PACE vs Nursing Home Care: When Community-Based Care May Be an Option
A person can need a nursing-home level of care without necessarily living in a nursing home. In areas where it is available, the Program of All-Inclusive Care for the Elderly (PACE) can coordinate medical and long-term services for eligible people who can still live safely in the community with PACE support.
PACE is not available everywhere and it is not the right fit for every family.
Who may qualify for PACE?
According to Medicare’s current PACE guidance, a person generally must:
- be age 55 or older;
- live in the service area of a PACE organization;
- be certified by the state as needing a nursing-home level of care; and
- be able to live safely in the community with PACE services at the time of enrollment.
Enrollment is voluntary.
PACE coordinates a broad package of care
PACE organizations coordinate Medicare- and Medicaid-covered services and other care the interdisciplinary team determines is necessary. Depending on the participant’s plan, this can involve primary care, specialists, medications, transportation, home care, adult-day services, therapy, hospital care and nursing-home care when needed.
PACE uses its own provider network
Participants generally receive care through the PACE organization’s providers. A family that strongly wants to keep a particular outside doctor or specialist should ask whether that provider participates and how exceptions work before enrolling.
PACE can reduce fragmented care—but it requires local availability
The model may appeal to families trying to coordinate many services while keeping a parent at home. But a PACE program must actually serve the person’s ZIP code and be able to support the person’s needs safely.
How nursing-home care differs
A nursing home provides 24-hour facility-based nursing and personal care. It may be more appropriate when the person cannot be supported safely in the community, needs facility-based services, or chooses residential care.
Questions when comparing PACE with nursing-home placement
- Is a PACE program available in the resident’s service area?
- Does the person meet state nursing-home-level-of-care criteria?
- Can the person live safely in the community with PACE support?
- What services would PACE provide at home and at its center?
- Which doctors and hospitals are in the PACE network?
- What will the participant pay based on Medicare/Medicaid status?
- What caregiver support is still expected from family?
- What happens if residential nursing-home care later becomes necessary?
Do not compare only monthly prices
Compare the full care package: housing, supervision, medical access, transportation, caregiver burden, safety, medication management and the person’s own preferences.
Reviewed October 24, 2026 using Medicare’s 2026 PACE guidance. Program availability and eligibility are local and can change. Verify directly with Medicare, Medicaid and the local PACE organization.
If residential care is still needed, browse nursing homes and senior-care communities or use the Care Finder.
