Mandatory Testing for Assisted Living Facility Staff  

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    AGENCY FOR HEALTH CARE ADMINISTRATION

    Health Facility and Agency Licensing

    RULE NO.: RULE TITLE:

    59AER20-4: Mandatory Testing for Assisted Living Facility Staff

    SPECIFIC REASONS FOR FINDING AN IMMEDIATE DANGER TO THE PUBLIC HEALTH, SAFETY OR WELFARE: The Novel Coronavirus Disease 2019 (COVID-19) is a severe respiratory illness that can spread among humans through respiratory transmission. According to the Centers for Disease Control and Prevention (CDC), people at risk for serious illness from COVID-19 include older adults and people with serious chronic medical conditions. In late 2019, a new and significant outbreak of COVID-19 emerged in China and the World Health Organization declared COVID-19 a Public Health Emergency of International Concern. The CDC also confirmed community spread of COVID-19 in the United States and has issued extensive written guidance to help control the spread of COVID-19. According to the CDC, at the time of this filing, the United States has over 1,900,000 total cases and over 110,000 total deaths. Older adults are at a higher risk of developing serious complications from COVID-19. According to the United States Census Bureau, Florida has the largest percentage of residents age 65 and older in the nation.

    On March 1, 2020, Governor Ron DeSantis declared a Public Health Emergency exists in the State of Florida as a result of COVID-19 pursuant to Executive Order number 20-51. On March 7, 2020, the State Surgeon General and State Health Officer declared a Public Health Emergency in the State of Florida as a result of COVID-19. On March 9, 2020, Florida Governor Ron DeSantis declared a state of emergency in Florida. As of the date of this filing, all counties in Florida have positive cases for COVID-19. There have been over 75,000 confirmed cases in Florida as a result of COVID-19 and over 2,900 deaths.

    In guidance issued by the CDC titled Key Strategies to Prepare for COVID-19 in Long-term Care Facilities (LTCFs), the CDC directed that “[g]iven the high risk of spread once COVID-19 enters a LTCF, facilities must act immediately to protect residents, families, and staff from serious illness, complications, and death.” In order to carry out this guidance, the CDC further instructs facilities to, among other things, 1.) Keep COVID-19 from entering the facility and 2.) Identify the infection early.

    Medical research shows the highly contagious COVID-19 virus can manifest as asymptomatic in positive individuals and the live, contagious coronavirus can shed at high concentrations before symptomatic development resulting in spread of the infection. Due to the congregate nature of long-term care facilities, the increased risk of transmission of COVID-19 is high. The highly transmissible nature of COVID-19 combined with the congregate nature of the long-term care facility settings and the close and personal contact that many long-term care facility staff have with the patients puts both residents and staff at a high risk of infection. Combining the high risk of long-term care facility settings with the risk posed by positive, asymptomatic staff creates a potential for sudden outbreaks in long-term care facilities.

    The Department of Health and its agents, including the Agency for Health Care Administration, are working daily to respond to positive cases to avoid outbreaks at long-term care facilities. These agencies have been systematically conducting infection control investigations and testing staff and residents at nursing homes and assisted living facilities across the state to quickly identify positive cases in order to avoid viral spread and outbreaks. A single positive staff member in a facility can cause an outbreak resulting in the hospitalization and death of many vulnerable residents. If the staff member works at multiple facilities, this can result in facility-to-facility spread. Early identification of positive cases in long-term care facilities allows the state to implement immediate action to control outbreaks and avoid the loss of life.

    Therefore, this emergency rule establishes a requirement that assisted living facilities must not admit any staff who have not been tested for COVID-19 beginning on July 7, 2020. Thereafter, assisted living facilities must also require all facility staff be tested for COVID-19 every two (2) weeks with testing resources provided by the state. Prompt implementation of this rule is necessary to ensure the health, safety and welfare of residents and staff in Florida’s assisted living facilities.

    REASON FOR CONCLUDING THAT THE PROCEDURE IS FAIR UNDER THE CIRCUMSTANCES: The procedure used to adopt this emergency rule is fair as the State of Florida is under a declaration of emergency due to the outbreak of COVID-19. This emergency rule is necessary and fair to ensure the health, safety, and welfare of the facility residents, and provides at least the procedural protection given by other statutes, the State Constitution, or the United States Constitution; and takes only that action necessary to protect the public interest under the emergency procedure.

    SUMMARY: This Emergency Rule establishes a requirement that assisted living facilities must not admit any staff who have not been tested for COVID-19, must require all facility staff be tested for COVID-19 every two (2) weeks, and requires staff to report the results of those tests to the facility.

