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 50
September 3, 2020
Please Begin Communicating Your Visitation Plans with Residents and Families on a Regular Basis!

As visitation begins to roll out in various stages across the state, FSLA strongly encourages all communities to make sure they are communicating regularly with their residents and family members about what to expect in terms of visitation and the dates visitation will open in your community.

Right now, family members have extremely high expectations when it comes to getting into your community because of what they're seeing and hearing in the media. These expectations are likely driven by emotion as well as a potential lack of understanding about how policies and procedures are created and implemented. We understand policies and procedures must be written, appointment and visitor forms must be created and a location for visitation inside or outside your buildings must be determined. Also, don't forget to consider new training requirements for infection control and proper PPE.

While we don't recommend making excuses about how long it will take for your community to get its processes updated and put in place, we do recommend providing regular updates with useful information, such as how residents and responsible parties can help identify the approved list of visitors, and the required training essential caregivers must complete.

Look for every opportunity to provide useful, timely and accurate information to your family members, whether by email, phone, text, social media or other communication channels.
Watch FSLA's Video Call with AHCA Secretary Mary Mayhew

Earlier this week, AHCA Secretary Mary Mayhew was our guest on the FSLA Members weekly COVID video call. Secretary Mayhew explained the new visitation order, DEM Order 20-009.

To watch the video call, CLICK HERE.

Download a copy of the PowerPoint Presentation by CLICKING HERE.
FSLA Answers Your Questions Related to the
New Visitation Order

On Wednesday during our COVID video call, we received many questions about the new visitation rules. Click below to print a copy of the Q&As.


These questions and answers are based on DEM Emergency Order 20-009 and AHCA’s’ verbal clarification from FSLA’s 9/2/20 video meeting and the 9/3/20 Industry Partner Call. As always, local governments may have more stringent requirements.

Implementation

Q: What is the expectation of the date communities need to implement?
A: Originally, DEM EO 20-006 suspended statutes regarding a community’s obligation to support visitation. The new Emergency Order (DEM 20-009, effective as of 9/1/20) partially lifts those suspensions. AHCA’s expectation requires communities to have policies and procedures in place, since communities should have known this day was coming. AHCA’s request is that implementation is done safely and thoughtfully, but with a sense of urgency. Family members are ready to begin visiting, and AHCA wants to make sure communities can meet the demands and expectations as quickly as possible.

Q: Can the general visitor policy acknowledgment be signed once for each registered visitor, and kept on file, or does this need to be done each time they visit?
A: The acknowledgement is sufficient if signed once. Communities may want verbally reinforce expectations of signed acknowledgement during screening.

Q: Does the Emergency Order allow or prohibit visitors from touching/helping residents?
A: General visitors must follow social distancing and may not touch. Essential and compassionate caregivers may touch as allowed under their respective criteria.

Essential Caregivers / Compassionate Caregivers

Q: Is allowing essential/compassionate caregivers a requirement or at the facility’s discretion?
A: The Emergency Order requires communities, in part, to “establish policies and procedures for designation and utilizations of essential caregivers and compassionate care visitors” and to “develop an agreeable schedule in concert with the resident and visitor.”

Q: Are service plans only required if a resident receives essential caregiving services?
A: The Emergency Order states that “care or services provided by essential caregivers must be identified in the plan of care or service plan and may include, bathing, dressing, eating, and/or emotional support."

Q: Where should we document the ADL performed by the essential caregivers?
A: The Emergency Order states that care services provided by Essential Caregivers must be identified in the plan of care or service plan, and may include bathing, dressing, eating, and/or emotional support."

Q: Can you provide clarification re “emotional support.”
A: As with any service in a service plan, there needs to be a formal conversation that is recognized in the service plan that includes a discussion with family member, any other clinician to support the decision.

General Visitation

Q: Can general visitors be within six feet of the resident they are visiting?
A: No.

Q: For indoor visitation is any barrier required such as plexiglass, etc.?
A: No.

Q: Can two designated visitors assist with moving in or out a resident's belongings?
A: AHCA should be able to look into this.

Q: If a new resident is isolated upon move-in and tests positive prior to release, would that be considered a "new facility onset resident case"?
A: This question has been forwarded to AHCA for response.

