There is a program operating in four Rhode Island buildings that pays for, coordinates and delivers almost all of a frail older adult's care while they keep living at home. It has been running here since 2005, it is open to people who already qualify for a nursing home, and most families we talk to have never heard its name. Here is what PACE is, who it fits, what it costs, and the one trade-off you have to be willing to make.
By Providence Senior Advisor Care Team · September 14, 2026
A case manager at Rhode Island Hospital or Kent has about twenty minutes with your family and a list of beds to fill. What you tend to hear in that room is rehab, then home with a few hours of help, or a nursing home. What you almost never hear is PACE, even though a meaningful share of the people sitting in those conversations would qualify for it that same week.
That is not anyone behaving badly. PACE is small, it is not a bed anyone is trying to fill, and it does not fit neatly into a discharge checklist. But if the person you are worried about has been certified as needing a nursing-home level of care and still very much wants to be in her own kitchen in the morning, it is the option most likely to be missing from your list.
We are free to Rhode Island families at (844) 735-1766 and we have no stake in which direction you go. We raise PACE with people constantly, not because it is right for everyone, but because it is the one choice families routinely learn about eighteen months too late.
PACE stands for Program of All-Inclusive Care for the Elderly. The Rhode Island version, PACE Organization of Rhode Island, is a not-for-profit that has served more than 2,000 participants and their families since it opened in Providence in 2005. The unusual thing about it is structural: PACE is both the insurance plan and the care provider. The same organization that pays the bill also employs the team that shows up.
In practice that means one interdisciplinary team, meeting about your mother by name, holds the whole picture. Primary care, nursing, physical and occupational therapy, a social worker, dietary, personal care at home, prescriptions, specialists, medical equipment, and the ride to every appointment all sit under one roof instead of scattered across six offices that never speak to each other. There is a day center component too, which is where a lot of the supervision and, frankly, the company comes from.
PACE-RI runs four centers and covers the whole state except Block Island and Prudence Island. The flagship and headquarters is in East Providence at 10 Tripps Lane in Riverside. Westerly, at 5 Union Street, joined the organization in 2013 after decades as an independent day center. Woonsocket, at 781 Social Street, opened in 2016. Newport, at 309 Spring Street, came in 2019 through a partnership with St. Clare Newport and serves Aquidneck Island.
Rhode Island applies four tests. The person must be 55 or older. They must need a clinical level of care as determined by the state, which is the same nursing-home level-of-care finding used elsewhere in the long-term care system. They must be able to live safely in the community at the moment they enroll, with PACE's help counted in. And they must live in the service area, which for PACE-RI means permanent Rhode Island residency anywhere but the two islands.
Read the second and third tests together, because that is where families get confused. PACE is aimed precisely at the person who is sick enough for a nursing home and stable enough not to be in one yet. Someone who is basically independent will not qualify. Someone who is already unsafe at home regardless of what anyone brings in will not either. The window is narrower than people assume, and it closes as things progress, which is the argument for asking early.
Nationally, roughly nine in ten PACE participants are eligible for both Medicare and Medicaid, but neither one is a condition of joining. The level-of-care finding is the gate, not the insurance card. If you are unsure whether your parent would be certified, that is a question worth asking before you assume the answer is no.
PACE-RI states that cost is set by the State of Rhode Island based on income. If your parent already has Rhode Island Medicaid Long-Term Services and Supports, the care is generally covered without a separate premium, because the state is already paying for a level of care she has been certified to need. If she does not have Medicaid LTSS, PACE-RI's enrollment staff will help work out whether she might be eligible and will help with the paperwork, which is not a trivial offer given how that application goes.
If Medicaid is genuinely out of reach, there is a private-pay option. Put it next to the alternatives before you dismiss it. In Rhode Island in 2026 a private room in a nursing home generally runs $11,000 to $13,500 a month. Assisted living generally runs $5,500 to $7,800, and a residence holding the state's dementia special-care designation generally runs $7,000 to $9,500. In-home care generally runs $34 to $40 an hour, which is about $6,000 to $7,000 a month at forty hours and considerably more once overnight coverage enters the picture.
