FHCA Updates Florida Legislature on Long Term Care Facilities’ Status During COVID-19

TALLAHASSEE – The Florida Health Care Association (FHCA) today provided a briefing to members of the Florida Legislature, updating lawmakers on the status of its member nursing centers’ and assisted living facilities’ response to the COVID-19 crisis. During the telephone briefing, FHCA Executive Director Emmett Reed was joined by Agency for Health Care Administration Secretary Mary Mayhew and members of FHCA’s Emergency Response Team as they advised legislators on the latest developments.

“The care and safety of our long term care residents, along with the caregivers who support them, continues to be our top priority throughout this state of emergency. The Legislature is a full partner in everything we are doing to protect the health and well-being of Florida’s frailest residents, and we appreciate their interest in hearing directly from us about the many steps being taken by long term care facilities around the state,” Reed said. “Getting through this crisis will require the full efforts of state officials, policy makers, the long term care profession, and the general public.”

Reed and the FHCA team provided the following information to legislators:

COVID-19 Cases Update

Of the nearly 700 Florida nursing homes and more than 3,000 Assisted Living Facilities (ALFs), totaling approximately 155,000 residents, a total of 1,332 Florida nursing home residents or staff have been confirmed with COVID-19 (Department of Health report, as of April 15, 2020). In total, fewer than 100 nursing homes and ALFs have had positive cases, and most have had four or less individuals who are asymptomatic or have had only mild symptoms. Any symptomatic residents are immediately transferred to a hospital for evaluation and treatment.

FHCA and the Florida Hospital Association are working together on clarifications regarding COVID-19 testing and disposition of hospital patients, with a daily reporting of COVID-19 status within buildings and PPE Supplies into the Agency for Health Care Administration (AHCA) Emergency Status System.

Facility Protocols Update

FHCA facilities continue to restrict all nonessential visitors, including family members and vendors. In lieu of face-to-face contact, facilities are coordinating alternative means of communication with family members such as Skype or Facetime, phone calls, texts, and/or social media.

Facilities are also continuing to actively screen staff, and any staff member who shows signs or symptoms is sent home immediately for a two-week self-quarantine. All staff and any essential health care workers entering the facility are required to wear a mask at all times. Those having direct contact with patients are also required to wear gloves.

In order to ensure the safety of residents, all communal dining and group activities have been suspended, with new alternative ways to support residents’ emotional well-being and psychosocial needs being reviewed.

All families are being notified immediately by facilities of any new positive cases.

Workforce Update

To address facilities’ workforce challenges, FHCA developed and received approval from AHCA to create a Personal Care Attendant Program — the Florida Hearts & Hands Program. It includes an eight-hour on-the-job training that prepares participants to support certified nursing assistants (CNAs) with some of their resident care duties, and working in the program can lead participants to sit for the CNA certification exam once the COVID-19 state of emergency has ended. The program provides a career ladder into the long term care profession.

AHCA also issued an Emergency Order with guidance on how long term care providers can address challenges involved with conducting background screenings for new hires. Facilities are still required to conduct a Level 1 screening using the Florida Department of Law Enforcement (FDLE) website. If Level 2 fingerprinting cannot be done, facilities may conduct candidate searches through the FDLE Career Offender Search database or the National Sex Offender database and add into the candidate’s file.

Stakeholder Support

In some locations, AHCA and Department of Health (DOH) strike teams are on-site to assist facilities with infection protocols. Epidemiologists are providing infection control advice and support, and in some counties, nurses are providing added support to facilities. Emergency Medical Services are also visiting facilities to review infection protocols, and the National Guard is assisting with testing residents and staff. The DOH and Emergency Management Offices are working to help facilities locate PPE.

Personal Protective Equipment Update

Long term care facilities continue to put requests into their local Emergency Management Offices; however, a recent FHCA membership survey of approximately 160 nursing homes found that most orders being received are only being partially filled. FHCA is encouraging facilities to stay in constant contact with their local Emergency Management offices regarding supply fulfillment and identify if they have a positive case in their request to help expedite supply fulfillment. Private sources of PPE are beginning to become available, but it will be a few weeks until there are comfortable supply margins.

The survey also found that in regard to having two-weeks’ worth of supplies, only 47% of facilities reported having adequate supplies to meet the need. Over 80% of facilities reported having adequate supplies to meet their needs for one week; however, most facilities indicated their supplies would quickly be depleted if a positive case is identified in their building.

FHCA also conducted a PPE Proper Usage Train-the-Trainer Webinar to support facility staff in performing observations and providing training about proper use of wearing, cleaning, and conserving PPE.

Funding Update

The CARES Act included $100 billion in relief funds to support health care-related expenditures and offset lost revenue for providers, including skilled nursing facilities and hospitals. The first distribution of $30 billion, which went to all providers who received Medicare fee-for-service reimbursements in 2019, was made available starting April 10. Florida providers received an estimated $2.2 billion of the total $30 billion funds as an immediate cash infusion to help with COVID-19-related expenditures.

Florida long term care facilities are still in need of additional funding to ensure that they can provide essential PPE to staff, along with hiring the additional support staff needed to care for residents.

For more information and a coronavirus web page specific to long term care providers, visit FHCA.org.

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FOR IMMEDIATE RELEASE
April 16, 2020

FOR MORE INFORMATION
Kristen Knapp, APR
(850) 510-4389 or kknapp@fhca.org