COVID-19 UPDATE #19 -- 4/10/2020

Please keep reading our information because the messaging is changing every hour of every day. Below is the latest information provided to the association -- please note that we will continue to send updates as soon as we receive any new information.

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Looping Back: AHCA Confirms FSLA's Initial Notice Regarding the 6-hour Assistance with the Self Administration of Medication Training Course

On March 27, 2020,the Florida Senior Living Association Covid-19 Update addressed a member question regarding whether the 6-hour Assistance with Self Administration of Medication Training could be offered in an online format during the COVID-19 response.

We checked in with the Agency for Health Care Administration again this week regarding this training. AHCA provided the following clarification regarding the training program:

"While the Agency has not yet issued a formal waiver of this requirement, given the current circumstances, during this declared state of emergency registered nurses and licensed pharmacists can offer the instructional portion of the 6 hour course in assistance with the self-administration of medication in an on-line course or webinar.

The modules can be broken into multiple sessions to add up to the required 6 hours. Testing of the students must be proctored to ensure actual mastery of the knowledge necessary to perform these responsibilities.

Skills demonstrations by the student are permissible via live video with the registered nurse or licensed pharmacist that taught the instructional portion of the course."

Mission Update: Face Masks

Yesterday (4/9), on the 4:15 p.m. DOH/AHCA Health Care Provider call, the State Surgeon General, Dr. Scott Rivkees, reported that Florida had received a large shipment of procedure/surgical face masks. The State Emergency Operations Center will be pushing out deliveries of face masks to County Emergency Management Offices beginning this weekend. In turn, the Counties will be contacting providers who have submitted requests through the County; providers will be given a location and asked to pick up their supplies.

Picking up Supplies from the local EMO

Due to nationwide shortages, expect that PPE requests may be partially filled. Open, count, and document supplies received through a County Mission request as providers may receive invoices for payment and you do not want to be invoiced for supplies that you did not receive.

Laundering Cloth Face Mask Coverings

State Surgeon General Dr. Scott Rivkees acknowledged by phone today that providers are utilizing cloth face masks in the absence of procedure/surgical face masks and reminded everyone that cloth face masks should be washed daily.

Q&A for Cloth Face Coverings (CDC)

Quick Site Tips

One-Stop Shop for COVID-19 Guidance

Discontinuing Isolation

DOH/AHCA Provides Key Prevention Guidelines About Staff Wearing Masks and Not Working When Ill

During the AHCA/DOH Conference Call on Thursday at 4:15 p.m., State Surgeon General Scott Dr. Rivkees and Agency for Health Care Administration Secretary Mary Mayhew cautioned against complacency and said that non-adherence to prevention guidelines will be take very seriously.

All health care settings must be particularly vigilant about not allowing personnel to work when they are sick;

Always have health care personnel wear face masks; use handmade cloth face masks if necessary; and

Audit staff for proper utilization of face masks; masks must cover both nose and mouth.

If you are looking for resources to purchase face masks, please contact us at (850) 496-2562.

Proper Utilization of Face Masks

State Surgeon General Dr. Scott Rivkees reiterated that N95 Respirators are masks used to protect staff when aerosol generating procedures are being used and when working with positive and asystematic residents

Procedure/Surgical masks are recommended for all other situations.

Aerosol Generating Procedures (AGPs)

Some procedures are more likely to generate higher concentrations of infectious respiratory aerosols than coughing or sneezing. The CDC has posted information about commonly performed medical procedures that are often considered aerosol generating procedures (AGPs).

Frequently Asked Questions: See Which Procedures are Considered AGPs ?

Training Staff on using

Personal Protective Equipment

The CDC has developed PowerPoint presentations suitable for use in training staff on the use of Personal Protective Equipment.

Personal Protective Equipment (PPE) - WB4225 Training PowerPoints

The National Emerging Special Pathogen Training and Education Center publishes resources that support PPE use and conservation.

Donning PPE (NETEC Video)

Graphic Sequence Guidance to Reinforce Proper Use of PPE

Produced by the CDC, this graphic guidance can be used during training audits to reinforce the proper use of PPE.

Calculating a PPE Burn Rate

FSLA has been calling Assisted Living Facilities this week and coordinating their entries into the Emergency Status System. One of the areas that can stump providers is determining how many days of PPE they have on hand.

The Personal Protective Equipment Burn Rate Calculator is a spreadsheet-based model that helps healthcare facilities plan and optimize the use of PPE for response to coronavirus disease 2019 (COVID-19).

PPE Burn Rate Calculator

Residents and Face Masks

A member asked us this week to verify whether residents had to wear face masks. The State Surgeon General has said more than once that there is not a one size fits all mandate that every resident in Florida must wear a face mask (as of this date).

Rather, it depends on the facility status (COVID Positive) and the resident status (PUI or COVID Positive); ALF leadership will need to monitor ongoing conditions. But, AHCA is monitoring whether staff is wearing masks when providing care and services to residents.

The Department of Health's Assessment of Long Term Care Facility Guidance provides the best Florida-specific guidance across several areas, including resident face masks. Providers should be reading this document closely and applying it to their specific community. The document recognizes that Counties may and do apply more stringent standards; it may be helpful to ask a County EMO for their written orders if and when something additional is suggested.

Testing Guidance for County

Emergency Management Offices

When engaging a non-County or non-Federal Testing Laboratory to conduct COVID-19 testing, consider asking them if they are reporting positive COVID cases to the Florida Department of Health and your local health department, or if they are depending on you to report positive cases.

Merlin Reports

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