Since COVID-19 gained momentum in March, Florida has taken preventative measures to protect vulnerable residents in long-term care (LTC) facilities. In the past month, these policies have been scaled back.
On Sept. 1, Governor Ron DeSantis, R-Fla., issued DEM Order No. 20-009 to allow visitors in LTC facilities. The announcement has been met with both support and criticism.
The emergency order details the necessary guidelines required for LTC facilities to accept visitors. This includes no new resident COVID-19 cases within 14 days, sufficient staff to manage visitors, adequate PPE for staff, and adequate cleaning supplies.
The American Association of Retired Persons supports these preventative measures. However, the AARP is hesitant about the effectiveness of these precautions.
One of their criticisms is the lack of mandatory testing. While visitors are screened for symptoms, they do not need to provide proof of a negative test.
Jeff Johnson, AARP Florida state director, said “Frail, older Floridians and their families have borne far too much of the pain and loss caused by this pandemic. To protect them, long-term care staff and the communities in which they reside, we need more testing, not less.”
In addition to permitting visitors, the DeSantis administration announced that it is eliminating state-supported every-other-week testing of LTC facility staff. The Florida governor says the state requirements are no longer needed because facilities have federal regulations to follow.
The Centers for Medicare & Medicaid Services have issued staff testing requirements based on the extent of COVID-19 in communities.
LTC facilities in counties with a COVID-19 positivity rate greater than 10%, such as Miami-Dade County, are required to test their staff twice a week. Weekly staff testing is required for areas with positivity rates between 5% and 10% while monthly testing is required where the positivity rate is less than 5%.
The federal government is providing antigen testing machines that perform rapid COVID-19 tests to LTC facilities to aid their testing efforts. However, facilities have reported that they were not given adequate testing kits to keep up with their required tests.
Elaine Bloom, CEO of Plaza Health Network in Miami, which operates five LTC facilities, said the new regulation requires her to administer almost 2,000 tests per week. The antigen testing machine arrived with only 300 testing kits, which is not enough to complete even one round of testing.
DeSantis also announced that Florida is closing its 23 COVID-19 isolation centers. These centers have been instrumental in the fight to slow the spread of COVID-19; they were places for COVID-positive residents to recuperate before being transferred to their LTC facility.
Mary Mayhew, secretary of the Agency for Health Care Administration, said the isolation centers are no longer needed due to an improving COVID-19 environment and the health care delivery system’s ability to provide treatment.
Florida’s LTC facilities have seen a decrease in COVID-19 over the past several months. As of October 3, Florida LTC facilities have a COVID-19 positivity rate of 0.87% compared to 4.00% on July 29.
It was these improved statistics that prompted the Florida governor to permit visitation in LTC facilities. While visitation is allowed, it is up to the discretion of each facility to decide whether or not they are ready to accept visitors.
At the forefront of the movement for open visitation is Mary Daniel, a 57-year-old woman whose husband has Alzheimer’s disease.
Daniel made headlines last month when she took a job washing dishes at her husband’s LTC facility in Jacksonville. While Florida’s visitation policies barred her from entering as a visitor, her new job allowed her to see her husband twice week.
Experts say that Florida’s plan is not going to reunite families in the way they want, and it might just make people angrier. Visitors will not be able to hug their loved ones as they must social distance and wear PPE pursuant to CDC recommendations.
There are concerns that the social isolation of LTC residents is taking a toll on their mental health. Some LTC residents are in end-of-life situations, and families want to be there for their loved ones’ final days.
For this reason, Mary Daniel is firm in her stance that opening visitation must be done safely and as soon as possible.
“I’d rather have my husband die with me by his side than die alone,” Daniel said. “I need to think about his quality of life as best as I can, and that’s what I’m trying to do.”
Featured image: Breaking bubbles with the elderly. Unmodified photo by Siouxsie Wiles and Toby Morris used under a Creative Commons license. (https://bit.ly/3kKlezE)
