
PACE, especially Ascension, aLiving PACE.
And it's we've just had realgood experiences there.
Our clients uh report back, youknow, very positive.
One of the things I've alwaysnoticed about the PACE Center is
the positive attitude of thefolks there, the caregivers and
everybody else that works there.
(09:11):
I've, you know, I'll stop byunannounced sometimes, and it
seems everybody has a verypositive attitude, which is
really nice.
SPEAKER_01 (09:18):
We're very proud of this.
SPEAKER_00 (09:19):
Well, talk to me about some of the common
misconceptions that people haveabout PACE, because I think
there are quite a few.
SPEAKER_01 (09:25):
Some of the common misconceptions, I'd say the
first one off bat is going to belosing their independence.
They really think they're goingto lose their independence by
reaching out to us, thinkingthat, you know, we're going to
take over their everydayhealthcare needs as well as, you
know, everything else they dofrom day to day.
And that's not the case at all.
This is, you know, a programwhere every healthcare aspect
(09:46):
comes in to try to formulate thebest plan for each participant.
So that way, you know, they'reactually gaining more
independence and potentiallygetting better in the long run
to be able to care forthemselves independently.
SPEAKER_00 (09:58):
And so getting back to the 11 disciplines, from what
I understand, that they come upwith a plan of care and then, of
course, review for that plan ofcare from time to time.
So there really is, like yousay, wraparound coverage to the
extent of you have advocates,which is really difficult to get
in the healthcare industry, tohave a social worker, to have
the advocates of the differentdisciplines that you have, where
(10:21):
they're creating a plan of careand then providing that plan of
care.
So talk a little bit about justthe customization of the care
services.
SPEAKER_01 (10:30):
Absolutely.
So, like I had said previously,you know, we, and you had also
mentioned, we do assigncaseworkers or social workers,
we call them here, to eachindividual to kind of, I guess,
help them navigate once they getinto the program.
So that's kind of their theirtouch base.
They can reach out to them forany kind of questions, concerns,
comments, anything that isbothering them.
(10:51):
If they need to reach out toanother department and they're
not sure who to reach out to,that's a good point of contact
to start with.
Some other disciplines in there.
We do have our physicaltherapist and occupational
therapists are listed in there.
We have home care nurses that doalso go into the home to check
on potential participants andfamily members for any issues
that they might be having.
But just checking in for thosethat don't come out to our
(11:14):
center.
I mean, we have so manydifferent disciplines.
I mean, even just our marketingdirector.
I mean, I'm a part of it aswell.
My intake team, we help you getinto the program.
I mean, we're your first pointof contact when you give us a
call to say, my loved one'shaving a hard time.
I need help.
So we help you get into theprogram.
And then we have people that,you know, are in our clinic area
and they're gonna be helping youalong the way, making sure your
(11:36):
appointments are set up and thatyou're coming in for those
scheduled appointments with yournew primary care physician,
which is another thing that weprovide, primary care provider.
So we become your primary careprovider, you know, have all
those services provided to youright here at the Pay Center.
You're welcome to meet with thatprovider prior to enrollment.
They talk with you directly sothat way you're not getting put
(11:56):
on the back burner talking witha nurse practitioner or a nurse
or a nurse assistant.
You'll get to talk one-on-onewith your provider.
So there's definitely a lot ofdifferent disciplines on your
side, and they really don'tchange.
Honestly, if you're coming intothe program, you're designated a
team.
So that team member for eachdiscipline is gonna stay the
same.
So you're not wondering, youknow, well, where is Nancy, you
(12:19):
know, my physical therapist thatcame in, you know, last week
when it's now Rob that's comingin to take care of me when I
discussed everything with Nancylast week.
SPEAKER_00 (12:28):
Right.
SPEAKER_01 (12:29):
So your care team members remain the same from the
day that you come into theprogram, which is nice.
It it stays the same across theboard.
So that way we know exactly whowe need to go to for each
individual patient as well.
SPEAKER_00 (12:40):
Well, Jessica, tell us a little bit more about your
journey.
You said you've been withAscension for 15 years.
So tell us about your journey inand caring for seniors.
SPEAKER_01 (12:49):
Senior care is actually fairly new to me
through Ascension.
This job kind of landed in mylap unexpectedly, and it was
kind of at a perfect time.
