March 27, 2020 -- Please keep reading our information because the messaging is changing every hour of every day. Below is the latest information provided to the association -- please note that we will continue to send updates as soon as we receive any new information.
Add Homemade Face Masks
to Contingency Plans

On Wednesday (and noted in yesterday’s FSLA COVID-19 Update, 3/26), we began to hear a message that health care providers may need to start making homemade face masks. Although the CDC states on their website that “caution should be exercised when using this option,” the message from the SEOC this morning was that homemade face masks is likely going to be one of the options for health care workers.

This morning, too, the Surgeon General charged Department of Health to continue conducting focused surveillance of ALFs and SNFs to ensure that face masks (homemade or factory made) are being used appropriately.

Florida’s State Surgeon General referenced using pillow cases, surgical drapes, bed sheets, and other high density, good quality cotton (shop fabric stores) in making face masks to replace surgical masks. Recall that the purpose of surgical masks is to protect residents from the virus that may be transmitted by staff. State has indicated there may be guidance forthcoming on washable and reusable face masks.
*Melinda Skirvin, Divisional Vice President, Five Star Senior Living shared the face mask photo -- Homemade Masks Made for her communities by her sisters.
Criteria for Testing Health Care Workers (3/27/20)

If you have heard conflicting information about health care workers being tested for COVID-19, it may be because there are two different criteria currently being used to test. The Federal Testing Sites (now being referred to as Community Testing Sites) and the County Emergency Management Offices are using two different standards. While Florida’s counties are using the CDC clinical recommendations, the Federal government sites are using a broader criteria but testing far fewer people:

Community Testing Sites (Federal Testing Sites) These Are:
Miami -- Hard Rock Stadium
Orlando -- Orange County Convention Center
Jacksonville -- Jaguar Stadium (TIAA Bank Field)

I.    Currently Testing the Following Persons:
a.        First Responders
b.        Health Care Workers (Assume that a badge will be needed; additional verification may be useful as in a statement on organization letterhead that the person is a health care worker)
c.        Persons over 65 who are symptomatic

County Emergency Management Offices (State Testing Sites)

I.    Currently testing anyone; however, must meet the CDC guidelines that include symptoms:

Adapting Regulatory Policies and Practices During
COVID-19: Medication Training, CPR, and Assessments

As ALFs are adhering to restricted visits, resident outings, and isolating mandates and recommendations, they are unable to meet operational requirements and resident assessments as their standard operating procedures direct.

Examples include the 6-hour Assistance with Self Administration of Medication training that must be delivered in a face to face venue. We shared member concerns with the Agency about not being able to or risk the face to face classroom interaction. The Agency verified in the 4:15 p.m. Healthcare Provider Conference Call yesterday (3/26) that delivering the 6-hour training online would be acceptable when followed by a live return demonstration of competency by a nurse.

Similarly, ALFs with specialty licenses often bring in contracted clinicians to conduct a variety of resident assessments, including initial and quarterly health assessments. These additional visits are being modified or curtailed in compliance with restrictions to visits and outings. Members asked if they could utilize alternate methods such as Skype or Zoom to conduct mandatory nursing assessments in their efforts to minimize transmission risks. During the same call, the Agency responded that expanding ways to provide non-hands on care is appropriate if the goal of the assessment (or regulation) can be accomplished in the alternate mechanism of care delivery: this is in the vein of telemedicine.

Another example discussed (3/26) was the requirement that a CPR-certified person be in the ALF at all times. CPR certification renewal is a live, classroom based training and is currently unavailable or unadvisable for staff.  Because certification could lapse, the Agency stated that ALFs should be reasonable in trying to provide the safety supported by the regulation and the Agency would be reasonable in their review of the modification.

As ALFs seek to provide care and services in a pandemic response that includes frequent Executive and Emergency Orders, a good rule of thumb in making adaptations is to develop a philosophy and/or policy that echoes the Agency’s statement:

“The organization will work to provide the resident and staff safety supported by regulation while recognizing that Florida’s regulatory bodies will reasonable in their review of the modification.”

Member questions may be directed to FSLA staff at
Please Request Special Delivery Options
From Post Office

"The Postal Service recognizes that some customers have expressed concerns about accepting mail, and a few have asked for unusual measures for deliveries. Our operational protocol does not require any Postal Service employee to follow requests outside of normal delivery methods. For customers who choose not to accept mail using established delivery practices, the Postal Service offers several options. Customers can arrange with their local Post Office to place a receptacle outside their office or home. Customers can also arrange to have their mail picked up at their local Post Office. In addition, customers can open a P.O. Box at the local Post Office. For those senior citizen homes, retirement communities, or similar places that would like to change their current drop location, they should contact their local postmaster’s office to make accommodations. The Postal Service continues to provide essential mail service and will work with customers to accommodate safe mail delivery."
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