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Nursing Homes Adjust Testing, Visitation Policies Amid COVID Surge

Federal guidelines issued by the Centers for Medicare and Medicaid Services will expand visitation in Florida, allowing some nursing home residents to hug their loved ones for the first time in months.
Federal guidelines issued by the Centers for Medicare and Medicaid Services will expand visitation in Florida, allowing some nursing home residents to hug their loved ones for the first time in months.

High levels of community spread and low vaccination rates are putting many nursing homes in Florida at risk for COVID-19 outbreaks. Some facilities are taking extra precautions.

Some nursing homes are seeing a rise in coronavirus cases among staff and residents as COVID-19 surges in Florida and vaccination rates lag. This is leading to some changes in operations.

Facilities in counties with high positivity rates are testing staff more frequently, according to Kristen Knapp, communications director for the Florida Health Care Association, which represents more than 80% of the state's nursing homes. In some cases, that means going from testing monthly to testing twice a week, depending on the level of community spread in the surrounding area.

Mask requirements and infection control protocols have remained in place throughout the pandemic and continue to be a priority, Knapp said.

Some facilities are also restricting visitation.

Since the state eliminated its visitation guidance for long-term care facilities in March, most homes have been following federal recommendations.

Those include pausing indoor visits in units where a resident or staff member tests positive, and limiting such visits for unvaccinated residents if they live in facilities with vaccination rates below 70% and are also in a community with high levels of transmission. The only exception is for compassionate care, which involves visiting terminally ill patients.

Knapp said some facilities are making their own decisions to move all visits outdoors or to other designated areas, regardless of vaccination status.

“It's really a facility-by-facility decision to make sure that their visitation policies are focused on resident safety,” she said.

Brian Lee, executive director of the advocacy group Families For Better Care, said he appreciates any effort to protect residents, but acknowledges the piecemeal approach can be frustrating for families.

“When we hear on one block they have restrictions in place and on the other block they don't have restrictions in place, families get confused. That's when angst develops,” he said.

The Florida Health Care Association is advising the facilities it represents to communicate closely with families about any changes in policy to avoid confusion, according to Knapp.

A shared concern among Knapp and Lee: the large numbers of unvaccinated staff and residents in Florida’s nursing homes.

About 30% of residents remain unvaccinated according to the latest federal data, some by choice, but many for medical reasons.

Just 44% of staff have gotten shots, giving Florida the second-lowest vaccination rate for nursing home staff in the country.

“I think there's still an opportunity to incentivize inoculation,” said Lee, suggesting the government use nursing home fines to fund financial bonuses for vaccinated staff.

Some organizations, including the Department of Veterans Affairs, have recently mandated health care employees get COVID-19 vaccines. Knapp said FHCA supports any facilities that choose to do that, but said the organization is focused on educating long-term care staff in the hopes they will voluntarily opt to get shots.

“What we’re doing is to try and provide information so people can make informed decisions about the vaccines, and part of that information is showing them that this is safe and effective and the best way to protect their residents,” she said.

Knapp added it’s also important for family members and other visitors to get vaccinated to prevent outbreaks in nursing homes.

Florida's long-term care facilities were hit hard by the pandemic last year and their residents accounted for a large portion of the state's COVID-19 deaths. Rates of severe illness and death among seniors have reduced significantly thanks to the vaccines, but it's unclear if the highly transmissible delta variant will erode some of that progress.

Copyright 2021 WUSF Public Media - WUSF 89.7

Stephanie Colombini joined WUSF Public Media in December 2016 as Producer of Florida Matters, WUSF’s public affairs show. She’s also a reporter for WUSF’s Health News Florida project.