All applicants will be contacted by a Total Senior Care staff about the program prior to enrollment. All prospective participants will receive in-home assessments by both Maximus and the Total Senior Care interdisciplinary team to determine clinical eligibility. Maximus, a Conflict-Free Evaluation and Enrollment Center (CFEEC), will do a separate evaluation to make the determination. The interdisciplinary team will review the assessments and develop a comprehensive plan of care prior to enrollment.
Your actual enrollment date will be confirmed by telephone as soon as possible – usually within a few days before your participation begins. Once you are a participant, your Care Team will ensure that you get all the services that are outlined in your plan of care.
To be eligible, an individual must meet all of the following criteria:
- Eligible participants must live in Cattaraugus, Allegany, or Chautauqua County
- 55 years or older
- Determined eligible for nursing home level of care
- Need community based long term care services for more than 120 days
- Able to live safely in the community with the services of the plan
- Eligible for Medicaid and/or Medicare, or willing and able to pay privately
For eligible individuals who are currently receiving services from a facility or from a Home and Community Based Services Waiver program, a covered individual cannot be in both fee for service covered services, and Total Senior Care. The individual must be discharged from the facility or waiver program prior to enrolling in Total Senior Care. Total Senior Care will have, upon the individual’s written authorization, their medical records transferred to Total Senior Care.
If you need further information, contact us.
Total Senior Care is a managed long-term care plan and is a not-for-profit organization.
PACE is a program of all-inclusive care for the elderly, funded by Medicare and Medicaid through a contract with the Centers for Medicare and Medicaid Services (CMS) and the New York State Department of Health.