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As coronavirus vaccines head to Florida, long-term care facilities finalize their rollout plans

About 2.9 million doses of the FDA-approved Pfizer vaccine are estimated to arrive at health care facilities and nursing homes this week.
Lab technician James Donald, right, uses a nasal swab to test Hugo Marti for COVID-19, Tuesday, July 28, 2020, at the AHEPA Apartments in Miami. Miami-Dade County Commissioner Esteban "Steve" Bovo and Prime Care Family Medical Centers opened the free testing site to test the residents of the senior apartments.
Lab technician James Donald, right, uses a nasal swab to test Hugo Marti for COVID-19, Tuesday, July 28, 2020, at the AHEPA Apartments in Miami. Miami-Dade County Commissioner Esteban "Steve" Bovo and Prime Care Family Medical Centers opened the free testing site to test the residents of the senior apartments. [ WILFREDO LEE | AP ]
Published Dec. 14, 2020

MIAMI — Sunday was the first time that Vivian Royuela, one of the residents at The Palace Suites independent living facility in Kendall, was able to meet her 7-month-old granddaughter, who was born in the throes of the coronavirus pandemic.

So after months of isolation, it was a no-brainer for Royuela, 66, to sign up to hopefully be one of the first to receive the COVID-19 vaccine, once it arrives to the South Florida facility.

“I don’t know why anybody would not,” said Royuela, who moved to The Palace Suites in the middle of the COVID pandemic. “I would hope that everybody does.”

Her son and daughter-in-law flew in from Virginia to spend 30 minutes with Royuela, as residents were rotated out of the seven white tents set up in the parking lot of the facility for a special holiday visit. It was the first event the facility held since the start of the COVID-19 safety measures began.

As 2.9 million doses of the FDA-approved Pfizer vaccine are estimated to arrive at health care facilities and nursing homes this week, Florida’s long-term care facilities and assisted living communities are finalizing their preparations to make sure their residents can have seamless access to the shot.

Nursing homes and assisted living facilities have been registering through the federal government for weeks, through partnerships with CVS and Walgreens. On Thursday, Florida Gov. Ron DeSantis announced the state health department will send strike teams into long-term care facilities to vaccinate those at greatest risk of contracting the disease.

But as an independent living facility, The Palace Suites is in the pool of facilities that may not get the highest priority under the state’s plan, as it is still unclear whether independent living residents who share a campus with nursing homes or assisted living facilities will also be able to get vaccinated.

Gabriel Garrido, general manager at The Palace Suites, said residents were optimistic about the potential of getting vaccines between late December and early January. The Palace has about 10 different senior residences and shares a campus with one of their nursing homes, which has a vaccine partnership with Walgreens.

“We believe that it will be at the same time like our sister buildings, the nursing home and the assisted living,” Garrido said. “They’ve been in contact with Walgreens to include us.”

There is plenty of enthusiasm among their residents. Out of 140 residents at The Palace Suites, 80 have already signed up to get the vaccine in just a 5-day outreach blitz from the facility’s management, Garrido said. The shot is not mandatory, and residents can opt out.

“Many families are calling: ‘Make sure that my loved one is getting the vaccine,’” Garrido said.

Gail Matillo, the president and CEO of the Florida Senior Living Association, said that she has fielded that same question, as some of the long-term care providers she represents share campuses with independent living facilities. She has also been asking the state how the providers can vaccinate staff and input data about the vaccinated residents without violating HIPAA, the federal privacy rule meant to protect individuals’ medical records and other personal health information.

Matillo said she has relayed many of the questions to the state but that generally, the members are “really excited about this.”

“They just want to get back to some kind of normal life,” she said. “By springtime, we could have some healthy residents again.”

Steve Bahmer, the president and CEO of LeadingAge Florida, was first tapped to serve on a state Department of Health planning subcommittee in October, and was tasked with ensuring Florida’s 4,000 long-term care providers got enrolled in the pharmacy partnership program so they could receive the vaccine when it became available.

The federal government’s partnership pharmacies, CVS and Walgreens, are tasked with making three visits to each facility, keeping records, reporting data to the state and coordinating each facility’s on-site clinic. The pharmacies have the proper refrigeration necessary for the vaccine.

So far, 100% of nursing homes have registered, while around 85% of assisted living facilities have. The Agency for Healthcare Administration issued an emergency rule December 1 to require all facilities sign up. Even though registering is mandatory, any resident has the right to opt out from receiving the vaccine.

So far, there have been a few bumps in the process, Bahmer said, like facilities that had registered not showing up on the state’s list. But much of the logistic issues have been ironed out over the last couple months.

“I think it speaks to how eager our providers are,” he said.

But not all leaders in the long-term care industry feel the same about widespread vaccination among seniors.

Brian Lee, a former Florida long-term care ombudsman who now leads an organization called Families for Better Care, said while he understands the optimism toward a return to normalcy, that optimism should come with a dose of caution.

There is still little data to show how the vaccine works outside a test setting, and he wonders if the elderly and infirmed are the right group to be the so-called “guinea pigs” for the rest of the country. He says front-line workers who are healthier should get the vaccine first, and then one or two months should go by before long-term care residents get it.

“I am concerned nursing home residents will be the control group for the nation. They are not a disposable generation,” Lee said. “Just because they are the oldest and the most informed, doesn’t mean they are expendable.”

Donna Rubin, 65, was visiting her 94-year-old mother Marilyn Lake at The Palace Suites’ holiday event on Sunday. It was one of the only times she’s been able to see her through the health crisis. The only other time she saw her mom in person was when staff noticed her mother was feeling depressed, and allowed her to visit.

“Here, they’ve been very careful and they’ve had very, very few cases,” said Rubin, who is a lab analyst in a South Florida hospital. “I work in a hospital and there was a time when we got 15 to 20 [positive COVID-19 patients] from one facility.”

Rubin added that despite some fears about getting the vaccine, she’s hoping to get the shot once it’s her turn, mostly so she can fly to see her daughters and grandchildren who live out of state. And even though she agrees that first responders should get priority, she’s afraid her mother, who lives in independent living, won’t be included in the first phase of vaccinations.

“Honestly, I have a concern that because this is independent living they won’t be first,” Rubin said. “We’ve talked about it, she would like to get it, I would like to see her get it because she’s very high risk.”

Vivian Rankin, a 10-year Palace Suites resident and friend of Rubin and Lake, said as conversations about the vaccine become more serious with tim, she has some doubts about getting the vaccine.

“I don’t know if I should bother taking it. Did you know I’m 101 years old?” Rankin said. “I would like somebody else who needs it to take it.”

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