Families confused, frustrated by Florida’s long-term care visitation policy

JACKSONVILLE, Fla. – Families with loved ones inside nursing homes and assisted-living facilities are confused over what they say is a shift in Florida’s visitation policy for long-term care homes.

Gov. Ron Desantis signed an executive order in October allowing for limited visits to nursing homes and assisted living facilities -- a departure from a months-long lockdown of long-term care homes in the state to prevent outbreaks of the coronavirus.

The Agency for Healthcare Administration sent out a letter to long-term care facilities on Nov. 4 clarifying elements of that order, including protocol for holiday visits.

The FAQ wrote: “residents must be permitted to leave the facility if they wish, including holiday visits” adding “if the resident passes screening criteria, then they do not have to be quarantined or isolated.”

But in a statement to the media and frustrated families, the ACHA said the procedures laid out in the Nov. 4 email were “minimum requirements facilities must meet” but that “subsequent recommendations were released by CMS which the Agency shared with all long-term care facilities.” The email also said facilities could implement additional measures to protect their residents while still allowing holiday leave.

The Centers for Disease Control and Prevention also recommended against residents leaving the nursing homes, saying: “with the potential for a safe and effective vaccine on the immediate horizon, extra precautions now are essential to protect nursing home residents until a vaccine becomes available.”

Mary Daniels sprang into the national spotlight after taking a job as a dishwasher in her husbands Jacksonville care facility in order to be near her husband during lockdown. Daniels was subsequently asked to take a role on the governor’s task force on reopening long-term care facilities.

Daniels says her husband’s facility is now requiring all residents whose families take them out for holiday breaks to quarantine for 14 days upon returning, despite passing screening. On Nov. 4, the FAQ from ACHA said the opposite.

“Do we break the promise and tell them they can’t come home? Even though they’ve been looking forward to that and hurt them with that decision? Or do we let them come home – and then have to put them in solitary confinement for 14 days? How cruel of a decision is that? That we’re are having to make for our families one day before Thanksgiving?”

One element of the governor’s October executive order that has not changed, is facilities are not required by state health officials to test residents for COVID-19 for them to re-enter the facility. Though, officials with ACHA says it is encouraged.

Brian Lee, an advocate for long-term care facilities and director of Families for Better Care, says without the requirement for testing there’s a risk of more outbreaks.

Already in Duval County, 41% of COVID-19 related deaths are in seniors and staff inside long-term care facilities.

“There’s screening protocols, but there’s not required compulsory testing at the door of whoever’s coming in,” said Lee. “That increased foot traffic just opens up the opportunity for breaches to occur within that bubble of protection. So, the virus can get in unbeknownst to the, to the staff to the residence, even unbeknownst to the people who are bringing it in because you have asymptomatic carriers.”

Other facilities in Jacksonville say they are also requiring varying days of quarantine for residents who leave the facility during the holidays, and in some cases, facilities are also requiring a negative test in order to get out quarantine.

Daniels says more than anything she’s concerned about directives from state health officials being unclear to facilities – and to families. The result – she says – is confusion and disappointment for families.

“Either enforce the order as it’s written or resend the order? If it’s too dangerous, if there’s too much risk, then say that educate us. We’re reasonable people, we will do what’s in the best interest of our family. But you can’t have it both ways,” said Daniels.

“You’ve made us face this situation, when we were really hopeful. And we were really looking forward to this time with them. This may be their last Thanksgiving. It is very possible for many of them.”

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