TALLAHASSEE — For two months, administrators at nursing homes and assisted living facilities across the state have been begging state officials to test their staff and residents to make sure that the deadly coronavirus wasn’t silently creeping into their facilities from staff who were showing no symptoms. But state health officials wouldn’t allow it, instead testing only homes that already showed signs of the virus.
Even though testing in those places was voluntary, it wasn’t always easy. Sometimes staff and residents who had no symptoms were refusing to be tested, said Veronica Catoe, chief executive officer of the Florida Assisted Living Association, an industry trade group.
So, the agency that regulates long-term care facilities has issued an executive order demanding that when the Florida Department of Health arrives to test staff and residents for COVID-19, everyone must submit to testing — even staff that may not be in the building at the time — or the facility could face fines or having its license revoked.
“We know the highly contagious COVID-19 virus can manifest as asymptomatic in positive individuals, thereby increasing the vulnerability and opportunity for transmission in the necessary resident to caregiver interactions that are essential in long-term care settings,’’ said Katie Strickland, a spokesperson for the Agency for Health Care Administration which issued the Sunday order.
There was no indication whether state officials will embark on the widespread and universal testing the homes have been seeking. A National Guard strike team began working with state officials to test all staff members at a small number of the 3,800 homes in Florida, but the focus has been only on homes where the virus has already claimed lives.
“In an abundance of caution, the agency issued these rules to support the testing efforts by the Florida Department of Health and the National Guard to alleviate any confusion of which entities are allowed access to facilities,’’ Strickland said.
Although the Agency for Health Care Administration acknowledged the importance of testing asymptomatic staff, it did not respond to Times/Herald questions about how broad the testing will be.
“They did not provide any details to who and when the Department of Health would be testing,’’ Catoe said.
The order is an attempt to clarify some confusion related to the National Guard testing, said Kristen Knapp, a spokesperson for the Florida Health Care Association, a trade group that represents nursing homes and assisted living facilities.
“Many providers had questions specifically related to testing their staff, such as, ‘Could all staff be tested even if they weren’t at the building for a shift on the day the National Guard was onsite?' and ‘Could the facility require that all employees be tested, which was unclear until this emergency rule?’’’ Knapp said. “Now we have better guidance on that issue and facilities can not only make more informed decisions, they can also give their staff direction when testing occurs.”
Residents and staff at long-term care facilities now account for 41% of all deaths from COVID-19 in the state and the mortality rate had risen to 703 as of Sunday morning.
Mary Mayhew, secretary of the Agency for Health Care Administration which issued the emergency order said it was necessary to “to guard against the rapid spread of COVID-19.”
The emergency rules require “that every facility allow access to the Department of Health or their authorized representative for mandatory testing for all facility staff by the Florida Department of Health during testing visits,’’ she said in a statement. “These rules will also require every facility to allow access to the Department of Health or their authorized representative for infection prevention and control purposes.”
But many administrators have been widely displeased with the state’s piecemeal approach to testing as elder care homes continue to become dangerous incubators of the deadly respiratory infection. They have lamented the week-long delays to get results, the absence of frequent tests for staff, and the failure of the Gov. Ron DeSantis administration to demand that the rapid testing machines be made available to them on a widespread basis.
As the governor re-opened the state for many businesses last week, and proclaimed that the number of COVID-19 cases is declining, nursing home cases continued to rise steadily in Florida.
In the last week, 242 people died at long-term care facilities and people in elder care homes now appear to account for 60% of all COVID-19-related deaths in Florida. For weeks, the state had refused to release the data detailing which nursing homes and assisted living facilities were seeing the highest number of positive cases and fatalities. Under pressure from the Miami Herald and other news organizations, the state started releasing the information two weeks ago.
Meanwhile, DeSantis has tried to accelerate the testing at long-term care facilities and the Department of Health recently altered its guidance to give workers at long-term care facilities new priority.
The governor ordered the National Guard to conduct on-site tests at elder-care homes and last week launched a mobile testing lab equipped with a rapid diagnostic testing machine that will travel to long-term care facilities, test residents and staff, and produce test results in 45 minutes.
But many administrators say it is not enough. Some told the Times/Herald the state’s testing policy for its most vulnerable residents has been an “unmitigated disaster,” “a shit-show” and “too late.”
“All of this is great, but way too late,” Doug Fresh, CEO of the senior care community St. Mark Village in Palm Harbor, told the Times/Herald. Nine of his residents have died of COVID-19 and he has tried to get all his residents and staff tested for weeks.
“If the testing is as available as they say, where is it?’’ he said. “I have tried everywhere.”
Knapp said the industry continues to hope things improve.
“We’re hopeful the Department of Health in conjunction with the National Guard continues expanding the number of care centers where testing will occur each day and that we have assurances of quick turnaround times,’’ she said Sunday.
“Our facilities remain focused on resident safety, yet, in the midst of that, there has been some conflicting guidance from federal, state and local officials. Flattening the curve in our long term care centers is a partnership that we have welcomed since the beginning, and as new mandates are released or state-directed activities are initiated, better clarification with rules like these supports our ongoing ability to make smart decisions about care, staffing and allocating resources.”
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