    THE PERSON TO BE CONTACTED REGARDING THE EMERGENCY RULE IS: Kimberly Stewart, Agency for Health Care Administration, Division of Health Quality Assurance, Bureau of Health Facility Regulation, 2727 Mahan Drive, MS# 28A, Tallahassee, FL 32308; Phone: 850-412-3492; Email: Kimberly.Stewart@ahca.myflorida.com.

    THE FULL TEXT OF THE EMERGENCY RULE IS:

    59AER20-4 Mandatory Testing for Assisted Living Facility Staff.

    (1) APPLICABILITY.  The requirements of this emergency rule apply to all assisted living facilities licensed under Chapter 429, F.S.

    (2) DEFINITIONS.

    “Staff” means all paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials, including body substances (e.g., blood, tissue, and specific body fluids); contaminated medical supplies, devices, and equipment; contaminated environmental surfaces; or contaminated air. Staff may include, but are not limited to, nurses, nursing assistants, physicians, technicians, therapists, phlebotomists, pharmacists, students and trainees, contractual staff not employed by the health care facility, and persons (e.g., clerical, dietary, environmental services, laundry, security, maintenance, engineering and facilities management, administrative, billing, and volunteer personnel) not directly involved in patient care but potentially exposed to infectious agents that can be transmitted among from staff and patients. This definition is consistent with the Centers for Disease Control and Prevention definition of Healthcare personnel as defined in Appendix 2. Terminology.

    (3) MANDATORY STAFF TESTING FOR COVID-19.

    (a) Beginning July 7, 2020, assisted living facilities shall not admit into the facility any staff who has not been tested for COVID-19.

    (b) Assisted living facilities shall require all staff be tested every two (2) weeks thereafter with testing resources provided by the state.

    (4) EXEMPTION FROM TESTING.

    Staff who have already been infected and recovered from COVID-19 do not need to be tested if they can provide medical documentation to the assisted living facility.

    (5) DOCUMENTATION.

    (a) If testing is conducted off-site, then staff must provide proof of testing to the assisted living facility. 

    (b) Assisted living facilities shall document all staff testing, including the name of the individual, time, and date of the test.

    (c) Assisted living facilities shall require all tested staff to notify the facility of the test results the same day the results are received. Written documentation of test results must be provided to the facility upon receipt by the staff.

    (d) Assisted living facilities shall keep copies of all staff testing documentation on site.

    (6) REVOCATION OF LICENSE, FINES OR SANCTIONS. For a violation of any part of this rule, the Agency may seek any remedy authorized by Chapter 429, Part I, or Chapter 408, Part II, F.S., including but not limited to, license revocation, license suspension, and the imposition of administrative fines.

    Rulemaking Authority, 429.41, 408.821(4) FS, Law Implemented 429.19, 429.28, 429.41 FS.

     

    THIS RULE TAKES EFFECT UPON BEING FILED WITH THE DEPARTMENT OF STATE UNLESS A LATER TIME AND DATE IS SPECIFIED IN THE RULE.

    EFFECTIVE DATE: June 15, 2020

     

Document Information

Effective Date:
6/15/2020
Subject:
The procedure used to adopt this emergency rule is fair as the State of Florida is under a declaration of emergency due to the outbreak of COVID-19. This emergency rule is necessary and fair to ensure the health, safety, and welfare of the facility residents, and provides at least the procedural protection given by other statutes, the State Constitution, or the United States Constitution; and takes only that action necessary to protect the public interest under the emergency procedure.
Summary:
This Emergency Rule establishes a requirement that assisted living facilities must not admit any staff who have not been tested for COVID-19, must require all facility staff be tested for COVID-19 every two (2) weeks, and requires staff to report the results of those tests to the facility.
Purpose:
The Novel Coronavirus Disease 2019 (COVID-19) is a severe respiratory illness that can spread among humans through respiratory transmission. According to the Centers for Disease Control and Prevention (CDC), people at risk for serious illness from COVID-19 include older adults and people with serious chronic medical conditions. In late 2019, a new and significant outbreak of COVID-19 emerged in China and the World Health Organization declared COVID-19 a Public Health Emergency of International ...
Contact:
Kimberly Stewart, Agency for Health Care Administration, Division of Health Quality Assurance, Bureau of Health Facility Regulation, 2727 Mahan Drive, MS# 28A, Tallahassee, FL 32308; Phone: 850-412-3492; Email: Kimberly.Stewart@ahca.myflorida.com.