Innovative Senior Care Facilities – The PACE Program

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CED Program Interns & Students

senior careSusie Senior, an 80 year-old participant in the Program of All Inclusive Care for the Elderly (PACE), begins her day with a home visit from a PACE home care assistant. The assistant helps Susie get dressed, organize medicines, and do some basic shopping and errands within the community. Following that, Susie is picked up by a PACE shuttle bus that takes her to her program center for the day. Here, Susie might have the primary care physician check on a specific health problem, socialize with friends, eat a lunch customized for his dietary needs, and exercise with a physical therapist to maintain mobility. Susie may attend the center from one to five days a week, based on the team’s recommendations and her needs and interests. Each evening, Susie boards the shuttle and returns home where she continues to live safely within the community.

Research demonstrates that participants in these programs have more enjoyment in life, remain independent longer, and receive more individual attention from a caregiver each day. Tracking participants over time shows they have experienced improved health outcomes and reduced health expenses. As a result, many long term care stakeholders have been supportive of expanding the PACE model of care. In 2005, legislation passed and created $7.5M in funding in an effort to expand PACE to rural communities. Predominantly a model targeted for urban settings, PACE now extends its reach into many rural areas across the United States.

Currently, there are seven PACE centers throughout North Carolina, with an additional two in the planning stages. The PACE model is just one of many innovative, community-based elderly care models in North Carolina aimed at providing better living options for the increasing senior population. As these centers become more popular throughout the state and the “age in place” notion spreads, developers and operators are searching for ways to increase centralized housing for program participants. By developing housing resources within close proximity to multiple centers, program operators are able to increase efficiencies associated with transportation and caretaking. In addition, the growing housing needs of the senior population are being met.

Potential housing models being discussed are able to take advantage of unusual financing mechanisms such as Low Income Housing Tax Credits, New Market Tax Credits, and even Historic Tax Credits with an adaptive reuse of a historic building. In addition, developers can obtain financing for these projects from the HUD Section 202 Supportive Housing for the Elderly Program. The Section 202 program aims to increase supply of affordable housing with supportive services for the elderly – supportive services like the PACE program.

As this trend continues to gain momentum and federal funding remains available, municipalities face a unique opportunity to partner with innovative elderly care operators and senior housing developers. The increasing senior population in North Carolina coupled with rising costs of long-term care make these partnerships a win-win situation. Most importantly, these facilities offer a better quality of life for our senior citizens.

For more information pertaining to the PACE program, please visit the following website:

Rory Dowling, a dual MBA/MCRP candidate at UNC’s Kenan-Flagler Business School and the Department of City and Regional Planning, is a Community Revitalization Fellow at the School of Government.

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