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How do Florida assisted living facilities afford staff coronavirus testing? Some can’t.

“Now they’ve already completely forgotten about us,” one administrator said.
Social distancing is required in the lobby of the Grand Villa of St. Petersburg, 3600 34th St S, an assisted living facility that has opened its doors to visitors after not permitting visitors for the past six months, Thursday, Sept. 10, 2020 in St. Petersburg.
Social distancing is required in the lobby of the Grand Villa of St. Petersburg, 3600 34th St S, an assisted living facility that has opened its doors to visitors after not permitting visitors for the past six months, Thursday, Sept. 10, 2020 in St. Petersburg. [ DIRK SHADD | Times ]
Published Oct. 16, 2020
Updated Oct. 16, 2020

TALLAHASSEE — In September, Florida decided to stop paying for staff coronavirus testing at assisted living facilities.

A month later, that decision has led to confusion and finger pointing in the state’s long term care industry. With state funding gone, some smaller facilities are unsure how they will handle the new cost of staff testing.

“It just really comes down to this feeling that we were absolutely front line, number one for a few months,” said Bay Oaks Historic Retirement Residence Administrator Kathryn Moore. “And now they’ve already completely forgotten about us.”

Moore, whose Miami assisted living facility has 18 residents, sent off her facility’s last free round of employee COVID-19 tests this week. Now, she said, she may have to depend on her staff to get tested at locally run sites. That would be a time-consuming solution, Moore said, but it’s imperative to her facility that employees know whether they are at risk of spreading the virus to vulnerable residents.

It wasn’t until Thursday that facilities like Moore’s felt the end of free testing. That’s because Curative, which collects and processes coronavirus tests for thousands of facilities across the state, had agreed to cover the cost for a month.

But Curative, in an email this week to assisted living facilities, said it would no longer be able to cover the cost of test processing. The message appeared to partly blame state officials.

Related: Assisted-living facilities in Florida no longer have to test staff for the coronavirus

“Unless the State of Florida or (the Centers for Medicare and Medicaid Services) expand the definition of essential employees to include your staff, October 15, 2020 is the last date we will be able to accept COVID-19 tests,” the company wrote. At the bottom of the message was a call to action to get in touch with Gov. Ron DeSantis and Florida’s two U.S. senators: Marco Rubio and Rick Scott.

By Thursday, however, Curative had walked back its message. The onus was not on the state to change its approach, the company said in a follow up email to facilities. Instead, it was up to insurance companies to cover the cost of staff testing at assisted living facilities.

“Despite the state’s continued support, private insurance companies have unfortunately not stepped up to the plate to address the critical need of providing testing to long term care facility employees to protect their vulnerable residents,” an email from CEO Fred Turner read.

In an interview, Turner said the original email to assisted living facilities about the state’s “essential employee” designation “didn’t receive enough of an internal review.” Turner stressed that it was up to insurance companies to cover the often expensive cost of testing assisted living facility staffers.

As an example, Turner mentioned that the insurance company Florida Blue has said it would not cover employer-based tests of assisted living facility staff.

In an email, Florida Blue spokeswoman Christie Hyde DeNave noted the company has spent about half a billion dollars on COVID-19 health care relief — including the cost of more than 270,000 coronavirus tests. But she said employer-based testing should fall to “a community-focused and collaborative approach in partnership with federal, state and local governments.”

When asked whether Florida planned to ask insurance companies to cover testing costs at assisted living facilities, a spokesman for the governor did not initially respond. However, several hours after this story was published online, the spokesman, Fred Piccolo, wrote in an email that “The state is actively reviewing how testing can be made easier for Floridians—especially the most vulnerable and those that care for the most vulnerable.”

Many assisted living facilities are not feeling so much of a pinch. Some have simply shouldered the cost of testing themselves, said Sandi Poreda, a spokeswoman for the industry group Florida Senior Living Association.

But caught in the middle of the finger-pointing are small facilities like Moore’s.

Last week, a box of testing equipment showed up without warning at her assisted living facility. Moore said the box included some of the rapid antigen tests the state is sending to facilities all over the state.

Related: Ron DeSantis: Florida to get more than 6.4 million rapid coronavirus tests

However, those rapid tests are functionally useless to Moore, she said. The reason she did not examine the box’s contents is because her facility does not have permission to conduct on-site testing and test processing. Moore said she fears her facility would be fined if she were to take the necessary precaution of testing her staff.

DeSantis has long maintained that his No. 1 coronavirus priority is protecting the state’s vulnerable elderly population. And for months, the state dedicated unprecedented resources to that end.

When Florida started requiring staff testing at long term care facilities earlier this summer, the state covered the cost of the testing using money from the Coronavirus Aid, Relief, and Economic Security Act that Congress passed in March. Its vendor was Curative. Florida paid the firm to quickly collect, ship and process tests from thousands of state facilities every two weeks.

Included in the testing pool were the state’s 700 or so licensed nursing homes — which offer on-sight medical care — and more than 3,000 licensed assisted living facilities — which do not always offer medical care.

The massive, state-funded testing system worked well, and likely saved thousands of lives, Turner said. But it was never intended to be a permanent solution.

“I think the state covering it for the time that they did was a fantastic deployment option on their part,” Turner said. “The state shouldn’t and can’t do that forever.”

In late August, the federal Centers for Medicare and Medicaid Services announced it would require — and help fund — the testing of staff at nursing homes. Two weeks later, Florida stopped requiring the testing of staff at nursing homes and assisted living facilities.

This meant the state’s assisted living centers that wished to continue testing would have to figure out another way to pay for it.

But while that’s all sorted out, Moore said she’s unsure what to do. The administrator said she doesn’t want to stop testing regularly. With her facility now welcoming visitors, it’s more important than ever to track the spread of the virus, she said.

“As an assisted living administrator, I think our staff are essential,” Moore said. “They absolutely should be tested every two weeks.”