Please keep reading our information because it changes 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.
COVID-19 UPDATE 41
July 16, 2020
Mark Your Calendar for the Next AHCA Weekly Provider/Health & Regulatory Partner
Conference Call

Thursday, July 16, at 4:15 p.m. EST
Dial 1-866-951-1151 and enter Room Number 8484844#
*Please note there are limited lines available for this call.
As a reminder, all calls are recorded and posted to the FHCA website here .  
CDC Recently Revises Eye Protection Guidance Twice

The CDC recently updated the Interim Infection Prevention and Control Recommendations for Healthcare Personnel during the COVID-19 Pandemic document on two occasions: first on July 9 relating to recommendations for universal use of eye protection (in addition to a facemask) for HCP working in facilities located in communities with moderate to sustained SARS-CoV-2 transmission is intended to ensure HCP eyes, nose, and mouth are all protected during patient care encounters; and second on July 15 by adding language that protective eyewear (e.g., safety glasses, trauma glasses) with gaps between glasses and the face likely do not protect eyes from all splashes and sprays. For more information, keep reading….

On July 9, the CDC modified this guidance document relating to implementing universal use of PPE, as it relates to recommended routine infection and control (IPC) practices during the COVID-19 pandemic. This guidance is intended to apply to all patients, not just those with suspected or confirmed COVID-19 infection. The modifications made by CDC are:

  • For HCP working in facilities located in areas with moderate to substantial community transmission was modified as follows: Wear eye protection in addition to their facemask to ensure the eyes, nose, and mouth are all protected from exposure to respiratory secretions during patient care encounterssplashes and sprays of infectious material from others.
  • For HCP working in areas with minimal to no community transmission was modified as follows: the universal eye protection and respirator recommendations described for areas with moderate to substantial community transmission are optional. However, HCP should continue to adhere to Standard and Transmission-Based Precautions, including use of eye protection and/or an N95 or equivalent or higher-level respirator based on anticipated exposures and suspected or confirmed diagnoses. Universal use of a facemask for source control is recommended for HCP.

  • NOTE: This change appears to non-substantive, as removing this language does not remove the option to use such protections and recommendations.

On July 15 the CDC modified a separate section of this guidance document – the part relating to the PPE recommended when caring for a patient with suspected or confirmed COVID-19 – by stating:

  • When putting on eye protection (i.e., goggles, or a face shield that covers the front and sides of the face) upon entry to the patient room or care area, if not already wearing as part of extended use strategies to optimize PPE supply: Protective eyewear (e.g., safety glasses, trauma glasses) with gaps between glasses and the face likely do not protect eyes from all splashes and spraysPersonal eyeglasses and contact lenses are NOT considered adequate eye protection.

As the COVID-19 response has evolved this summer, eye protection has been known to be a marker for County Health Departments in determining a staff person’s level of exposure and their subsequent quarantine. The CDC’s Interim Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure details when eye protection would make a difference in exposure risk when working with COVID-positive residents. 

Florida’s Department of Health and County Health Departments follow the CDC guidance as they related to their facility assessments. As part of their assessments, County Health Departments are likely to ask about eye protection use by personnel working in facilities located in areas with moderate to substantial community transmission

Definitions
Definitions are provided at this site:

  • Substantial community transmission: Large scale community transmission, including communal settings (e.g., schools, workplaces)

  • Minimal to moderate community transmission: Sustained transmission with high likelihood or confirmed exposure within communal settings and potential for rapid increase in cases

  • No to minimal community transmission: Evidence of isolated cases or limited community transmission, case investigations underway; no evidence of exposure in large communal setting

Specific questions about a county’s community transmission may be directed to County Health Department Leadership .

It may also be helpful to review Florida’s COVID-19 Data and Surveillance Dashboard (select the menu icon on mid-right for the cases per county legend).
AHCA Provides Guidance on Reporting Results to DOH
The Agency for Health Care Administration sent a memo on 7/14 reminding laboratories to report conditions of urgent public health importance, including COVID-19; as noted below, this includes both positive and negative test results:
 
RON DESANTIS
GOVERNOR
 
MARY C. MAYHEW
SECRETARY
Home  |  About Us   |  Medicaid   |  Licensure & Regulation   |  Report Fraud
 
 
July 14, 2020
 
COVID-19 IS A REPORTABLE CONDITION OF URGENT PUBLIC HEALTH IMPORTANCE AND MUST BE REPORTED TO THE DEPARTMENT OF HEALTH IMMEDIATELY
_______________________________________ _________
 
Florida Statutes section 381.0031 and Florida Administrative Code Chapter 64D-3 require all laboratories, regardless of public or private status, to report without delay conditions of urgent public health importance, including COVID-19.
 
Reports that cannot timely be made during the County Health Department business day shall be made to the County Health Department after-hours duty official. If unable to do so during normal business hours, the laboratories are required to contact the Department after-hours duty official at (850)245-4401.
 
Rule 64D-3.047 provides:
 
(1) Any practitioner, hospital or laboratory who is subject to the provisions of this rule who fails to report a disease or condition as required by this rule or otherwise fails to act in accordance with this rule is guilty of a misdemeanor of the second degree, and, upon conviction thereof, shall be fined not more than five hundred dollars ($500.00) as provided in Section 775.082 or 775.083, F.S. Each violation is considered a separate offense.
 
(2) All violations by practitioners, hospitals or laboratories shall be reported to the appropriate professional licensing authorities and public financing programs.
 
All federally certified Clinical Laboratory Improvement Amendments (CLIA) labs must comply with 42 CFR §493.1101 Standard: Facilities (c) states the laboratory must be in compliance with applicable Federal, State, and local laboratory requirements. CLIA certified laboratories are laboratories that have a Certificate of Waiver, a Provider Performed Microscopy certificate, a Certificate of Compliance, and a Certificate of Accreditation.​
 
Please note, reporting results means reporting all positive and negative results​.
 
