Overview of the CMS Fine
Federal regulators are moving to penalize a California-based PACE facility operated under the Providence health system. The Centers for Medicare and Medicaid Services issued a $48,833 civil monetary penalty against the organization, according to an April 29, 2026 notice. The fine follows a compliance audit that uncovered multiple service delivery and record-keeping violations. This action signals CMS’s continued focus on enforcing federal standards within PACE programs nationwide.
Who Is Collabria Care?
The penalty targets Collabria Care, the operating name under which Providence Community Health Napa Valley holds its PACE contract with CMS. Based in Napa, California, the organization joined the Providence health system — headquartered in Renton, Washington — in 2018. Subsequently, it rebranded under the Collabria Care name in 2023. Today, the facility serves elderly adults in the Napa Valley region through coordinated, community-based care.
What the CMS Audit Found
CMS conducted an on-site audit from August 25 to September 8, 2025. Auditors identified three distinct areas where the organization failed to comply with federal PACE regulations. Together, these gaps affected how the facility tracked, reviewed, and delivered approved patient services.
Failure to Track Approved Services
Collabria Care lacked sufficient processes to confirm that interdisciplinary team-approved services reached patients as planned. Auditors documented specific gaps, including missed specialist consultations, incomplete laboratory work, and missing durable medical equipment. These failures indicate a breakdown in the coordination pipeline — from order to delivery. Consequently, some patients may not have received all the care their care teams had authorized.
Delayed Review of Clinical Recommendations
Federal PACE rules require interdisciplinary teams to review and act on recommendations from staff, contractors, and outside specialists within defined timeframes. However, the organization did not consistently meet these deadlines. Moreover, when teams chose not to approve certain recommendations, they failed to document the reasons for those decisions. This lack of documentation creates accountability gaps and limits oversight of patient care decisions.
Missed Medication and Service Timelines
Additionally, Collabria Care failed to arrange or schedule approved medications and services within federally required windows. PACE regulations are clear on these timelines: medication dispensing must occur within 24 hours of a physician’s order, while other approved services must begin within seven days. Auditors found the organization fell short of both benchmarks. These delays can directly affect patient health outcomes, particularly for older adults with complex medical needs.
Providence Responds to the Findings
Providence acknowledged the audit results and accepted CMS’s determination. A Providence spokesperson told Becker’s that the audit identified gaps related to a newer standard on how ordered services are tracked and completed. The spokesperson also noted that auditors found no broader quality-of-care concerns beyond the tracking and documentation issues. Furthermore, Providence confirmed it has since strengthened its internal oversight processes to prevent similar delays going forward. The system says it continues to work collaboratively with CMS as it refines its approach to timely, coordinated elder care.
What This Means for PACE Programs
This enforcement action is a reminder that PACE organizations face detailed federal scrutiny across every layer of service delivery. CMS expects facilities to maintain airtight tracking systems, meet strict clinical timelines, and document all team decisions thoroughly. Facilities that fall short — even without broader quality failures — remain subject to financial penalties. Therefore, PACE administrators across the country should treat this case as a benchmark for reviewing their own compliance frameworks, particularly around interdisciplinary team workflows and service scheduling protocols.