And the reason I say that isbecause I had, you know,
outgrown my roots at my previousdoctor's office that I was
working at, and I felt like Iwas just butting my head.
So I started to branch out alittle bit in the Ascension
community, and pace just poppedup.
(13:12):
So I got interested in what theywere doing, and it seemed like a
great program.
It almost seemed too good to betrue, and that seems to be
something that a lot of peoplebring to the table every time we
mention it as well.
But it landed in my lapunexpectedly, like I said.
But I've actually grown prettyfond of the elderly community
since I've gotten here becausenot only, you know, is it close
(13:32):
to my heart and a work aspect,it's also close to me as a
caregiver aspect.
I have a grandmother in theprogram who's current.
Yeah.
And she was diagnosed withdementia just a couple of years
ago.
So Pace stepped in and they'vebeen able to, you know, give her
that wraparound care to keep herliving safely in the community
still while her dementiaadvances.
(13:54):
So it's definitely, you know,very close to my heart in a
couple of different ways now.
SPEAKER_00 (13:59):
Yeah, you mentioned dementia, and that's something,
you know, we we realized a fewyears ago that a good percentage
of our clients that we help withlong-term care have some form of
memory loss or dementia.
Not all of them.
Certainly, we have plenty ofclients that don't have any
memory loss or cognitive issues.
But we try to always talk alittle bit about that.
So talk about how the PACE canbe a particularly good option
(14:23):
for those, especially in sort ofthe beginning stages of dementia
or even further along with ifthey have family support and
things like that.
SPEAKER_01 (14:31):
So we've actually come into a lot of cognitive
deficits over the years, andit's very common.
It's more common than whatpeople realize.
And, you know, it's justsomething that we really have to
focus on because it is such anintegral part of our community.
So, really, our program is meantto be a big support system to
any caregivers experiencing anyburnout because it's very hard.
(14:53):
I mean, dealing with any kind ofdementia or cognitive deficit
for from a loved one is alreadyvery hard.
You're not sure how to navigateit.
You don't know what they'regonna be like from one day to
the next.
So we just kind of step in andoffer that little bit of extra
help to keep them from feelingthat burnout by taking care of
their loved one, offeringrespite for them at our day
center where they can come outand socialize and know that
(15:14):
their loved ones being takencare of by their medical staff
and that they'll be safelyreturned home at the end of the
day after the caregivers hadsome respite.
But respite, you know, kind ofgoes a long way with dementia
patients.
I mean, it's not just daily thatthey need respite.
Sometimes it's weekends, itcould be a week at a time.
And we do offer that assistanceas well.
(15:34):
We partner with neighboringassisted living facilities and
memory care facilities that willhouse our participants in the
event that, you know, familymembers go out of town.
If there's a surgery that one ofour participants has and they
need that 24-7 recovery, I mean,those are absolutely options for
our caregivers just to kind ofease the burden.
(15:55):
And, you know, we're there tohelp them out in every other
aspect of their health careneeds as well.
SPEAKER_00 (15:59):
I think that's particularly important for
dementia.
We've been talking of this witha lot of our guests that, you
know, some families when theyget the diagnosis of dementia,
there's some families that justkind of, you know, hide in the
home, they cocoon and they don'treally interact with others.
Well, that's likely to only makeit worse.
And there's all kinds ofresearch that says, you know, if
we start experiencing somecognitive ability, you know,
(16:20):
deficits or memory loss, thatone of the things that can slow
that down is social interaction,socialization, activities,
keeping active.
And that's one of the thingsthat pace can really participate
in to have a very active lifewith uh someone with dementia
and really kind of stall offthat progression of the disease.
SPEAKER_01 (16:41):
That's absolutely right, Bob.
We have a lot of, like I said,Alzheimer's, you name it, we've
had to deal with it.
And we've gone through a lot ofdifferent processes to help each
individual as they'reprogressing.
And, you know, those activities,the respite, all of it really co
goes hand in hand with makingsure that, you know, everybody's
taken care of in this picture.
SPEAKER_00 (17:00):
And, you know, not only does it kind of slow the
slow the progression, but it'sbetter quality of life during
that period of time, too.
So it can be better quality oflife not only for the
participant, for the person withdementia, but also for their
loved ones.
They get to experience more ofthe you know fullness of life.
So I want to ask you, I reallyappreciate you coming on the
(17:21):
podcast.
