Mandatory Testing: What We Know (Today)
Yesterday, representatives from AHCA and DOH held a rare statewide conference call with industry partners to review plans to test all staff and to test all residents who agree to be tested in all long-term care facilities and assisted living facilities over the next two weeks.
This statewide policy shift was first announced in FSLA’s COVID-19 Update #26 on Friday, May 8, when we informed our members to make preparations for the upcoming emergency rule. On Sunday, May 11, FSLA shared AHCA’s
Emergency Rule 59AER20-2
(for assisted living facilities) and
(for nursing homes) with our members via COVID-19 Update #27.
The Emergency Rule requires assisted living facilities to:
- Allow the DOH or its authorized agents entry into the facility for the purpose of conducting COVID-19 infection control duties as well as testing of residents and staff;
- Comply with all DOH infection control directives concerning staff and resident testing; and
- Require staff to submit to a COVID-19 test when the DOH or its authorized agent enters the facility in its public health function for purposes of COVID-19.
While these emergency rules are written broadly to allow DOH to require testing of residents and staff upon DOH's arrival at facilities, to date it was not an across-the-board mandate for all facilities to test immediately (e.g., unless otherwise required by DOH, testing was still a voluntary decision). After yesterday’s phone call, we can now anticipate a new directive from DOH that requires imminent testing of all staff along with residents who do not opt out.
Florida's new approach, and indeed a new approach being taken by many states, is in line with recent guidance issued by the federal government regarding loosening restrictions on long-term care facilities and reopening the economy.
While the representatives said that further guidance would be issued, the call provided an overview of how testing will be implemented. Please keep in mind that information shared on the call is subject to change as the formal guidance continues to be constructed.
Key points include:
- It is critical that senior living facilities timely and accurately report ESS data (especially the questions added May 13). This data will be used to plan and implement testing (e.g., whether the facility can test staff themselves or needs state resources to conduct the testing).
- The state is developing plans for conducting testing. For example, if a community has already tested a significant number of staff or residents, the community will likely be asked to continue using their own resources.
- If a community has a small number of staff remaining to be tested, they may choose to use available options such as drive-through testing, mobile testing units or the county health department.
- If a community can conduct the tests themselves using state kits, the state will send the kits to the community. Likewise, if a community needs state representatives to come onsite and conduct the tests, arrangements will be made with as much advance notice as possible. State teams could consist of scalable teams from multiple people such as National Guard members, registered nurses, paramedics, etc. (wearing their own PPE).
- All staff must be tested. This includes all staff and contractors. A good rule of thumb is to test everybody who works in any capacity in the building (e.g., does not log in as a visitor).
- Results will typically take 24-48 hours to return. The state is working on an electronic portal that would let the community log in and see results from its staff and residents. The portal may go live as early as this week.
- Additionally, all staff are being encouraged to get tested on a recurring basis (e.g., weekly or biweekly); however, it is possible this encouragement will turn into a directive. If the facility cannot make arrangements itself, one option is for the staff to regularly use the state’s drive through testing locations.
The premise for this recent shift appears to stem from the consensus that for senior living communities, the threat from COVID-19 will last for many months. AHCA and DOH appear to be attempting to create an early alert system that will allow them to effectively and efficiently deploy resources to assist senior living communities.
Additionally, it appears that for nursing homes, the federal government is reluctant to allow any restrictions to be loosened without first conducting a baseline test of all staff and agreeing patients. This philosophy is likely being applied to assisted living facilities by state. In other words, we may not see the visitation ban, etc., relaxed until this baseline is created and reviewed. Mandatory, across the board testing for residents and staff may be a key factor to allowing for visitation.
These are stressful times. AHCA and DOH understand that as a result of this testing, we will likely see an increase in the numbers of positive cases in both staff and residents. Likewise, AHCA and DOH are pledging to continue to work closely with all facilities and associations to make sure we are able to support our communities and not lose sight of the elderly and vulnerable. Rest assured, FSLA will continue to monitor the situation and be a constant advocate on behalf of our members.
FSLA is in contact with AHCA leadership and in anticipation of the upcoming guidance, FSLA is coordinating the collection and submission of follow-up questions to assist AHCA in efficiently responding. FSLA will then compile a FAQ for distribution. Please send questions to
as soon as possible now or after guidance is issued.