As Florida’s Assisted Living Facilities prepare for what may be an extended national response to Coronavirus-19 (COVID-19), they are leveraging the preparatory work from their required Comprehensive Emergency Management Plans and existing Infection Prevention and Control procedures.

Providers are using resources and relationships as the private and public sectors coordinate to protect seniors living in our assisted living communities and their critical health care teams.

Assisted Living Communities may contact helpline@floridaseniorliving.org with questions.

Members of the media working on a deadline may contact Sandi Poreda at 850-766-1906 / sandi@bulldogstrategygroup.com.


Florida DOH Aging and Vulnerable Populations Call

UPDATED Tuesdays and Thursdays from 4:15 p.m. – 4:45 p.m. Eastern Time

This is a twice-weekly conference call hosted by the Florida Department of Health to disseminate the most up-to-date information regarding COVID-19. All residential facilities that provide care and support to aging and vulnerable populations are invited to participate on the call. There will be an opportunity for questions as time permits.

Call In Number: 888-585-9008
Participant Code: 208-305-233

Lines are limited; dial in early.


Emergency Status System (ESS)

The Agency for Health Care Administration (AHCA) has opened the event “COVID-19 Monitoring” in the Emergency Status System to monitor assisted living facility census, available beds, and related information statewide.

All assisted living facilities are asked to ensure the “Facility Contacts” section is up-to-date and to report Current Resident Census and available beds daily by 10 a.m. EDT starting Sunday, March 15 until further notice.

Instructions for entering facility data for events is available online. For additional assistance, contact the appropriate AHCA licensing unit during normal business hours:

  • Long Term Care Services Unit, at 850-412-4303
  • Assisted Living Unit, at 850-412-4304.

Hospital to Post-Acute Care Facility Transfer

All hospitalized patients should be assessed for COVID-19 prior to transfer to a post-acute care facility. This tool should be used to document an individual’s medical status related to COVID-19 and to facilitate communication between the hospital and the receiving facility during patient transfers. This document must be signed-off by the physician, APRN, or PA who completes the clinical assessment.

UPDATED Download the Assessment Tool


florida Resources

DOH: Livescan Vendor Service Providers

DOH: COVID-19 Call Center Script (3/20/2020)
DOH: Health Care Professional Travel Letter (3/17/2020) / Sample Facility Letter (3/24/2020)

AHCA: COVID-19 Resources for Facilities and Medicaid Providers

DOH: State of Florida Interactive Data and Surveillance Map

Executive Orders re: COVID-19

Executive Order 20-83 – Directs the Department of Health to issue public health advisories urging anyone over the age of 65 and anyone with a serious underlying medical condition that places them at a high risk of severe illness from COVID-19 to stay home and to take any other measures necessary to limit their risk of exposure to COVID-19; directs the Department of Health to issue a public health advisory against all social or recreational gatherings of 10 or more people; and directs the Department of Health to issue a public health advisory urging people who can work remotely  to do so. (3/24/2020)
Executive Order 20-82 – Adds a penalty of a second-degree misdemeanor to violation of Executive Order 20-80; requires the person to inform any person they have been in contact with in the past 21 days that they have traveled from an area of substantial community spread; requires any law enforcement officer who interacts with someone in violation of the order to report it. (3/24/2020)
Executive Order 20-80 – Imposes a 14-day self-isolation order on anyone traveling to Florida from an area with substantial community spread, including New York, Connecticut and New Jersey, to begin upon their arrival in Florida. (3/23/2020)
DOH Emergency Order 20-003 – Extends renewal deadline for any professional license issued by the Department or a Department board or council to May 31, 2020; allows state licensing boards to conduct licensure approval and denial hearings, and some disciplinary hearings, through teleconferencing or other technological means; allows some training for licensure to be done via supervised remote live videoconferencing; expands telehealth options for 30 days; allows licensed/certified EMTs and paramedics to provide basic or advanced life support in an acute care setting at a licensed hospital. (3/21/2020)
Executive Order 20-72 – Suspends non-essential elective medical procedures (3/20/2020)
Executive Order 20-71 – Suspends the sale of alcoholic beverages for on-premises consumption; allows vendors to continue to sell alcoholic beverages for off-premises consumption; suspends on-premises food consumption for customers for all restaurants and food establishments; allows continued sales for delivery or take-out; and closes gyms and fitness centers, excluding specified hotels, residential buildings, etc. (3/20/2020)
Executive Order 20-70 – Closes on-premises services for restaurants, bars, etc., with seating for more than 10 people in Broward and Palm Beach Counties; exempts grocery stores, pharmacies, gas stations, etc. (3/20/2020)
Executive Order 20-68 – Suspends for 30 days the sale of alcoholic beverages for consumption on premises by establishments that derive more than 50% of their gross revenue from the sale of alcoholic beverages. (3/17/2020)
DEM Emergency Order 20-006 – Implements a 30-day ban on visits to nursing centers, assisted living facilities and adult group homes throughout the state. Exceptions may be made for compassionate cases, based on new guidance from the Centers for Disease Control and Prevention (CDC). (3/15/2020)
FLHSMV Emergency Order 20-52 (3/14/2020)
DEM Emergency Order 20-005 – Implements a 30-day ban on visits to nursing centers, assisted living facilities and adult group homes in Broward County. (3/13/2020)
FDOT Emergency Order 20-52 (3/13/2020)
FDOT Memo re: Emergency Road Use Permit (3/13/2020)
DEM Emergency Order 20-002 – Implements limits on who can visit nursing centers, assisted living facilities and adult group homes. (3/11/2020)
Executive Order 20-52 – Declares a state of emergency in Florida (3/9/2020)
Executive Order 20-51 – Declares a public health emergency in Florida (3/1/2020)