I want to see if you have any,you know, general key takeaways
that you want to leave ouraudience with about the PACE
program.
SPEAKER_01 (17:29):
The biggest thing for me is when I start talking
to people about the PACEprogram, they do say that it is
too good to be true, like Ipreviously mentioned.
So I just want people to knowthat, you know, we are here for
any questions, comments,concerns.
We always try to address anykind of situation that might
arise with potentialparticipants and their
caregivers.
So it's not it's not taking awaytheir independence.
(17:52):
We're not trying to take overanything in anybody's life.
We're just here to offer thatextra support for both the
participant and the caregiversout there.
So I hope that kind of clearsthings up for some people just
to know that you know we're awraparound care team for not
just the participant, but forfamilies and caregivers as well.
So we're all here for you.
SPEAKER_00 (18:12):
Well, again, I appreciate you coming on.
Jessica Downing from AscensionLiving PACE.
And so, what is the best way forthat anybody that's interested
to start that intake process orjust learn more?
SPEAKER_01 (18:26):
So you can actually look for us online,
ascensionliving.com.
So if you actually go right tothe website, we talk about, you
know, a lot of things that wehave going on here at PACE, or
you're welcome to give us a calland we can talk with you
directly.
We could even set up aface-to-face session where we
can go over all of the potentialparticipants' healthcare needs
and see what we can do to betterassist.
(18:47):
You can call us at 810-236-7500.
SPEAKER_00 (18:52):
Thanks, Jessica.
And for the listeners, if you'veenjoyed this presentation and
you want to make sure that youknow when we drop a new podcast,
which we do every other week,feel free to subscribe at any
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So you can do Apple Podcasts orSpotify or any of those.
And if you want, you can watchus if you just want to see the
(19:15):
podcast condition to listen toit on YouTube and on our
website, which ismanorlawgroup.com.
So don't forget to subscribe andwe'll see you next time.
SPEAKER_01 (19:29):
Thanks for listening.
To learn more, visitmanorlawgroup.com.
You're listening to Advice from Your Advocates, a
show where we provide elder lawadvice to professionals who work
with the elderly and theirfamilies.
SPEAKER_00 (00:09):
Welcome back to Advice from Your Advocates.
I'm Bob Manner.
I'm a board-certified elder lawattorney in Michigan.
And we have a great show today.
We have Jessica Downing fromAscension Living PACE.
And we've had folks from PACEbefore, and this is a great
topic.
We really want to spread theword about PACE, the program for
all-inclusive care for theelderly.
(00:30):
So, Jessica, welcome.
SPEAKER_01 (00:32):
Thank you so much, Bob.
I'm so happy to be here.
SPEAKER_00 (00:35):
And so tell us a little bit about yourself and
your job, and then we'll getinto the PACE program that you
work for and everything aboutthat.
SPEAKER_01 (00:45):
So my name is Jessica Downing.
I am the marketing and intakedirector here at Ascension
Living Pace, Michigan.
I have actually been in myposition since May of this year,
but I've been with the PACEprogram going on three years
now.
I've worked for Ascension,though, for about 15 years
total.
So this is Wow.
Yeah.
So this is actually a greatopportunity for me.
I do have a husband and sixkids.
(01:07):
So I guess the level of care hasalways been up there for me.
Definitely raising six kids.
SPEAKER_00 (01:12):
So yeah, I've got five kids.
So you got one on so uh let'sspecify a couple things about
pace.
First of all, I understand youyou moved into your new digs,
your new building, and I think Iwas a little uh short on the
uptake.
I had been still talking to Payabout pace and saying that you
were in the old building, butyou guys called me and let me
(01:35):
know that you've moved fullymoved.
And so tell us about the newlocation and the new great uh
space that you have.
SPEAKER_01 (01:42):
Oh yes, I'm happy to.
So we were previously behind theFlint Farm Market, which was a
great location, but we hadoutgrown our facility, honestly.
We were bursting at the sceneswith bringing in participants
left and right.
Right.
So we had to expand toaccommodate.
So we recently moved into ournew building in the middle of
May.
We're actually located off ofthe Dorton Stewart exit off of
(02:05):
475 by the water plant.
We actually are on a privatedrive just off of there.
I'm not sure if you guys knowwhere the the previous Security
Federal Credit Union was.
