DeSantis rejects recommendation for state to test all elder care residents

New data show that after DeSantis claimed to be accelerating testing on April 11, by using National Guard medical teams, about 32,000 residents and staff at 223 long-term care facilities were tested — just 6% of all 3,800 long term care homes in the state.
Sunstar employees walk gurneys into a wing of St. Mark Village nursing home Monday, April 20, 2020 in Palm Harbor. Several residents were transported from St. Mark Village Monday to local hospitals. It is presumed the residents had tested positive for COVID-19 or coronavirus.
Sunstar employees walk gurneys into a wing of St. Mark Village nursing home Monday, April 20, 2020 in Palm Harbor. Several residents were transported from St. Mark Village Monday to local hospitals. It is presumed the residents had tested positive for COVID-19 or coronavirus. [ CHRIS URSO | Times ]
Published May 13, 2020|Updated May 13, 2020

Two days after the White House coronavirus task force urged that all residents and staff of elder care facilities be tested over a two-week period, Gov. Ron DeSantis indicated Wednesday that Florida's government won't be doing that.

But he opened the door to allowing homes to do it themselves.

“We’ve led the way on testing,” DeSantis said at a news conference surrounded by representatives from two of the three industry trade groups in Florida that urged him not to reopen the state without providing additional testing of nursing home and assisted living facility staff.

Unlike other states, which have mandated diagnostic coronavirus tests of all residents and staff at homes with frail elders because of evidence that staff without symptoms are becoming lethal carriers, DeSantis has relied on a voluntary approach that allows homes to decide if they want their residents and staff tested.

On Wednesday, the number of COVID-19 related deaths in nursing homes and assisted living facilities climbed to 776. That’s 42 percent of all COVID-19 deaths in the state, a percentage that is steadily creeping higher.

Under the current policy, which will remain in place, the state waits to send a “strike team” of the National Guard medics to conduct testing at homes after it reports having staff or residents showing symptoms of COVID-19, exposed to the virus, or having already tested positive. Until Sunday, the tests were voluntary for staff but state regulators ordered homes with positive cases to require all staff to submit to tests if the National Guard arrives.

Despite the governor’s claims that Florida has been aggressive with testing at long term care homes, records released this week by the Department of Health to the Tampa Bay Times and Miami Herald and several news organizations show that health officials tested only about 6% of the state’s long term care facilities between April 11 and May 11. The strike teams appear to have tested only three of the 10 facilities with the most COVID-19 cases as of Tuesday.

It’s a piecemeal testing policy that many in the industry, as well as advocates such as AARP, have said is flawed, dysfunctional and has contributed to the 745 deaths from COVID-19 at elder care homes in Florida. Residents of nursing homes and assisted living facilities now comprise 42 percent of all deaths in the state, a percentage that has been creeping upward.

With deaths mounting at nursing homes across the country, Dr. Deborah Birx, the coordinator of the White House coronavirus task force, on Monday strongly recommended to governors that all residents and staff at long term care facilities be tested immediately.

“We really believe that all 1 million nursing home residents need to be tested within next two weeks as well as the staff,” Brix said on a video conference call with DeSantis and other governors, according to a recording obtained by the Associated Press.

DeSantis insisted Wednesday the state doesn’t have the resources to conduct the widespread tests that are occurring in at least four other states, including Texas, Maryland, West Virginia and New York.

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“We want to test as many people as we can,’’ he said. “But we have 4400 [health care] facilities, so I don’t want to give false hope to say, oh yeah everyone will just show up.”

DeSantis also said Wednesday that starting this week he has allowed state officials to distribute tests to homes that want to conduct testing and encouraged other facilities with workers who need to be tested to use the 15 drive-up or walk-in testing sites offered in large metro areas.

Until now, the state had refused to distribute diagnostic test kits to elder care homes so that their medical staff could administer them. Instead, the state relied on state personnel using state labs to conduct and process tests, a protocol that often delayed getting results to the facilities by more than a week, allowing time for the infections to spread.