DOH and AHCA: COVID-19 Update

DOH: Health Care Coalitions in Florida

County Health Departments: Reporting Possible Infectious Outbreaks

Florida DOH: COVID-19 Statistics

COVID-19 Call Center – 8am-8pm EST
1-866-779-6121
COVID-19@flhealth.gov

DEO: Business Damage Assessment Survey


AHCA ALERTS

Please note: This list may be partial or may not reflect the most up-to-date information. Additional information is available on AHCA’s website.

3/28/2020

Health Care Provider Background Screening
AHCA Emergency Order 20-001
COVID-19 Facility Site Visit

3/22/2020

COVID-19 Testing of Asymptomatic Staff and Residents

3/21/2020

Be Aware of Current Hospital and Physician COVID-19 Testing Criteria for Elderly and Medically Vulnerable Individuals
Guidance for Senior Living Communities (Independent Living)
Summoning Local Law Enforcement to Facilities

3/20/2020

UPDATED SNF to Hospital Transfer Form
Guidance and Clarification on Division of Emergency Management (DEM) Emergency Order No. 20-006

3/18/2020

Hospital and Physician COVID-19 Testing Criteria for Elderly and Medically Frail
COVID-19 Transfer Communication Tool (posted 3/11/2020)
Employee Screening Tool

3/17/2020

Visitor Screening Tool
DOH: Health Care Professional Travel Letter

3/16/2020

Medicaid Coverage of Services During the State of Emergency Related to COVID-19
Employee Criteria Not Met Log
Visitor Criteria Not Met Log
COVID-19 Emergency Requisition Request Form

3/15/2020

Emergency Order Visitation Limits at Residential, Skilled Nursing and Long-term Care Facilities Emergency Status System Activation and Reporting

3/13/2020

Novel Coronavirus Update for Health Care Facilities and Providers

3/12/2020

COVID-19 Facility Visitor Screening Toolkit

3/11/2020

Emergency Order 20-002 Re: Prohibiting Certain Individuals from Visiting Facilities

3/9/2020

Executive Order 20-52: Emergency Management-COVID-19 Public Health Emergency 
CDC Infection Prevention and Control Guidelines

2/20/2020

New ICD-10-CM code for the 2019 Novel Coronavirus (COVID-19
ICD-10-CM Official Coding Guidelines – Supplement Coding encounters related to COVID-19 Coronavirus Outbreak 

2/6/2020

Information for Healthcare Facilities Concerning 2019 Novel Coronavirus Illness

1/31/2020

Detection and Reporting of 2019 Novel Coronavirus (2019-nCoV)

alfs

FSLA Infection Control Regulatory Overview (Members Only)

Last month, members received the FSLA Infection Control Regulatory Overview in the Assisted Living Administrative Rule Review (2/6). The Overview summarizes infection control actions for which Assisted Living Communities are responsible. If you missed your copy, contact staff at lgriffin@floridaseniorliving.org with Infection Control Overview in the Subject.

Argentum: Coronavirus Preparation and Response Toolkit

Argentum: Sample Messaging for Media, Staff and Family (members only)

American Health Care Association: Sample Letter for Resident and Families


Q&A

Q&A Information on COVID-19

PLEASE NOTE: Some of the information that we have previously published has either changed or been updated based on your questions and concerns, for example allowing home healthcare providers into your buildings and admitting new residents. We are in constant contact with the Agency for Health Care Administration (AHCA), Department of Health, (DOH) and the Emergency Management Office (EOC) and as information changes, we will provide you with the most up-to-date guidelines and restrictions.

3/17/2020: AHCA addressed the following questions yesterday on a conference call.

Staffing

Q: Will ALFs and NHs be cited for failing to meet staffing ratios during the COVID-19 outbreak?
A: AHCA will not penalize a facility for not meeting staffing requirements [in rule, statute]; however, facilities must have sufficient staff to take care of their residents. That includes providing the same level of care that you are providing now.

Visitors

Q: Physical Plant/Operation workers were not mentioned in the Executive Order’s list of persons exempted from the visitor ban. Can they be admitted to perform maintenance or repairs to essential equipment?
A: Admit repairmen as needed to keep operations running. However, apply the screening standards and personal protective equipment (PPE) as indicated and limit exposure and close contact to residents and staff. This should be handled on a case by case basis. Look for alternative ways to meet the need, an d document all actions taken.

