Earlier this month, Florida Gov. Ron DeSantis announced that nursing homes and assisted living facilities will allow visitors again after a six-month visitation ban due to the coronavirus pandemic. The governor signed an executive order on Sept. 1, lifting the ban immediately after receiving a report with recommendations from his Task Force on the Safe and Limited Re-Opening of Long-Term Care Facilities.
Emergency Order 20-009 reversed the ban on visitations, allowing long-term care facilities (LTCs) to open for general visitation if they have not had any new cases of COVID-19 among residents or staff members for 14 consecutive days. Gov. DeSantis did not mandate the testing of visitors upon entering long-term care facilities (LTCs), however many facilities already have testing in place for staff or plan to implement testing for visitors.
Not So Fast…
Despite being officially open to visitors, not all Florida LTCs have opened their doors to visitors as of the writing of this article. According to the executive order, LTCs will need to have a written plan in place before allowing visitation, and then the visits will be allowed only by trained essential caregivers, by loved ones for compassionate visits (if a resident is near death) and for general visitation by family and friends. Each resident will be allowed to designate up to two essential caregivers and two compassionate visitors, and up to five general visitors, but only two can visit at a time. The visitors must be over age 18. There are many other limits and qualifications as well.
It could be several weeks or longer for some facilities to develop and put their policies and processes in place, develop training for essential caregivers, and to set up designated visitation areas and disinfection procedures. Once everything is up and running, there is no doubt that families will be happy to visit their loved ones again.
Is the Timing Right?
However, not everyone is pushing for reopening. Some elder care advocacy groups are questioning why the ban is being lifted now and why testing is not required when the virus is still prevalent and circulating in these facilities and in communities across the state. Currently, the case count is down from its high point in late June and July, but it’s still higher than it was in March through May. As of Sept. 10, there have been 654,731 positive cases with 12,326 deaths in the state. Approximately 2% of LTC residents and 2% of LTC staff in Florida have tested positive for COVID-19.
At a recent press conference, the governor acknowledged that allowing visitation will increase the number of COVID-19 cases in LTCs, but indicated the need for visitation couldn’t be ignored any longer. Some members of the task force argued that the visitation ban was even more harmful than the virus, because some LTC residents were suffering from depression or even death due to the isolation.
New Guidelines for Essential Caregivers
In addition to reversing the ban, the executive order expands the type of services that essential caregivers can provide to include emotional support. Essential caregivers typically help facility residents with activities of daily living such as eating, bathing and dressing. With the new executive order, essential caregivers will be allowed into residents’ rooms and will not have to adhere to social distancing requirements (i.e., they will be allowed to touch and hug residents). While the new guidelines will allow each resident to have two designated essential caregivers, only one at a time will be allowed to visit.
The governor’s executive order also applies to intermediate care facilities and group homes for people with special needs. People with developmental and intellectual disabilities will be allowed to have visits from two essential caregivers at a time.
While essential caregivers will be allowed to have direct contact with residents, general visitors will be required to adhere to social distancing policies at the facilities, including wearing masks and personal protective equipment (PPE). LTC facilities will be able to ask visitors to take COVID-19 tests before entering if they comply with the federal Centers for Disease Control and Prevention and the Food and Drug Administration guidelines, which currently is only for people showing symptoms of the coronavirus. Some facilities are set up to do rapid testing, while others are not. It depends on the individual provider and facility’s visitation plan.
The executive order includes the following guidelines for general visitation:
- All visitors will need to wear PPE and pass a screening.
- All visitation is by appointment only.
- Designated visiting areas must be cleaned and disinfected between visitors (no visiting in residents’ rooms).
- Nobody under age 18 is allowed to visit.
- Barbers/beauty salons are allowed to resume services.
Facilities can allow visitors only if 14 days have passed without a positive case, other than in a dedicated section of the facility that accepts COVID-19 cases from the community. If a staff member at the facility tests positive for the virus, the facility must stop all visitation. There must be sufficient staff to support the management of visitors and adequate PPE for staff, as well as cleaning and disinfecting supplies and capacity at referral hospitals for the facility.
Facilities must still limit visitation to only family members, friends and individuals visiting residents in end-of-life situations, hospice or palliative care workers for residents in end-of-life situations, health care providers that comply with CDC guidelines, facility staff and residents, residents’ attorneys if computers/phones are not available, public and professional guardians and their staff, essential caregivers and compassionate care visitors, and government/elected officials on government business.
For the latest updates on COVID-19 in Florida, visit the Florida Dept. of Health, or contact the COVID-19 Call Center (available 24 hours a day, seven days a week) at (866) 779-6121, or email COVIDfirstname.lastname@example.org.