Please be advised that strict compliance with this rule is of the utmost importance during this public health emergency. The Department of Health, in conjunction with state, federal, and local authorities, uses this data in real time to prepare and respond to the COVID-19 emergency.
 
Any gaps or delays in reporting time hinder efficient emergency response and resource allocation. All CLIA-certified facilities are expected to report immediately during this pandemic.
 
RON DESANTIS
GOVERNOR
 
MARY C. MAYHEW
SECRETARY
Home  |  About Us   |  Medicaid   |  Licensure & Regulation   |  Report Fraud
 
 
July 16, 2020
 
Long-term Care Testing Clarification
________________________________________________
 
To prevent the spread of COVID-19 at long-term care and residential facilities, the Agency for Health Care Administration issued Emergency Rule 59AER20-6 . This rule replaces the previous Emergency Rule 59AER20-01 and provides further clarity to hospitals and long-term care facilities about clinical decision making during the discharge of residents.
 
  • A hospital is prohibited from discharging any resident who has tested positive for COVID-19 or is exhibiting symptoms consistent with COVID-19 to any long-term care facility until the resident has been cleared for discharge using either a test-based strategy or a symptom-based strategy, unless the receiving facility has a dedicated wing, unit, or building with dedicated staff to accept the COVID-19 positive resident. 
 
Under the symptom-based strategy, the long-term care facility resident must meet the following criteria:

  • At least 3 days (72 hours) have passed since resolution of fever without the use of fever-reducing medications; and
  • Improvement in respiratory symptoms; and
  • At least 10 days have passed since symptoms first appeared.

Under the test-based strategy, the long-term care facility resident must have:

  • Resolution of fever without the use of fever-reducing medications
  • Improvement in respiratory symptoms; and
  • Two consecutive negative test results separated by 24 hours. The first by an FDA Emergency Use Authorized COVID-19 molecular assay RT-PCR test and the second by either an FDA Emergency Use Authorized COVID-19 molecular assay RT-PCR test or an FDA Emergency Use Authorized COVID-19 antigen test.

Individuals who have not tested positive for COVID-19 and who are not suspected of having COVID-19 must still be tested but may be admitted to the long-term care facility while awaiting their results as long as they are isolated until they receive a negative result. 
 
Isolation Following Admissions
 
Long-term care facilities may admit a patient with an unknown status (has not tested positive for COVID-19 nor been suspected of having COVID-19) as long as they isolate the resident for 14 days or until they receive a negative test result. For anyone who has tested negative prior to long-term care admission or is discharged from a hospital using the symptom-based strategy, the resident does not require isolation for 14 days but should be monitored.
  INTRODUCING
TGI-FSLA: Fridays with Jason Hand
Coffee and Conversations
 
Fridays, from 8:30-8:50 EDT
 
Join us every Friday morning for a virtual cup of coffee and some candid interactive conversations about the issues facing senior living in Florida. These 20-minute sessions will be an informative look behind the curtain at how policy and rules are made and how to interpret this process effectively. Sign into Zoom so we can interact with you face-to-face and don't forget to bring your comments and questions.
 
Register Now to Participate
Participants in these Friday conversations will be able to purchase continuing education credits. One unit (1 hr) can be awarded for every three (3) meetings attended. Attendance will be verified by the virtual meeting platform. Sign up today and join us! Link to purchase credits coming soon.
 
**Please note: Participating in this meeting will require you to have a Zoom account. Zoom accounts are free and can be set up quickly. Click here for more info.
DATES AND TOPICS
Fridays, from 8:30-8:50 EDT
 
  • 7/17 - HB 767 Technological Advances For Safety & Security
  • 7/24 - HB 767 Adverse Incident Reporting & Monthly Claim Reports
  • 8/7 - HB 767 Resident admission/retention
  • 8/14 - HB 767 Physical Restraints
  • 8/21 - HB 767 Assisting Residents – appointments, bandages and patches
  • 8/28 - HB 767 Inspection surveys rule removal – what it means
  • 9/4 - HB 767 Emergency Management Plan – and FSLA Hurricane Workgroup Update
  • 9/18 - HB 607 Direct care workers (monthly report)
  • 9/25 - HB 731 Agency For Health Care Administration
  • 10/2 - SB 664 Verification of Employment Eligibility
  • 10/9 - SB 400 Elder Abuse Facility Review Teams
  • 10/16 - 2020 Tort Bills That Died: HB 6029 – Punitive Damages; HB 9 – Damages; etc.
  • 10/23 - 2020 Other Bills That Died
  • 10/30 - Looking Ahead to the 2021 Legislative Session: Tort Reform; Covid-19 Package; ALF-centric issues; and other issues of interest to ALFs
  • 11/6 - Election Wrap-up
 
Sign up now and join us tomorrow morning!

COVID-19 Isolation Centers Identified

The battle to contain the spread of COVID-19 is a significant challenge in long-term care facilities. To address this issue, Governor DeSantis has directed the establishment of COVID-19 only isolation centers and units to serve patients in need of long-term care services who have contracted COVID-19. These facilities will help halt the spread of the virus in long-term care settings, allow for the appropriate isolation and recovery of COVID-19 positive patients, and ultimately save lives. As such, the Agency has entered into agreements with certain nursing facilities or portions of nursing facilities to designate them as COVID-19 Isolation Centers.

These Isolation Centers are regional resources for any COVID-19 positive patient requiring nursing facility level of care. The Centers may accept patients with any type of insurance and patients who are uninsured.

Communities can learn more by clicking here .
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