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Panel mulls nursing home visits without testing

A worker and a resident at a nursing home. (Pexels)

TALLAHASSEE, Fla. – Top health care regulators in Gov. Ron DeSantis’s administration on Friday discussed a limited reopening of nursing homes and other long-term care facilities that would not require COVID-19 screening for visitors.

Members of the Task Force on the Safe and Limited Re-Opening of Long-Term Care Facilities met for about 90 minutes before agreeing to meet again Tuesday to consider the details of allowing  “essential” and “compassionate” visitation at nursing homes, including facilities that have residents who have tested positive for COVID-19.

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Under the proposal floated Friday, people visiting the long-term care facilities would have to wear personal protective equipment, such as face masks.

Agency for Healthcare Administration Secretary Mary Mayhew, who is the task force’s chairwoman, said she wants the panel to provide short-term recommendations to DeSantis immediately. One of the suggestions would require facilities to keep records authorizing individuals to visit certain residents.

Mayhew made clear Friday that visitation shouldn’t hinge on testing. 

“Testing is very important for a host of reasons, but my cautionary note about testing is it’s a point in time. You can test someone yesterday and they can be positive the next day, which is where the PPE is important,” Mayhew said. “What we don’t want is for it to detract from the vigilance around the use of PPE because fundamentally I am confident that with the right (personal protective equipment), with the right training, we can safely allow individuals to be back with their loved ones.”

Florida Department of Health Secretary Scott Rivkees, also a task-force member, backed Mayhew’s position.

“I agree completely. A test is a point in time. Somebody can test negative one day and be positive the next day,” said Rivkees, who is also the state surgeon general. “But by wearing masks, by having the distancing, by having the hygiene, and by having the screening, you can  mitigate the risk of transmission even if somebody would  happen to be in there and would be positive.”

But Brian Lee, executive director of Families For Better Care, said allowing entrance into a facility without prior testing is dangerous.

“My jaw dropped to the floor,” Lee told The News Service of Florida, when asked about the panel’s proposal. Lee’s organization advocates for residents of long-term care facilities.

DeSantis stopped visitation at nursing homes and other long-term care facilities in March, as the coronavirus pandemic began to sweep the state.

Task force member Mary Daniel, who  drew national attention after she went to work as a dishwasher at a memory-care facility so she could spend time at the center with her husband, agreed that testing is necessary.

She said family members would be willing to pay for tests if they knew the screenings would allow safe visitation.

“I do believe that testing is our end answer and that we need to get point-of-care testing at these facilities,” Daniel said Friday.

The DeSantis administration’s position on allowing limited visitation without testing also is at odds with the Florida Health Care Association, the state’s largest nursing-home industry. The association recommended that indoor visitation only be allowed in facilities that do not have any cases of COVID-19 and that visitors be tested for the virus before being allowed to enter a facility.

Florida Health Care Association Executive Director Emmett Reed, who also serves on the task force, said a July poll showed that nursing-home providers’ overarching concerns are how the visitation ban affected residents’ well being and how lifting the ban could increase exposure to the virus.

“When they think of visitors coming in, those two things are what they are thinking about,” said Reed, added that nursing homes have “worked so hard to keep it (COVID-19) out.”

As of Friday, 10,437 long-term care residents were infected with the virus, according to state health officials. The long-term care facilities include nursing homes, assisted-living facilities and intermediate-care facilities for the developmentally disabled.

More than half of the residents --- 5,457 --- have been transferred out of the facility where they resided to a hospital or to one of 23 nursing homes the state has signed contracts with to care for residents who have tested positive for COVID-19.

When DeSantis announced the creation of the task force earlier this month, the governor said the state was considering whether to allow people who test positive for COVID-19 antibodies --- an indication they have already had the respiratory disease caused by the coronavirus --- to be able to enter nursing homes and assisted living facilities.

While the DeSantis administration boasts that it has made protecting Florida’s senior population its top priority, federal health care regulators have identified nearly 70 percent of the state’s nursing homes as having increased risks for COVID-19 infections.

The designation means that 471 facilities will be receiving COVID-19 rapid test kits in the coming weeks. 

The DeSantis administration contracts with Curative to provide COVID-19 testing to long-term care staff at nursing homes and assisted-living facilities. The company recently agreed to provide the tests to community group homes and institutions for people with developmental disabilities.