“I think we can accommodate every worker,’’ DeSantis said Wednesday. “But it’s going to take a nuanced approach to be able to logistically do it, and of course we’ve already tested a lot of folks.”

The records released to the Times/Herald and several news organizations were in response to a lawsuit that asked the state to turn over public records it was collecting about COVID-19 cases, deaths, and testing at elder care homes the serve the state’s most fragile and vulnerable populations.

The data show that after the governor claimed to be accelerating testing on April 11, by using National Guard medical teams, about 32,000 residents and staff at 223 long-term care facilities were tested — just 6% of all 3,800 long term care homes in the state. There are nearly 700 nursing homes and 3,100 assisted living facilities in Florida with more than 190,000 residents.

For three days, the Times/Herald has asked for an explanation of the apparent disparity. None has been provided.

On April 13, DeSantis announced at a news conference that “rescue teams have responded to 93 long term care facilities with COVID-19 positive patients.” The “state had successfully trained 30 paramedics to perform specimen collection and use 12 advanced life support ambulances to randomly collect samples from long term care facilities throughout the state,’’ he said.

By that point, however, the records show only eight nursing homes and assisted living facilities had been tested.

A week later on April 20 — when the state first released on April 20 a list of 307 long term care facilities with COVID-19 cases as a result of a public records lawsuit by a consortium of news organizations, including the Miami Herald — the strike teams had tested fewer than 20 homes, according to the subsequent records release this week. The results for two additional facilities were rejected by the lab.

For the next 10 days after DeSantis’ initial announcement, testing would remain steady but far from comprehensive, the records from the state indicate.

By April 27, when the state released its first list of COVID-19 cases by facility, the strike force had tested fewer than one-third of the 100 facilities with the most cases, the state data shows.

The Fair Havens Center in Miami Springs, which has reported 143 total cases as of Tuesday, and the Claridge House Nursing and Rehabilitation Center in North Miami, which reported 79 cases, both were listed in the state database as “Tasked,” while testing at NSPIRE Healthcare in Lauderhill was listed as “Pending.”

The state policy remained: randomly sample and select staff instead of testing everyone at each facility and focus strike teams to test all staff and residents only at homes that already had positive cases. Because the testing was voluntary, some administrators turned the National Guard teams away.

After weeks of pleas from the industry, the state launched a mobile testing lab last week, equipped with a rapid diagnostic testing machine that is traveling to long-term care facilities, testing residents and staff, and producing test results in 45 minutes.

Meanwhile, positive tests have continued to climb.

The governor has boasted about his response, saying that the White House and other states have adopted his approach.

His team has celebrated DeSantis’ approach.

“FACT: @GovRonDeSantis saved our elderly population; increased testing; empowered local leadership; partnered with the medical community & prevented travelers from spreading the virus,’’ wrote DeSantis spokesperson Helen Aguirre Ferré in a tweet on Tuesday and again on Wednesday morning.

For many administrators at homes that have been working hard to keep the deadly virus at bay, the gradual move to expanded testing has been welcome news, although some suggest they are coming later than they should have.

“This is positive, but we need regular surveillance testing, not one-time hits,’’ said Doug Adkins, chief executive officer at Dayspring Village, an assisted living facility north of Jacksonville.

“Seniors are such a critical part of Florida’s economy, and if Florida is going to make a strong comeback we need to restore pubic confidence in ensuring that seniors are safe,’’ he said.

AARP has been working aggressively to lobby the state for regular, comprehensive testing.

“To ensure that Florida communities continue to avoid the surge in hospitalizations that has crippled other parts of the world, AARP Florida strongly recommends that state leaders mandate a regimen at long-term care facilities that tests workers regularly for the virus before they enter a facility,’’ the organization that represents seniors said in a statement weeks ago. “On-site, quick-turn testing can best prevent the coronavirus from being introduced to fragile long-term care residents.”

“All of this is great, but way too late,” said Doug Fresh, CEO of the senior care community St. Mark Village in Palm Harbor, in an interview with the Times/Herald. Nine of his residents have died of COVID-19. “If the testing is as available as they say, where is it? I have tried everywhere.”

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