Florida's long-term care providers prepare for COVID-19


Florida health officials said Thursday that preventing “community spread” of the novel coronavirus through the state’s long-term care industry has become a top concern.

To that end, long-term care providers were told to quickly report to county health departments any positive or suspected cases of COVID-19, the deadly respiratory disease caused by the virus. They also were advised that the Florida Department of Health will authorize tests for the transfer of hospitalized residents back to nursing facilities.

“If a resident goes into a hospital and they test positive, it is very important that you report this to your local health department so that they can work with the staff and work with your facility to ensure all the necessary precautions are in place,” Department of Health Deputy Secretary Shamarial Roberson said on a Thursday afternoon conference call with long-term care providers.

“In addition to that, even if residents are presenting with symptoms and you are getting them tested or facilitating care, we still would like you to communicate that to county health departments, so we can better help serve you,” she said. “And we can be proactive in getting into the facilities and doing infection-control measures to make sure we don’t have community spread in these facilities.”

Agency for Health Care Administration Secretary Mary Mayhew announced that the Department of Health has authorized hospital physicians to order COVID-19 tests before transferring residents back to nursing homes. There has been a growing tension between hospitals and nursing homes, Mayhew said, over whether residents should be tested before being transferred back. Some nursing homes were refusing to accept residents back, fearful that they were contagious.

“If a patient is hospitalized and the clinician believes that the patient should be tested for COVID-19, they can call the Department of Health,” Mayhew said. “That test can be processed by the public health lab, and the public health lab has a turnaround time of between 24 to 48 hours. And how critically important that is in helping support the timely discharge and transfer back to the subacute setting.”

Coronavirus is spread primarily by droplets from people who cough or sneeze or through saliva and can be prevented by thoroughly washing hands. But community spread, according to the federal Centers for Disease Control and Prevention, means that some people are not sure how or where they became infected with the virus. It is harder to contain.

Thursday’s announcements came after the number of long-term care residents who have tested positive for the virus increased to 131 as of Thursday evening. Also, federal health inspectors arrived in Florida this week to evaluate infection-control efforts at long-term care facilities in a “handful of counties.”

Federal Centers for Medicare & Medicaid Services Administrator Seema Verma announced March 23 that the agency would conduct targeted infection-control inspections in areas the CDC deemed likely to have potential outbreaks.

As of Thursday evening, Broward County led the state in the number of infected long-term care residents with 32, followed by Duval County with 22 and Miami-Dade County with 19.

The spread of the virus in long-term care facilities is a concern nationwide but perhaps nowhere more than Florida, which has 691 nursing homes and another 3,000-plus licensed assisted living facilities. Combined, the facilities house about 190,000 residents.

A recently published federal report on the outbreak of the virus at a Seattle-area nursing home said “COVID-19 “has the potential to result in high attack rates among residents, staff members and visitors” after being introduced into a facility.

Working with Washington state health officials, CDC investigators also found that the virus has a way of spreading to nearby health-care facilities.

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