Expanded COVID-19 Testing in Florida's ALFs and Nursing Homes
As referenced in our COVID-19 Update #30 (5/19), Secretary Mayhew announced a directive for Assisted Living Facilities and Nursing Homes to test all residents and staff. This verbal direction expanded the Agency's written Emergency Rule from the prior week that mandated ALFs and Nursing Homes comply with staff testing arranged by the Department of Health. Assisted Living Facility providers responded to the Secretary's latest announcement by ramping up their ongoing efforts to obtain test kits and to order tests for residents and staff.
The Department of Health is supporting the expanded testing initiative by continuing their facility assessments, arranging testing through public labs, and by sending test kits to ALFs and Nursing Homes that have the clinical capability to conduct testing, but do not have their own testing source.
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Save the Date
for FSLA's 2-Part Webinar Series on COVID-19 Rapid Response and Direct Care Teams in ALFs.
Friday, June 5 at 12:30 p.m.
Friday, June 12 at 12:30 p.m.
Taught by Janet Tiemeyer, RN, Senior Vice President of QA & Risk Mgt, for Elegance Living, this former Certified Infection Preventionist applies infection prevention and control to assisted living's unique characteristics.
Watch your FSLA communication channels for registration details.
Thank you to Guardian Pharmacy Florida for their support of this special series.
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The ESS Connection to the Statewide Testing Initiative
The daily data added to the Emergency Status System by ALF providers is used by the Agency and DOH to determine which ALFs are suitable candidates to receive test kits. Certain ESS fields, in particular, inform DOH of those ALFs that may be appropriate to contact about test kits:
- All residents and consenting residents tested since April 11 (Yes/No)
- Facility has own arrangements to actively test current and new employees (Yes/No)
- Clinical staff capable of collecting test specimens (Yes/No)
A new field has also been added to ESS:
ESS: "For the previous day (12:00am to 11:59pm), total residents with confirmed or suspected COVID‐19 that were transferred out of your facility to another health care facility or hospital"
The purpose of the field is to capture fluctuations in daily transfers and positivity.
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Statewide Testing Initiative Resources
The Department of Health has published several new infographics that describe aspects of the Statewide Testing Initiative:
DOH Lab Results Call Center:
833-956-0323
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DOH Infection Control Assessment and Response Tool Updated
As the Florida Department of Health teams continue their telephone and onsite screening assessments of ALFs and nursing homes, FSLA reached out to DOH this week and learned that the DOH teams will soon be using a modified tool to support their interviews and assessments.
The
Infection Assessment and Response Tool
(ICAR) is similar to the prior version but the format is significantly different and includes questions and interviewer direction. While the title specifies nursing homes, it also acknowledges that the tool
may contain content relevant for assisted living facilities
. It's likely that ALFs being evaluated by DOH representatives will be given a copy of this tool before an assessment begins. It's also valuable to note this version includes sample questions to gauge the well being and status of the facility. According to the tool, assessment activities are not a regulatory inspection and are designed to ensure the facility is prepared to quickly identify and prevent the spread of COVID-19.
As we have seen, guidelines and tools have changed over time throughout the COVID-19 response and FSLA will continue to monitor and communicate changes as we learn of them.
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Hurricane Preparedness Plans and COVID-19
Hurricane Season begins on Monday, June 1, 2020.
Today the Agency for Healthcare Administration issued a notice to regulated health care providers addressing collective concerns about possible disruptions caused by the COVID-19 response to existing, approved hurricane preparedness plans.
The memo states that bolded items must be completed by your facility and, following your assessment, list the changes made to your plan to accommodate COVID-19 and report these modifications to your local Emergency Management Agency.
As always, local Emergency Management Agencies may have additional county requirements.
FSLA Hurricane/COVID-19 Preparedness Committee
On a related matter, FSLA has created a Hurricane/COVID-19 Preparedness Committee to develop best practices for hurricane season now that we have additional COVID-19 restrictions. This committee is still being formed; however, current members are:
- Chair: Chris Callahan, Brookdale Senior Living, Regional Vice President Operations
- Melissa Bossert, Legend Senior Living, Regional OPS, Area Director
- Margie Longstreth, Five Star Senior Living, Region 19, Regional Director of Operations
- Bryce Robinson, Sonata Senior Living, Regional Director
- Diana Saxton, Senior Lifestyle Corporation, Regional Director of Operations
- Jason “Jay” Thomas, Atria Corporate Office, Assistant General Counsel-Operations
- Michele Thompson, Elegance Senior Living, Regional Vice President
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Visitation Restrictions and Testing
75 days into Emergency Order 20-006 which suspended nearly all visitation for Assisted Living Facility residents, caregivers and clinicians are expressing growing concern about the impact of the isolation required to keep COVID-19 outbreaks under control. From missing family and friends to going without therapeutic trips to their community's salon, we are hearing that residents are experiencing increasing pressures to their psychological well being in spite of the ongoing efforts and creativity of staff.
Florida's ALFs, nursing homes, hospitals, regulatory, and executive leadership have worked tirelessly to mitigate the spread of COVID-19 throughout in-facility residences and care units. As Florida moves through reopening Phases, ALFs and nursing homes will be brought along very slowly and with intense scrutiny.
As ALF leadership plan for Florida's eventual easing of restrictions, it's important to be familiar with the Centers for Medicare and Medicaid Services
Nursing Home Reopening Recommendations for State and Local Officials
. While aimed toward Nursing Homes, it seems clear that Florida is leaning into these recommendations for Assisted Living Facilities to some degree.
For example, it's no coincidence that Florida is undergoing a tremendous Statewide Testing Initiative in ALFs and nursing homes; baseline testing is, essentially, step one for consideration of relaxing visitation restrictions. CMS's recommendations include this:
Nursing homes should not advance through any phases of reopening or relax any restrictions until all residents and staff have received a base-line test, and the appropriate actions are taken based on the results;
(p. 4)
It's also noteworthy that the White House Task Force specifically identifies senior care facilities in the
Guidelines for Opening Up America Again
. In the guidelines, senior care facilities are theoretically cleared to resume visits in a state's Phase Three.
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A Strategy for Visitors
As your Assisted Living Facility looks ahead toward Florida allowing visitors once again, we can expect a tiered approach that monitors outcomes. If your community has an idea for safely welcoming visitors into your ALF, we'd like to hear from you so we can share with others.
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Share Your Inspirational Stories
We would like to spread some joy and helpful information on our Facebook page!
What interesting ways are your residents and staff interacting or contributing to their community in these trying times?
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CDC Guidelines in the Spotlight
In guidance to the general public,
When You Can Be Around Others
, the CDC addresses when people who have had COVID can resume social activities. (5/28)
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White House Task Force
Keep up with the Task Force work being done in response to COVID-19.
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