Q: What are the considerations for communities that have different types of licensed facilities under one roof in terms of new COVID cases shutting down visitation? Do they have to be in separate buildings? No staff crossover? Are they looked at as one facility for visitation or can the COVID-free entity allow visitation? Does this change at all for independent living?
A: AHCA will take these questions into further consideration.

Q: Are quarantine requirements still in effect for people who are traveling to Florida to visit their loved ones?
A: The CDC has revised their guidance around travel and are no longer requiring a 14-day quarantine for travel. AHCA encourages all communities to review CDC travel guidance, as there are exceptions based on which states/countries people have traveled to.

Q: When does the 14-day timeline start for new COVID cases?
A: For symptomatic cases, the 14 days starts as soon as symptoms are identified. For asymptomatic cases, the 14 days starts as soon as they are tested.

Q: With cold and flu season coming upon us, if anyone shows symptoms of cold and flu that are similar to COVID, does visitation have to cease immediately while we identify if they are COVID positive?
A: AHCA is evaluating how this will be considered/differentiated.

Q: General visitation guidelines require adequate staff. If our facility does not have enough staff, how do we get around that?
A: This question has been forwarded to AHCA for response.

Testing

Q: Are testing protocols continuing for staff and vendors (e.g., Curative testing)?
A: The Emergency Order has no implication on the statewide biweekly staff testing requirements. There a lot of conversations about the Curative contract and mandatory testing rule while, at the same time, trying to balance with the nursing home testing requirements that came out of CMS. There will be more to come from AHCA in the next week or two.

PPE

Q: Is a surgical mask a requirement for facility staff or can staff wear their own mask?
A: AHCA’s expectation is that staff are wearing PPE that serves the purpose consistent with CDC requirements.

Q: If an essential caregiver comes to our facility and no other community, do they need to wear a PPE while providing services?
A: Yes.

Q: What are the specific PPE requirements for visitors?
A: For essential caregivers and compassionate care visits, it is dictated by the interaction. For essential and compassionate caregivers, PPE must be consistent with the care being provided and for the resident in terms of risk. This would likely be a surgical mask and gloves, with gowns and/or eye protection if needed. General visitors are required to wear a face mask.

Salons

Q: Salon workers must meet the "same requirements as Essential Caregivers." Does this mean they must wear the same PPE as health care workers? Must they complete Infection control and prevention training?
A: The Emergency Order states, in part, that “barbers and salon staff must wear surgical masks, gloves, practice hand hygiene, and follow the same requirements as essential caregivers.”

Q: The Order states that salon services cannot be provided to residents who test positive? What if the resident has recovered and is no longer subject to CDC quarantine?
A: This question has been forwarded to AHCA for response.

Q: Do the beauty salons have to close if a positive resident or associate occurs following the reopening?
A: The Emergency Order states that barbers and beauty salon services are permissible only if: the facility has had no new facility onset of resident COVID-19 cases in the previous 14 days; and 14 days have passed with no new staff COVID-19 cases where a positive staff was in the facility in the 10 days prior to the positive test.

Q: Do allowable Salon services include nail services and waxing?
A: This question has been forwarded to AHCA for response.

Tours

Q: Are we allowed to have prospects tour/visit inside our communities?
A: AHCA is working on this and will provide further information.

Residents Leaving the Facility

Q: Are residents allowed to leave communities for reasons other than essential medical visits, ie: entertainment, dinner with family members, off-site visits?
A: The Executive Order states in part that residents leaving the community temporarily for medical appointments or other activities must wear a face mask if tolerated by the resident’s condition. All residents must be screened upon return to the community.

Q: Do we still need to quarantine residents who leave the facility and then return, or is encouraging them to wear masks, screening them upon return, monitoring for symptoms, etc. sufficient?
A: This question has been forwarded to AHCA for response.

Miscellaneous

Q: How do we know if a community’s referral hospital has adequate capacity?
A: This question has been forwarded to AHCA for response.

Q: Are we allowed to have outside entertainment?
A: This question has been forwarded to AHCA for response.

Q: Where can I find the new screening question criteria?
A: DEM Emergency Order 20-009, section 2.

