Gov. DeSantis rejects White House proposal to COVID test all elder-care residents

Two days after the White House coronavirus task force strongly recommended to governors that all residents and staff at long-term care facilities be tested immediately, Gov. Ron DeSantis on Wednesday rejected that suggestion.

Then he opened the door to allowing homes to do it themselves — with state resources.

“We’ve led the way on testing,” DeSantis said at a news conference surrounded by representatives from two of the three long-term care industry trade groups that urged him not to reopen the state without providing additional testing of staff.

Unlike other states, which have mandated diagnostic coronavirus tests of all residents and staff at homes with frail elders because of evidence that staff without symptoms are becoming lethal carriers, DeSantis has relied on a voluntary approach that allows homes to decide if they want their residents and staff tested.

Under the policy, the state waits to send a “strike team” of National Guard medics to conduct testing at homes after they report having staff or residents with symptoms of COVID-19, having been exposed to the virus, or having already tested positive. Until Sunday, the tests were voluntary for staff but state regulators ordered homes with positive cases to require employees to submit to tests — if and when the National Guard arrives.

Despite the governor’s assertion that Florida has been aggressive with testing at long-term care homes, records released this week by the Department of Health to the Miami Herald and several news organizations show that health officials tested only about 6% of the state’s long-term care facilities between April 11 and May 11. As of this Tuesday, the strike teams appear to have tested three of the 10 facilities reporting the most COVID-19 cases.

It’s a piecemeal testing policy that many in the industry, as well as advocates such as AARP, have said is flawed and has potentially contributed to the 776 deaths from COVID-19 at Florida elder-care homes. Residents of nursing homes and ALFs now comprise 42 percent of all deaths in the state, a percentage that has been steadily creeping upward.

With deaths mounting at nursing homes across the country, Dr. Deborah Birx, the coordinator of the White House coronavirus task force, on Monday strongly recommended to governors that all residents and staff at long-term care facilities be tested immediately.

“We really believe that all one million nursing home residents need to be tested within the next two weeks as well as the staff,” Birx said on a video conference call with DeSantis and other governors, according to a recording obtained by the Associated Press.

DeSantis insisted Wednesday the state doesn’t have the resources to conduct the widespread tests that are occurring in at least four other states: Texas, Maryland, West Virginia and New York.

“We want to test as many people as we can,’’ he said.

DeSantis said Wednesday that starting this week he has allowed state officials to distribute tests to homes that want to conduct testing on their own and encouraged other facilities with workers who need to be tested to use the 12 drive-through and 10 walk-up testing sites offered in large metropolitan areas.

Until now, the state has relied on state personnel using state labs to conduct and process tests, a protocol that often delayed getting results to the facilities by more than a week, allowing time for infections to spread.

“I think we can accommodate every worker,’’ DeSantis said Wednesday. “But it’s going to take a nuanced approach to be able to logistically do it, and of course we’ve already tested a lot of folks.”

The records released to the Miami Herald and several news organizations were in response to a lawsuit that demanded the state turn over public records it was collecting about COVID-19 cases, deaths, and testing at elder-care homes that serve the state’s most fragile and vulnerable populations.

The data show that in the month-long period after April 11 — around the time DeSantis announced accelerated testing using National Guard medical teams — about 32,000 residents and staff at 223 long-term care facilities were tested. That’s 6% of the 700 nursing homes and 3,100 assisted living facilities in Florida. The industry says it cares for more than 190,000 residents.

For three days, the Miami Herald has asked the health department for an explanation of whether the data released this week provides a complete picture of Florida’s testing protocols. None has been provided.

On April 13, DeSantis announced at a news conference that “rescue teams” had responded to 93 long-term care facilities with COVID-19 residents. The “state had successfully trained 30 paramedics to perform specimen collection and use 12 advanced life support ambulances to randomly collect samples from long-term care facilities throughout the state,’’ he said.

But the data show they weren’t testing comprehensively. By that point, however, the records show only eight nursing homes and assisted living facilities had been tested by the state.

A week later on April 20, when the state first released a list of 307 long-term care facilities with COVID-19 cases — a release that resulted from the public records lawsuit — “strike teams” had by then tested at fewer than 20 homes, records show. The results for two additional facilities were rejected by the state lab.

For the next 10 days after DeSantis’ initial announcement, testing would remain steady but far from comprehensive, the records from the state indicate.

By April 27, when the state released its first list breaking down COVID-19 deaths by facility, strike forces had tested fewer than one-third of the 100 facilities with the most reported cases, the state data shows.

The Fair Havens Center in Miami Springs, which had reported 143 total cases as of Tuesday, and the Claridge House Nursing and Rehabilitation Center in North Miami, which has reported 79 cases, both were listed in the state database as “Tasked,” while testing at NSPIRE Healthcare in Lauderhill (86 cases reported) was listed as “Pending.”

The state has refused to explain what those terms mean.

Because the testing had been voluntary, some administrators have turned away the National Guard teams.

Last week, after repeated pleas from the industry, the state launched a mobile testing lab equipped with a rapid diagnostic testing machine that is traveling to long-term care facilities, testing residents and staff, and producing test results in 45 minutes.

Meanwhile, positive tests have continued to climb.

The governor has boasted about his response, saying that the White House and other states have adopted his approach. His team has declared victory.

“FACT: @GovRonDeSantis saved our elderly population; increased testing; empowered local leadership; partnered with the medical community & prevented travelers from spreading the virus,’’ tweeted DeSantis spokesperson Helen Aguirre Ferré on Tuesday and again on Wednesday morning.

For many administrators at homes that have been working hard to keep the deadly virus at bay, the gradual move toward expanded testing has been welcome news, although some suggest it has happened later than it should have.

“The expansion of testing has been terrific,’’ said Steve Bahmer, president of LeadingAge, which represents homes throughout the state. He emphasized, however, that he hopes the state moves toward restoring visitation rights at nursing homes. Visitation was halted at the start of the pandemic.

“I want to get to yes on that,’’ DeSantis said. “I just want to be able to know that we have procedures in place that if someone goes to visit their mother that two weeks later we’re not going to have 50 infections.”

Doug Adkins, chief executive officer at Dayspring Village, an assisted living facility north of Jacksonville, has called the state’s testing policy an “unmitigated disaster” but said he was encouraged by the move to expand testing and require all homes with positive cases to have staff tested when state-issued teams show up.

“This is positive, but we need regular surveillance testing, not one-time hits,’’ he said. “Seniors are such a critical part of Florida’s economy, and if Florida is going to make a strong comeback we need to restore public confidence in ensuring that seniors are safe.”

AARP has been working aggressively to lobby the state for regular, comprehensive testing.

“To ensure that Florida communities continue to avoid the surge in hospitalizations that has crippled other parts of the world, AARP Florida strongly recommends that state leaders mandate a regimen at long-term care facilities that tests workers regularly for the virus before they enter a facility,’’ the organization that represents seniors said in a statement early in the pandemic. “On-site, quick-turn testing can best prevent the coronavirus from being introduced to fragile long-term care residents.”

“All of this is great, but way too late,” said Doug Fresh, CEO of the senior care community St. Mark Village in Palm Harbor, in an interview with the Herald/Times. Nine of his residents have died of COVID-19. “If the testing is as available as they say, where is it? I have tried everywhere.”

This story was originally published May 13, 2020 at 11:52 AM.