DeSantis increases fight against coronavirus in Florida’s long-term care facilities

Governor wants to clear the way for nursing home visitors, but it’s unclear when that will occur

TALLAHASSEE, Fla. – Noting that people 65 years and older make up 84% of the COVID-19 deaths in Florida, Gov. Ron DeSantis is stepping up the state’s response to COVID-19 in long-term care facilities.

As of Wednesday’s Florida Department of Health update, 776 residents and staff of long-term care facilities have died. Fourteen of Clay County’s 22 deaths and 11 of Jacksonville’s 32 deaths were connected to one of those facilities.

“We have over 4,400 long-term care facilities in the state of Florida, over 150,000 residents and almost 200,000 staff who work at these various facilities which is a very important vector to worry about in the transmission of the disease,” DeSantis said.

In a meeting Wednesday, the governor reiterated that the state is working to establish and support more nursing centers that treat COVID-19 patients like Dolphin Pointe Health Care in Jacksonville that he visited last week.

DeSantis issued an emergency order in March that would prohibit visitors in nursing homes and long-term care facilities and would not allow hospitals to send patients who tested positive for COVID-19 back to their respective living facility.

Last week, DeSantis updated that rule and asked the Agency for Health Care Administration to require COVID-19 testing of all hospital patients, regardless of symptoms, prior to releasing them to a nursing home and residential care facility.

The governor’s emergency order also required all vendors and staff to be screened for the virus prior to entering any facility.

The state has also given flexibility within the Medicaid program to allow for medically necessary behavioral health.

The governor said Wednesday that in order to continue to protect the elderly in nursing homes and long-term care facilities as the state continues to ease into reopening, surveillance testing would be done to monitor new infections in these populations.

“There is surveillance testing that is going on that is a way to identify a trend or a blip, you’re not testing everyone when you’re doing surveillance, you’re trying to test representative samples and figure out if we see any flair ups in any of these facilities,” DeSantis said. “We think that’s the only way that we can get to a sustainable point where we’re minimizing risk to the vulnerable population.”

According to the Centers for Disease Control and Prevention, COVID-19 surveillance testing is being done on a national level as well, and “draws from a combination of data sources from existing influenza and viral respiratory disease surveillance, syndromic surveillance, case reporting, commercial lab reporting, the healthcare safety system, ongoing research platforms, and other new systems designed to answer specific questions.”

The CDC said this type of testing is used to help achieve the following goals:

  • To monitor spread and intensity of COVID-19 disease in the U.S.
  • To understand disease severity and the spectrum of illness
  • To understand risk factors for severe disease and transmission
  • To monitor for changes in the virus that causes COVID-19
  • To estimate disease burden
  • To produce data for forecasting COVID-19 spread and impact
  • To understand how COVID-19 impacts the capacity of the U.S. healthcare system (e.g., availability and shortages of key resources)

Meanwhile, long-term care provides and state officials are working on a plan to eventually allow visits back in facilities, but contact visits with family are weeks, if not months, away.

“Having the isolation does come at a psychological and social cost,” DeSantis said.

When asked if a timetable given by Agency for Health Care Administration Secretary Mary Mayhew, which suggested visits were likely months away was accurate, DeSantis said, “I don’t think any of us really know.”

“I wouldn’t want to put a firm time table on it, and I also don’t want to give people false hope and say we could be in there in two weeks because I can’t guarantee that,” DeSantis said.

The industry itself is in the middle of a debate of what's possible.

“You’re going to have to look at how long is a care center COVID free. Is the safe date 14 days? Is it 28 days? But I would say you’re looking somewhere at two weeks to 28-days COVID free before you can even think about letting folks come and visit. At least in a semi-normal manner,” said Florida Health Care Association Executive Director Emmett Reed.

The report on returning to some normalcy in longterm care facilities is due next week, and then it’s up the governor.

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