Growing Trend in Senior Living: PACE Centers

By Andy McLeod
Senior Living

PACE centers are an invaluable resource to families

For decades, families across the United States had difficult decisions to make and nowhere to turn for help with their aging loved ones who were sandwiched between needing significant assistance with daily life but did not need the care or setting of skilled nursing. That “in-between” phase is difficult and sometimes dangerous for the elderly person. It is also difficult for the family members and caregivers. But that is changing with the growing implementation of the Program for All Inclusive Care for the Elderly (PACE).

What is PACE?

PACE is a government program that is centered on the belief that it is better for the well-being of seniors with significant care needs and their families to be served in the home or community whenever possible. PACE provides comprehensive medical and social services to seniors in need of significant assistance. An interdisciplinary team of health professionals provides PACE participants with coordinated care. Services can be provided in a participant’s home, at an inpatient facility, or at an adult day health center.

According to the National PACE Association, there are currently 131 PACE programs operating in 31 states. But, the numbers are growing. The National Pace Association has a goal of increasing participant enrollment from nearly 50,000 nationally this year, to 200,000 by 2028.

We are already seeing an increase in the number of people interested in developing and participating in PACE. Most PACE centers make their home in buildings that have been repurposed from their original use to serve participants. We have seen PACE centers in buildings that were previously banks, shopping centers, and office buildings. We encourage an assessment of the proposed building to be completed by the team leads and a design professional with PACE experience.  While square footage and location are truly important, plumbing requirements play a critical role in a PACE center design.

PACE Center Design Considerations

PACE centers vary in size, but the majority land in the 14,000 to 22,000 square foot range, are single story and (ideally) have a large, covered entry way. Other design considerations include:

Clinic and Therapy Area

The clinic and therapy areas require a large part of the building’s footprint. The clinic will require exam rooms, triage, observation room, a nurse station, and medication storage. We often recommend the inclusion of a treatment room to serve those with diabetes or requiring oxygen.

The therapy area would include private treatment area(s) and a space for several therapy stations. Equipment such as hydrocollator, fridge, freezer, treadmills, recumbent cross trainers, therapy balls, tabletop arm bikes, and folding parallel bars should be included in the design as well as ample storage for movable equipment.

Conference Spaces

One of the great features of PACE is the interdisciplinary nature of its care for participants. A large conference or meeting room with ample seating and table space is a high priority for this design. There is also a need for small and medium spaces to allow for small group meetings or a place for staff to interact with participants on an individual basis.

Dementia Area

A separate area for people living with dementia can support treatment unique to their needs. A kitchenette and living area provide a home-like setting that is calming to participants. Activity stations should be designed with enough flexibility to rotate in and out, depending on the desires of the participants. And incorporating a quiet area can help soothe participant agitation. And if budget and space allow, a Multi-Sensory Stimulation Environment can greatly reduce stress and agitation.

Bathrooms and Showers

Designing well above what the code requires in a bathroom is beneficial for participants and staff. We recommend that all stalls be ADA-compliant, rather than just a singular stall. And don’t overlook storage in the bathroom to house incontinence and other supplies.

Many participants rely on the assistive showers at the PACE center for bathing, so a well-designed ADA shower is really important as part of their well-being. We like to design in-room storage with close proximity to the shower to house towels, supplies, and participant clothing. These are just a few of the things to consider when designing a PACE center.


Andy McLeod brings more than a dozen years of senior living design experience to the team as our Senior Living Practice Leader. He has a driving passion to see residential settings for seniors transformed into spaces that feel like home. Andy has even taken the unusual step of becoming a Certified Dementia Practitioner to better understand how design can positively impact adults with memory loss.