State rolls back some long-term care visitation restrictions

Posted at 10:06 PM, Mar 23, 2021
and last updated 2021-03-24 17:25:25-04

TAMPA, Fla. — New direction from the state is lifting limitations on long-term care facility visitations enacted due to COVID-19, with declining COVID-19 cases and more vaccinations.

The Florida Division of Emergency Management quietly published a new emergency order late Monday.

The order rescinds previous executive orders that limited visitations, but notes facilities should maintain visitation and infection control policies in line with state and federal laws, as well as monitor the Centers for Medicare and Medicaid Services and the CDC for guidance.

Earlier this month, CMS released guidance for nursing home visits expanding indoor visits and touching. While similar to the state's order, it differed on things like visitations when there's a COVID-19 case and physical contact.

The CMS guidelines outline:

  • Screening and temperature checks for those entering the facility
  • Face coverings, social distancing, hand hygiene, staff PPE use and cleaning and disinfecting
  • Resident and staff testing
  • Outdoor visitation is preferred, even when the resident and visitor are fully vaccinated, and infection control practices should be followed
  • Facilities should allow indoor visitation, except for a few circumstances due to high risk of COVID-19 transmission. (For example, unvaccinated residents if the county’s positive rate is greater than 10 percent and less than 70 percent of residents at the facility are fully vaccinated).
  • Compassionate care visits should be allowed at all times
  • If necessary facilities should consider scheduling visits for a specified length of time, and limit visitor movement in the facility.
  • If a resident is fully vaccinated, they can choose whether to have close contact with their visitor while wearing a face mask and using hand hygiene.
  • If a new case of COVID-19 is identified, the facility should suspend visitation and conduct testing. If there are no additional cases in other areas, visitation can resume in areas with no case. Visitation should be suspended on the affected unit. Compassionate care visits should be allowed at all times.

Following the state’s latest emergency order, the Agency for Healthcare Administration, a regulatory agency, said nursing homes must follow CMS visitation guidelines. Meanwhile assisted living facilities and other long-term care facilities are to follow state and federal recommendations, as well as “industry best practices for visitation, infection prevention, and the screening and triage of everyone entering a facility for signs and symptoms of COVID-19.”

AHCA noted the toll on the quality of life restrictions have taken, stating long-term care facilities should “…help alleviate the burden caused by the separation of residents from their loved ones.”

“I think it’s good news. I think certainly removing emergency orders is a step in the always a step in the right direction, but because I don’t know what it means specifically, I’m a little leery to get excited or get hopeful,” said Mary Daniel, the founder of Caregivers for Compromise, a group of residents family members that formed during the pandemic.

Daniel said the order, and subsequent clarification still left questions, which she hopes AHCA will provide more clarity on in the future. She said she wishes all the documentation came out together, noting she had already received calls from facilities saying they don’t know what it means.

“I think we as caregivers want to follow the rules, we want to know what those rules are and we want our facilities to follow those rules but when it’s so vague and we don’t have that direct guidance, it just creates chaos,” Daniel said. “Because we don’t know what we’re allowed, they don’t know what we’re allowed and I can promise you generally those two things are going to disagree when there aren’t clear direction to everybody.”

The Florida Senior Living Association said it expects its members will look at CDC and CMS guidance, though for assisted living associations AHCA is the regulatory agency.

“We’re really excited to see this happen where visitation is open again. The residents can feel safer and secure going out of their apartments and visiting with their family members,” said the organization's president and CEO, Gail Matillo.

The organization said while some visitation restrictions may be lifted, there are still guidelines in place like screening, temperature checks and face coverings.

“I think by now they really have a good idea of what it is they’re supposed to be doing. And I know that they definitely do not want to have another outbreak of COVID in their communities,” said Matillo.

The Florida Health Care Association, an advocacy group representing nursing homes across the state, said it is pleased with the extended “ability to make family visits possible.” It released this statement:

“Since the start of the COVID-19 pandemic, Florida's long-term care centers have been looking forward to when we could freely welcome our residents' loved ones back for visits. We have been facilitating safe visitation since September and continue to do so in a way that keeps everyone protected. We are of course pleased that Governor DeSantis has extended our ability to make family visits possible. With nearly 70% of all seniors vaccinated, we know we can more safely welcome visitors while continuing to follow safety precautions. We continue to encourage everyone to be vaccinated as soon as they become eligible because that is another important safety measure to protect our residents and staff.”

While some organizations said they’ve reached out to the state on how the order is to be implemented, Daniel said she expects to see more explanation from AHCA soon.