SPEAKER_00 (02:16):
Okay, right.
SPEAKER_01 (02:16):
Yeah, so we're the old building.
Uh, we've revamped it.
We can accommodate up to 400participants now.
Previously, we were only able toaccommodate about 250.
Um, so this move was definitelya need for us.
But we're absolutely happy to beover here.
It's nice and quiet.
It's a private drive.
The state park across the streetis always nice and well kept,
(02:37):
and it's nice and ready for theparticipants.
SPEAKER_00 (02:40):
And one of the things I always like to point
out about PACE becausesometimes, and we'll get into a
lot of the details on PACE, butthe thing is that the part of
the deal is the for theparticipant, travel is part of
the arrangement that I know youguys have used the term sort of
indoor to indoor.
In other words, they go to wherethey're living and help them
(03:03):
get, you know, situated in thetransportation and then get to
the PACE center and then getthem inside, get them situated,
all of that.
It's not uh the the familiesdon't have to arrange their own
transportation.
SPEAKER_01 (03:15):
Yes, that's correct.
So that seems to be a really bigaspect of the PACE organization,
I have to say.
Transportation, you know, is avery integral part of our
community because a lot ofseniors do not get the privilege
of being able to drive muchanymore, if at all.
So we provide those services toand from our PACE facility and
to and from outside appointmentsas well.
(03:36):
And like you had mentioned, theyare a door-to-door service.
So we'll go right to the door topick up your loved one, take
them to our bus.
We have lift systems for anykind of assistance medical
devices that your loved onemight have, whether it be a
walker, cane, or wheelchair.
So our buses can assist justabout an array of anything you
can think of to be able to getthem safely to and from our pace
(03:56):
center and to and from theirappointments.
SPEAKER_00 (03:58):
Now, it sounds like with the numbers that is about
double or more than double thethe uh volume that you're
allowed that you can get that asmany that many people now that
you can serve.
SPEAKER_01 (04:08):
We're almost double.
We were at about 250, we're at400 now that we can potentially
bring in.
Yeah, but after we get closer to400, we get to be reevaluated,
so we might even be able tobring in more as we reach that
cap as well.
SPEAKER_00 (04:21):
Okay.
Yeah.
So for those that don't reallyknow about PACE, I'd like you to
kind of give an explanation ofhow PACE works, how people, you
know, the the participants'contribution towards it, if they
as far as what insurances theyneed and things like that.
So if you can uh just kind ofgive us a background on how PACE
works.
SPEAKER_01 (04:42):
Absolutely.
So it's kind of an extensiveprocess to kind of go from start
to finish.
So to start up, to get anindividual into our program,
they do need to have Medicareand Medicaid to be in our
program completely free ofcharge.
We do have out-of-pocket costsfor those that cannot qualify
for Medicaid.
So that is an option.
But we are an all-inclusive careprogram.
Pay stands for program ofall-inclusive care for the
(05:04):
elderly.
Um, so we service those 55 andolder who are struggling to
remain independent in theirhomes and in the community.
We just offer that little bit ofassistance to keep them living
independently in the communitywith, you know, safeguards in
place that we are helping themwith and their caregivers with.
So that way they can remainindependent in their homes and
in the community.
SPEAKER_00 (05:23):
And that's what it seems like most people would
really want, you know, that theywant to stay independent as much
as possible.
They'd like to stay home or inthe community.
And so I understand that pacecould work with someone who's at
home, maybe living at theirdaughter's home.
They could be an independentliving.
And then there's othersituations that can be advanced
(05:44):
to later.
But basically, where you live isyour home.
And so it doesn't have to be,you know, in your own home.
It could be your daughter'shome, it could be independent
living.
SPEAKER_01 (05:54):
Yes, that's correct.
So we service a bunch ofdifferent living situations for
participants in our program.
Absolutely.
SPEAKER_00 (06:00):
Now tell me about, and this is something I've
always found fascinating.
The 11 different, I don't knowif you want to call them
specialties, there are 11different areas where they come
up with the plan of care for theparticipant.
SPEAKER_01 (06:14):
So there are 11 different disciplines that come
into play.
It's kind of a wraparound careprogram, is how we like to
describe it.
So the wraparound is the 11different disciplines come in to
kind of cater to eachindividual's health care needs
to assist them in livingindependently and safely in the
community.