Those ranges shift by exit number in a state you can cross in an hour. Providence's East Side, the East Bay towns and Newport County sit at the top of every band. Woonsocket, West Warwick and the Blackstone Valley generally come in lower. PACE is priced against the nursing home figure rather than the assisted living figure, because the nursing home is the thing it is designed to replace.
Here is the part that decides it for most families. When your mother joins PACE, PACE becomes her health plan. Her care goes through PACE's own providers and its own network. If she has been seeing the same internist in Cranston for twenty-two years, that relationship most likely ends unless that physician happens to work with PACE. Any Medicare Advantage plan she currently holds ends too.
For some people that is unacceptable and the conversation is over in one sentence, which is fine. For others it is a relief, because the current arrangement is nine specialists, four pharmacies, three portals and a daughter in Attleboro trying to hold the schedule together by herself. The honest question is not whether giving up her doctor sounds bad in the abstract. It is whether what she has now is actually working.
One thing that softens the risk: enrollment is voluntary in both directions. A participant can disenroll. It is not a door that locks behind you, and it is worth confirming how the transition back would work during the enrollment conversation rather than afterward.
Against a nursing home, PACE is the better answer when the clinical need is real but the person is not yet unsafe alone between visits, and when someone in the family can still be a partner in the plan. Rhode Island nursing facilities are licensed by the Rhode Island Department of Health under R.I. General Laws Chapter 23-17, and a good one is a genuinely good outcome. But it is a move, and moves are hard to reverse.
Against assisted living, PACE is a different kind of product and people mix them up. An assisted living residence is housing plus services, licensed by RIDOH under the Assisted Living Residence Licensing Act, R.I. General Laws Chapter 23-17.4, and the rules at 216-RICR-40-10-2. Rhode Island issues no standalone memory care license, so a residence marketing dementia care should hold the state's dementia and Alzheimer's special-care designation. PACE is not housing at all. It is care wrapped around wherever your mother already lives, and the two can be combined in some circumstances.
Against piecing it together yourself with hourly aides, PACE mainly buys you coordination. Hourly help is flexible and can be dialed up or down; what it does not do is notice the pattern across three months and change the plan. That noticing is the thing an interdisciplinary team is for, and it is the reason PACE participants tend to reach a nursing home later than similar people who never enrolled.
PACE-RI takes calls directly at 401.434.1400 and has an enrollment team whose job is exactly this conversation. Before you call, have a rough sense of the diagnoses, the current help, and what specifically is failing, because the level-of-care question moves faster with that in hand.
THE POINT, the free information line run by the Rhode Island Office of Healthy Aging, is at 401-462-4444, and is the right second call for the Medicaid LTSS side and for anything PACE does not cover. Adult Protective Services is 401-462-0555 if the situation is unsafe today. If your parent is a veteran, the Providence VA Medical Center, VA Aid and Attendance, the Rhode Island Veterans Home in Bristol and the VA Caregiver Support Line at 1-855-260-3274 are all worth working in parallel, since VA benefits and PACE are not mutually exclusive.
If you are coming out of a hospital stay at Rhode Island Hospital, The Miriam or Newport Hospital, all part of Brown University Health, or Kent or Women and Infants under Care New England, or Roger Williams or Fatima under CharterCARE Health of Rhode Island, or Landmark under Prime Healthcare, ask the discharge planner directly whether PACE has been screened for. Asking by name gets a different answer than asking what the options are. And if you want a second set of eyes on the whole comparison, call us at (844) 735-1766. It is free to Rhode Island families, and we would rather you hear about this option now than next spring.
Free, no pressure, and no one rushing you. We answer to families, not to facilities.
Or call (844) 735-1766