New Rule Requires or COVID-19 Testing at Skilled Nursing Facilities

Florida state officials announced on June 15, 2020 that skilled nursing facility staff, including physicians, will be required to take a COVID-19 test every two weeks starting July 7. Testing protocols and proper documentation must be in place regardless of whether the staff feels sick or has symptoms.  


Florida is a Coronavirus hotspot, with over 4,000 deaths from COVID-19 as of July 2020. To date, Florida’s nursing home facility staff and residents account for more than half of all COVID-19 deaths in the state.  


Serving nearly 3,000 skilled nursing facilities (SNFs) across the country and over 300 SNFs in Florida, Vohra Wound Physicians urges its physicians, and all healthcare workers, to keep current with the regulations set forth by the Agency for Healthcare Administration (AHCA), and to comply with testing protocols set forth in their states. 

Editor’s Note: Vohra Wound Physicians would like to offer your facility a complimentary 15-minute wound care consultation to discuss how we can help reduce operating costs, prevent hospitalizations, and reduce the risk of COVID-19 exposure by managing patients in-house – all at no cost to you. Schedule a Free Wound Care Consultation for your SNF Now.

Florida’s Spike in COVID Cases

Florida set a record with 11,458 new cases reported on July 4thpushing the state’s case total over 200,000 cases since the start of the pandemic. With so many new cases, Florida has taken action to ensure that the spread does not continue unchecked in SNFs by mandating regular testing for staff. At the moment, there is no requirement for residents to be tested, although many SNFs are testing residents independently. Despite the lack of a formal regulation, the Agency for Healthcare Administration (AHCA) expects Florida nursing homes to test residents with COVID-19 signs or symptoms. This is in keeping with national CDC recommendations for nursing home COVID-19 response. 


Health officials cannot definitively determine why Florida has seen such a dramatic increase, but they can hypothesize. As the weather has warmed up, the beaches have seen an influx of crowds. The end of the school year also means that more young people are out and about, often congregating in large groups. In response, the state has announced a return to stricter lockdown measures, with Miami-Dade County shutting down indoor dining and gyms starting on Wednesday July 8th and implementing a countywide curfew. Broward County officials suggest they may soon implement similar measures. 

How Will This Impact Doctors in Florida’s Skilled Nursing Facilities?

Starting July 7, nursing home staff who have not been tested for COVID-19 are not permitted entry into the facility. Physicians and staff who do not comply with the new rules are not allowed into work. In addition to implementing regular staff testing, SNFs must update AHCA’s Emergency Status System (ESS) with staff test results daily by 10AM EST. SNFs will be required to maintain on-site documentation on the testing status of their staff members.  


To begin the new testing protocol, each SNF needs to submit information about its staffing level to the ESS. Once the Department of Health reviews the information, they will determine the health provider’s testing needs and send the appropriate number of testing kits.  


The testing materials will be provided and paid for by the state. Jason Mahon, a spokesperson for the Division of Emergency Management told the Miami Herald on June 18“All costs associated with state-conducted testing at long-term care facilities will be submitted to FEMA for reimbursement.”  


According to the Mandatory Testing mandate, staff who have had and recovered from COVID-19 are exempt from testing if they share documentation of their illness with their employer.  


SNFs that do not follow the new rules could be fined or have their license revoked, and AHCA has already started cracking down. In fact, a Miami nursing home was already shut down in May after staff failed to follow protocol designed to limit the spread of coronavirus.  

Where Can Physicians and Staff at Skilled Nursing Facilities Get Tested?

Testing kits will be mailed to nursing facilities for self-administered testing. Tests may not be taken home by staff. Tests will be sent to the facility by Curative Labs, Inc., a testing center that has contracted with the Division of Emergency Management. The number of tests sent is based on the information submitted into ESS by the facility. Once testing is complete, the facility will send completed tests back to Curative using a pre-addressed return shipping label for laboratory testing. Initial test shipments will contain two sets of tests, or a one month’s supply.  


Staff can also get tested off-site, but they will need to supply their workplace with documented proof. 


Locate State Supported Testing Sites in your area now.  

What if Staff Tests Positive?

In the event of a positive result, the infected staff member must immediately leave the site and practice self-isolation. Staff cannot return to work until they have two negative tests separated by 24 hours. 


It is important to note that positive tests can occur among patients who no longer have an infectious virus in their system. COVID-19 viral tests detect RNA from the SARS-CoV-2 virus, and that RNA can linger after the patient has recovered. Some people may also be infected but asymptomatic, so comprehensive testing is critical to stop the virus from spreading. 


In case a significant number of their physicians and other staff members test positive, SNFs should plan for staffing shortages as part of their Comprehensive Emergency Management Plan 


At a time when SNFs are more likely to face staff shortages, Vohra Wound Physicians ensures continuity of care for SNF residents with wound care via telemedicine using the Vohra@Home platform. Vohra’s telemedicine platform ensures Vohra Physicians are able to deliver quality care to patients safely and effectively, even during COVID-19. Physicians are invited to learn more about careers with Vohra Wound Physicians today.  


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Author: Dr. Janet Mackenzie, CMO

Janet S Mackenzie MD is the Chief Medical Officer at Vohra Wound Physicians. She has been with the company since 2013 and has almost 30 years of wound care experience as both a plastic surgeon and a wound care specialist. After obtaining a Master’s degree in Education, she obtained her Medical Degree from the University of Pennsylvania Perelman School of Medicine. She trained in general surgery at Dartmouth Hitchcock Medical Center and plastic surgery at McGill University. She is board certified by the American Board of Plastic Surgery, the American Board of Wound Management, and the American Board of General Medicine, and is a Certified Wound Specialist Physician (CWSP).