Feds to Ship Fast COVID-19 Tests to Assisted Living Sites

WASHINGTON (AP)  A federal official said Tuesday the government plans to ship rapid coronavirus tests to assisted living facilities, moving to fill a testing gap for older adults who don't need the constant attention of a nursing home.
Health and Human Services Assistant Secretary for Health Adm. Brett Giroir said assisted living facilities will be followed by senior day care centers and home health agencies in getting the tests.

The tests will come from a supply of 150 million ordered from test maker Abbott Laboratories. Abbott's rapid test, the size of a credit card, is the first that doesn't require specialty computer equipment to process. It delivers results in about 15 minutes and is priced at $5, significantly lower than similar older tests. Read more.
Florida Medicaid Health Care Alert
 
September 3, 2020
 
Provider Type(s): 14
 
IMPORTANT FUNDING ANNOUNCEMENT
 
ASSISTED LIVING FACILITIES NOW ELIGIBLE *** 10 DAYS LEFT TO APPLY

NEW!: The U.S. Department of Health and Human Services (HHS) has announced that assisted living facilities (ALFs) that may have been previously ineligible may now apply for funding under the Provider Relief Fund Phase 2 General Distribution allocation. Like other providers applying for Phase 2 funding, eligible ALFs will receive 2 percent of their annual revenue from patient care. ALFs, like all providers applying for the current Phase 2 General Distribution funding, will have until September 13, 2020 to begin their application.

DEADLINE EXTENDED TO SEPT. 13: The federal government has extended the deadline to apply for Medicaid/CHIP Provider Enhanced Provider Relief Fund Payments until September 13, 2020.

REMINDER!: Second Chance for Certain Medicare Providers: Starting the week of August 10, HHS began allowing Medicare providers who missed the opportunity to apply for additional funding from the $20 billion portion of the $50 billion Phase 1 Medicare General Distribution. Providers will have until September 13, 2020, to complete an application to be considered for the balance of their additional funding up to 2 percent of their annual patient revenues.

REMINDER!: Payments for Providers Who Had a Change in Ownership: Starting the week of August 10, HHS began allowing providers who experienced a change in ownership in 2019 or 2020 under Medicare Part A who did not have Medicare Fee-For-Service revenue in 2019 to submit their revenue information, along with documentation proving a change in ownership, by August 28 for consideration for a Provider Relief Fund payment.
Step by Step Provider Guide: The federal Health Resources & Service Administration has created a step by step provider guide to help providers learn more about the provider relief fund and how to apply. The Agency has posted this guide on our COVID-19 website, but it can also be accessed here http://ahca.myflorida.com/docs/PRF_Step-by-Step_Provider_Guide_8-11-2020.pdf

Relief Fund Payments for New Providers: HHS is currently working to address relief payments to new providers in 2020 along with those that have yet to receive any funding for a variety of reasons, including the fact that they may only bill commercially, or do not directly bill for the services they provide under the Medicare and Medicaid programs and thus have not receive any funding yet. HHS has advised that future announcements will be provided as additional information becomes available.

License Number Issue is Fixed: The requirement to input a license number during the application process has been resolved. Medicaid providers that are not licensed can put NA in the license field.
Previously Recorded Webinars: HHS has posted a recording of past webinars for providers who were unable to attend. These recordings can be accessed here: https://webex.webcasts.com/starthere.jsp?ei=1334682&tp_key=9dd6d30493

Updated FAQs: HHS has posted updated FAQs to address questions submitted during the previous webinars. The updated FAQs can be found here: FAQs

Funding Overview: HHS launched an enhanced Provider Relief Fund Payment Portal that allows eligible Medicaid and CHIP providers to report their annual patient revenue, which will be used as a factor in determining their Provider Relief Fund payment. The payment to each provider will be at least 2 percent of reported gross revenue from patient care; the final amount each provider receives will be determined after the data is submitted, including information about the number of Medicaid patients providers serve.

For more information, please visit www.HHS.gov/providerrelief
Agency COVID-19 Website: As a reminder, the Agency’s COVID-19 alert website ensures providers have all Agency guidance in one centralized location. The website can be accessed through the following link: http://ahca.myflorida.com/covid-19_alerts.shtml 
 
COMPLAINTS OR ISSUES? ON LINE http://ahca.myflorida.com/Medicaid/complaints/| CALL 1-877-254-1055