Care Delivery Model Toolkit

Assessing Care of Vulnerable Elders

Available Resources

For More Information

For any questions not answered by materials provided within this profile, please contact Wayne Pendleton, CEO of LIFE, at wayned@nursing.upenn.edu.

Or contact Shawn Bloom, President and CEO of the National PACE Association, at shawnb@npaonline.org.

Utilization

Compared to nursing facilities, where most of LIFE patients would reside without the program, LIFE has posted impressive utilization figures.  According to data collected by the Pennsylvania Department of Public Welfare, LIFE’s statewide rate of preventable hospitalizations per 1000 people, 168.07, is less than half the rate at Pennsylvania nursing facilities, 352.18.  LIFE at Penn Nursing has posted even better results, with 138 preventable hospitalizations per 1000 enrollees.

In fiscal year 2006, LIFE achieved the following utilization figures.

  • Lower-than-targeted ER utilization—2.9 ER visits per 100 member months
  • Lower-than-targeted homecare utilization—33.6 average hours per member per month
  • Higher-than-targeted hospital utilization—5.1 admissions per 100 member months, although 5.1 is considered a good outcome given the acuity level of LIFE participants, which is 2.9 compared to national PACE average of 2.1
  • Higher-than-targeted nursing home residents—14.9 nursing home residents per 100 member months

Patient

For fiscal year 2006, LIFE achieved the following quality outcomes.

  • Lower than targeted pressure ulcers--3.7 members with pressure ulcers per 100 member months
  • Lower than targeted falls resulted in fractures or hospitalizations—0.64 falls per 100 member months.
  • Better-than-targeted medication safety standard—97 members not taking potentially inappropriate medications (based on Beers criteria as categorized by Zhan) per 100 member months.

Nationally, the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA) has approved the PACE model as an evidenced based model of care.  (Please see www.nrepp.samhsa.gov/programfulldetails.asp?PROGRAM_ID=117 for more information.)

Provider

For the fiscal year 2006, LIFE achieved a lower-than-targeted staff turnover rate of 9.09 percent. 

Anecdotally, nurses and nurse aids particularly enjoy working in PACE programs.  Many of the caregivers believe in the model and the way care is delivered.  In addition, in most PACE programs, being a nurse or a nurse aid is an 8 to 5 job.  The focal point of delivery, the adult day center, is structured around daytime hours.

Patient

For the fiscal year 2006, LIFE achieved a better-than-targeted member satisfaction rate of 92.9 percent.

Impact

By reducing preventable hospital admissions in the elderly population, LIFE should help to reduce the long-term demand for acute care nurses.