Complete Compliance

Welcome to the Serenity Care PACE Contract Compliance Program

As part of our annual compliance and quality review process, we are updating our records to ensure that all contracted providers remain aligned with current regulatory and organizational requirements.

Please complete the PACE Vendor Compliance Checklist here (link should jump down to the form). As part of the digital compliance process, we’ll request that you upload the most up-to-date version of the following documents:

  1. A copy of your most current Professional Liability/General Liability (PL/GL) Certificate of Insurance
  2. A newly completed IRS Form W-9

You may upload these securely using the form below.

Additional Details About This Compliance Update

To support your ongoing work with PACE, Serenity Care PACE will also provide access to:

These documents outline program requirements, quality expectations, and best practices for serving PACE participants.

Your documents may be submitted via secure upload (preferred), encrypted email, or another previously approved method.

If you are not the correct individual to complete this checklist, please forward this notice to the appropriate representative within your organization.

For questions or support, please contact info@serenitypace.org.

Affidavit of Compliance Checklist

This process should take 10-15 minutes. Here is a list of items you’ll need in order to complete this process:

  • A certificate of your current Professional and General Liability Insurance
  • An updated and completed W-9 for the organization

Please initial and sign the following checklist for Serenity Care PACE for compliance monitoring as required by Federal PACE regulations. Thank you.

Compliance Affidavit Form

Checkboxes

Upload Your Files

Please upload the following documentation:

  • A certificate of your current Professional and General Liability Insurance
  • An updated and completed W-9 for the organization
Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.

Confirmation

Please initial and sign the following checklist for Serenity Care PACE for compliance monitoring as required by Federal PACE regulations. Thank you.

Date / Time
Clear Signature
Future communications for contract compliance and credentialing will be done via email.
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