So they each play an integralrole in each participant's
health care needs.
(06:34):
It could be your social workerthat's just kind of reaching out
to make sure that your Medicaidredetermination is taken care of
as it's coming up.
And that takes a little burdenoff of those potential
participants or caregivers totry to scramble and figure that
out.
Or it could be, you know, simplyjust our receptionist answering
the phone to take a referralfrom you regarding your
neighbor.
So it's all kinds of aspectsjust kind of coming together to
(06:58):
help with their healthcareneeds.
SPEAKER_00 (07:00):
One of the things that I think is unique about
PACE, so for our clients, weoften have clients that really
it's really important that thefan to the family that their
loved one continue to getphysical therapy, occupational
therapy.
Well, under Medicare andtraditional insurance, that
usually is for a set period oftime.
(07:22):
But if you're part of the PACEprogram, they're not going to
put a limit on that.
If if it's part of the plan ofcare.
And if, you know, so forexample, we have families that
have a loved one with a stroke,and they feel like, boy, they
made such great progress whenthey were getting therapies,
physical therapy, occupationaltherapy, maybe even speech
therapy.
And the idea that, you know, itgets cut off after a set period
(07:44):
of time based on the insurances,and that's one of the unique
things about PACE is that youdon't have those types of
limitations because you've gotthe physical therapists and all
that right there at the PACECenter.
SPEAKER_01 (07:56):
Yes, that's correct.
We do have physical therapy andoccupational therapy on site
here.
So we actually have expanded ourfootprint for our services with
our therapy department from ourprevious building.
We've actually tripled thatdepartment by three times.
So we're able to accommodatemore participants with the need
of therapy services by havingthat extra room here in this new
(08:17):
building.
But they also do, you know, gointo the homes to help people
who are more bedbound orhousebound, those that can't
come into our center, they do goin there just to make sure that
everybody is getting the carethat they need.
SPEAKER_00 (08:28):
Now we've worked with the pace, especially
Ascension Living PACE, a lotbecause, you know, ideally the
participant has Medicare andMedicaid, and that's something
that we help people with.
And so often they might not be,you know, currently eligible for
Medicaid.
And we can look at theircircumstances and see, you know,
what would be necessary to getthem eligible.
(08:50):
So that's one of the ways thatwe've worked pretty closely with
PACE, especially Ascension, aLiving PACE.
And it's we've just had realgood experiences there.
Our clients uh report back, youknow, very positive.
One of the things I've alwaysnoticed about the PACE Center is
the positive attitude of thefolks there, the caregivers and
everybody else that works there.
(09:11):
I've, you know, I'll stop byunannounced sometimes, and it
seems everybody has a verypositive attitude, which is
really nice.
SPEAKER_01 (09:18):
We're very proud of this.
SPEAKER_00 (09:19):
Well, talk to me about some of the common
misconceptions that people haveabout PACE, because I think
there are quite a few.
SPEAKER_01 (09:25):
Some of the common misconceptions, I'd say the
first one off bat is going to belosing their independence.
They really think they're goingto lose their independence by
reaching out to us, thinkingthat, you know, we're going to
take over their everydayhealthcare needs as well as, you
know, everything else they dofrom day to day.
And that's not the case at all.
This is, you know, a programwhere every healthcare aspect
(09:46):
comes in to try to formulate thebest plan for each participant.
So that way, you know, they'reactually gaining more
independence and potentiallygetting better in the long run
to be able to care forthemselves independently.
SPEAKER_00 (09:58):
And so getting back to the 11 disciplines, from what
I understand, that they come upwith a plan of care and then, of
course, review for that plan ofcare from time to time.
So there really is, like yousay, wraparound coverage to the
extent of you have advocates,which is really difficult to get
in the healthcare industry, tohave a social worker, to have
the advocates of the differentdisciplines that you have, where
(10:21):
they're creating a plan of careand then providing that plan of
care.
So talk a little bit about justthe customization of the care
services.
SPEAKER_01 (10:30):
Absolutely.
So, like I had said previously,you know, we, and you had also
mentioned, we do assigncaseworkers or social workers,
we call them here, to eachindividual to kind of, I guess,
help them navigate once they getinto the program.
So that's kind of their theirtouch base.
They can reach out to them forany kind of questions, concerns,
comments, anything that isbothering them.