Q: If a family member is the one providing health care, can they be admitted?
A: If you have a care plan and are charging the family for care, then the community is the primary caregiver.

Testing

Q: Does a staff member returning from a domestic flight trip have to be tested for COVID-19 before returning to work?
A: According to the Governor’s Emergency Order, anyone who traveled through any airport within the past 14 days will not be allowed to enter a community.

Resident Transfers

Q: Should a nursing home or ALF be expected to admit a patient from a hospital?
A: Hospitals should be testing for COVID-19 before they transfer a patient to a nursing home or ALF. The Florida Health Care Association and the Florida Hospital Association developed a Voluntary Transfer Form that was designed to be used for hospital-nursing home transfers; It should be suitable for hospital-ALF transfers as well.

COVID-Positive Cases in a NH or ALF

Q: What actions should a NH or ALF take if a resident tests positive for COVID-19, recognizing that the capabilities are significantly different?
A: Isolate in place to the extent possible (using the COVID-19 infection control guidelines). If PPE is inadequate to prevent contagion, work to transfer to a hospital or to another facility that is better equipped.

If one or more of your residents are being tested as a person under investigation, call your local County Health Department and contact AHCA. Both should be aware so they can immediately reach out to the facility.

AHCA representatives continue to work closely with other local and state agencies to monitor any persons under investigation in a nursing home or ALF.

An AHCA visit will not be regulatory in nature but to make sure adequate PPEs and supplies are in place and being utilized.

Personal Protective Equipment and Supplies

Q: If a nursing home or ALF is running out of PPE and their regular supplier/vendor has indicated that they can’t make deliveries as needed, what should the provider do?

Contact your County Health Department (which will likely be activated into the local emergency management office). FSLA Note: Please fill out the Requisition Form. Providers may be charged for the supplies later.

Q: We’re a small community and get our supplies from WalMart; they have suspended deliveries of food. Is there anything we can do besides sending staff to the store to get needed provisions?
A: Contact your County Health Department; they may be able to help with a pathway.

Surveyor Activities

Q: Is the Agency conducting recertification surveys?
A: At this time, AHCA is only conducting surveys for 1.) recent infection control deficiencies; 2.) complaints that could be Immediate Jeopardy; and 3.) complaints that are related to abuse or neglect.

Screening

Q: Are residents to be screened for COVID-19 every day?
A: Yes.

Q: Is there a form for screening staff for a respiratory illness?
A: A form for staff screening is not specified by the Emergency Order; there are some authoritative resources that can be used on the DOH site.

Resident Care and Services

Q: Is it okay to restrict residents to their rooms?
A: For now, the provider and/or the County Health Department/Emergency Management Office will decide on this policy, and it will likely be a case by case basis depending on resident population and contagion risk.

Q: We have two symptomatic residents; do we need to isolate them?
A: Call the doctor and tell them the resident(s) is symptomatic and the doctor will order the tests as needed and give you further instructions about getting a test. If you have to transport the resident for testing alert the transportation provider that they are transporting a resident that is being tested. Hospitals are doing most of the testing right now.

Communal Dining

Q: Is communal dining okay especially if distance is maintained?
A: The Center for Medicare and Medicaid Services provides regulatory mandates to skilled nursing facilities and survey requirements to the state survey agency directors.

CMS’s latest Guidance (QSO-20-14 NH Revised 3/13/20) indicated nursing homes should cancel communal dining. However, this document is NH guidance, and AHCA will consider whether to restrict communal dining in ALFs.

Communal Activities

Q: Rehabilitative services are provided in a small group setting. Is this all right to continue?
A: AHCA will obtain further clarification and are focused on supportive measures.

Q: Activities such as games are provided in a small group setting. Are these all right to provide for residents?
A: The 3/13/20 CMS Memo is guidance and the facility may need to make an executive decision based on the guidelines. Educate residents on the facility’s process.


vendor information

FSLA will provide updates from our industry partners and vendors; however, this information is accurate as of the time of its posting. This situation is very fluid, and we recommend reaching out to vendors directly for up-to-date information.

FSLA does not endorse or guarantee any product or service listed here; this is meant to be informational only.

March 17, 2020 – ASAP Lab Corp

ASAP Labs is a PCR Molecular Lab that is local to Florida and currently has the COVID-19 and Respiratory NexGen Testing.
Testing Registration Form
Lab Respiratory NGS Requisition Form
New Lab Account Form

March 17, 2020 – Care Purchasing Services

CPS is committed to our clients and their supply needs. We will provide updates during the COVID-19 outbreak as they are received from our distribution partners who provide supplies identified to help prevent the spread of COVID-19 and as provided with the items listed below. Inventories have and will continue to be fluid. Our distributor partners are providing CPS regular updates as they relate to inventory changes (PPE/cleaning/disinfectants) and other supplies impacted as a result of the manufacturing shutdowns in China. Read more.