(10:51):
If they need to reach out toanother department and they're
not sure who to reach out to,that's a good point of contact
to start with.
Some other disciplines in there.
We do have our physicaltherapist and occupational
therapists are listed in there.
We have home care nurses that doalso go into the home to check
on potential participants andfamily members for any issues
that they might be having.
But just checking in for thosethat don't come out to our
(11:14):
center.
I mean, we have so manydifferent disciplines.
I mean, even just our marketingdirector.
I mean, I'm a part of it aswell.
My intake team, we help you getinto the program.
I mean, we're your first pointof contact when you give us a
call to say, my loved one'shaving a hard time.
I need help.
So we help you get into theprogram.
And then we have people that,you know, are in our clinic area
and they're gonna be helping youalong the way, making sure your
(11:36):
appointments are set up and thatyou're coming in for those
scheduled appointments with yournew primary care physician,
which is another thing that weprovide, primary care provider.
So we become your primary careprovider, you know, have all
those services provided to youright here at the Pay Center.
You're welcome to meet with thatprovider prior to enrollment.
They talk with you directly sothat way you're not getting put
(11:56):
on the back burner talking witha nurse practitioner or a nurse
or a nurse assistant.
You'll get to talk one-on-onewith your provider.
So there's definitely a lot ofdifferent disciplines on your
side, and they really don'tchange.
Honestly, if you're coming intothe program, you're designated a
team.
So that team member for eachdiscipline is gonna stay the
same.
So you're not wondering, youknow, well, where is Nancy, you
(12:19):
know, my physical therapist thatcame in, you know, last week
when it's now Rob that's comingin to take care of me when I
discussed everything with Nancylast week.
SPEAKER_00 (12:28):
Right.
SPEAKER_01 (12:29):
So your care team members remain the same from the
day that you come into theprogram, which is nice.
It it stays the same across theboard.
So that way we know exactly whowe need to go to for each
individual patient as well.
SPEAKER_00 (12:40):
Well, Jessica, tell us a little bit more about your
journey.
You said you've been withAscension for 15 years.
So tell us about your journey inand caring for seniors.
SPEAKER_01 (12:49):
Senior care is actually fairly new to me
through Ascension.
This job kind of landed in mylap unexpectedly, and it was
kind of at a perfect time.
And the reason I say that isbecause I had, you know,
outgrown my roots at my previousdoctor's office that I was
working at, and I felt like Iwas just butting my head.
So I started to branch out alittle bit in the Ascension
community, and pace just poppedup.
(13:12):
So I got interested in what theywere doing, and it seemed like a
great program.
It almost seemed too good to betrue, and that seems to be
something that a lot of peoplebring to the table every time we
mention it as well.
But it landed in my lapunexpectedly, like I said.
But I've actually grown prettyfond of the elderly community
since I've gotten here becausenot only, you know, is it close
(13:32):
to my heart and a work aspect,it's also close to me as a
caregiver aspect.
I have a grandmother in theprogram who's current.
Yeah.
And she was diagnosed withdementia just a couple of years
ago.
So Pace stepped in and they'vebeen able to, you know, give her
that wraparound care to keep herliving safely in the community
still while her dementiaadvances.
(13:54):
So it's definitely, you know,very close to my heart in a
couple of different ways now.
SPEAKER_00 (13:59):
Yeah, you mentioned dementia, and that's something,
you know, we we realized a fewyears ago that a good percentage
of our clients that we help withlong-term care have some form of
memory loss or dementia.
Not all of them.
Certainly, we have plenty ofclients that don't have any
memory loss or cognitive issues.
But we try to always talk alittle bit about that.
So talk about how the PACE canbe a particularly good option
(14:23):
for those, especially in sort ofthe beginning stages of dementia
or even further along with ifthey have family support and
things like that.
SPEAKER_01 (14:31):
So we've actually come into a lot of cognitive
deficits over the years, andit's very common.
It's more common than whatpeople realize.
And, you know, it's justsomething that we really have to
focus on because it is such anintegral part of our community.
So, really, our program is meantto be a big support system to
any caregivers experiencing anyburnout because it's very hard.
(14:53):
I mean, dealing with any kind ofdementia or cognitive deficit
for from a loved one is alreadyvery hard.
You're not sure how to navigateit.
You don't know what they'regonna be like from one day to
the next.
So we just kind of step in andoffer that little bit of extra
help to keep them from feelingthat burnout by taking care of
their loved one, offeringrespite for them at our day
center where they can come outand socialize and know that
(15:14):
their loved ones being takencare of by their medical staff
and that they'll be safelyreturned home at the end of the
day after the caregivers hadsome respite.
But respite, you know, kind ofgoes a long way with dementia
patients.
I mean, it's not just daily thatthey need respite.
Sometimes it's weekends, itcould be a week at a time.
And we do offer that assistanceas well.
(15:34):
We partner with neighboringassisted living facilities and
memory care facilities that willhouse our participants in the
event that, you know, familymembers go out of town.
If there's a surgery that one ofour participants has and they
need that 24-7 recovery, I mean,those are absolutely options for
our caregivers just to kind ofease the burden.
(15:55):
And, you know, we're there tohelp them out in every other
aspect of their health careneeds as well.
SPEAKER_00 (15:59):
I think that's particularly important for
dementia.
We've been talking of this witha lot of our guests that, you
know, some families when theyget the diagnosis of dementia,
there's some families that justkind of, you know, hide in the
home, they cocoon and they don'treally interact with others.
Well, that's likely to only makeit worse.
And there's all kinds ofresearch that says, you know, if
we start experiencing somecognitive ability, you know,
(16:20):
deficits or memory loss, thatone of the things that can slow
that down is social interaction,socialization, activities,
keeping active.
And that's one of the thingsthat pace can really participate
in to have a very active lifewith uh someone with dementia
and really kind of stall offthat progression of the disease.
SPEAKER_01 (16:41):
That's absolutely right, Bob.
We have a lot of, like I said,Alzheimer's, you name it, we've
had to deal with it.
And we've gone through a lot ofdifferent processes to help each
individual as they'reprogressing.
And, you know, those activities,the respite, all of it really co
goes hand in hand with makingsure that, you know, everybody's
taken care of in this picture.
SPEAKER_00 (17:00):
And, you know, not only does it kind of slow the
slow the progression, but it'sbetter quality of life during
that period of time, too.
So it can be better quality oflife not only for the
participant, for the person withdementia, but also for their
loved ones.
They get to experience more ofthe you know fullness of life.
So I want to ask you, I reallyappreciate you coming on the
(17:21):
podcast.
I want to see if you have any,you know, general key takeaways
that you want to leave ouraudience with about the PACE
program.
SPEAKER_01 (17:29):
The biggest thing for me is when I start talking
to people about the PACEprogram, they do say that it is
too good to be true, like Ipreviously mentioned.
So I just want people to knowthat, you know, we are here for
any questions, comments,concerns.
We always try to address anykind of situation that might
arise with potentialparticipants and their
caregivers.
So it's not it's not taking awaytheir independence.
(17:52):
We're not trying to take overanything in anybody's life.
We're just here to offer thatextra support for both the
participant and the caregiversout there.
So I hope that kind of clearsthings up for some people just
to know that you know we're awraparound care team for not
just the participant, but forfamilies and caregivers as well.
So we're all here for you.
SPEAKER_00 (18:12):
Well, again, I appreciate you coming on.
Jessica Downing from AscensionLiving PACE.
And so, what is the best way forthat anybody that's interested
to start that intake process orjust learn more?
SPEAKER_01 (18:26):
So you can actually look for us online,
ascensionliving.com.
So if you actually go right tothe website, we talk about, you
know, a lot of things that wehave going on here at PACE, or
you're welcome to give us a calland we can talk with you
directly.
We could even set up aface-to-face session where we
can go over all of the potentialparticipants' healthcare needs
and see what we can do to betterassist.
(18:47):
You can call us at 810-236-7500.
SPEAKER_00 (18:52):
Thanks, Jessica.
And for the listeners, if you'veenjoyed this presentation and
you want to make sure that youknow when we drop a new podcast,
which we do every other week,feel free to subscribe at any
place that you listen topodcasts.
So you can do Apple Podcasts orSpotify or any of those.
And if you want, you can watchus if you just want to see the
(19:15):
podcast condition to listen toit on YouTube and on our
website, which ismanorlawgroup.com.
So don't forget to subscribe andwe'll see you next time.
SPEAKER_01 (19:29):
Thanks for listening.
To learn more, visitmanorlawgroup.com.
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