South Florida elder-care facilities say new COVID testing rules are 'impossible'

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Health care workers collect samples at a testing site at the Miami-Dade County Auditorium in Miami, Florida on July 23, 2020. - Mike Stocker/Sun Sentinel/TNS

FORT LAUDERDALE, Fla. — COVID testing requirements for nursing home staff put into effect this week are “impossible” to meet, operators of South Florida facilities say.

The federal rules require routine staff testing twice a week in communities with high infection rates — such as Miami-Dade and Broward counties — and once a week in Palm Beach County. The nursing homes must meet the testing requirement for participation in Medicare and Medicaid or incur fines as high as $8,000 per instance when they don’t comply.

But nursing home operators say they don’t have the supplies to conduct the tests.

Employees are thought to have played a major role in inadvertently introducing the virus to nursing homes and spreading it among residents, both nationally and in Florida. The new federal requirement is an effort to curb the virus, which has proved deadly among the elderly. In Florida, at least 4,811 deaths have occurred among residents and staff of nursing homes and assisted-living centers.

In recent weeks, the federal government has delivered antigen testing machines to nursing homes nationwide. The new antigen tests are somewhat less sensitive than lab tests, but have a 15-minute turnaround time and can process 10 to 20 tests per hour.

Some Florida nursing home operators who received the machines report they are still waiting for instructions and test kits to make them usable.

The frequency of the required staff testing follows a formula. By federal calculations, Miami-Dade and Broward counties have infection rates greater than 10%, the Centers for Medicare & Medicaid Services requirement for twice-a-week testing. Palm Beach County has an infection rate greater than 5%, the requirement for once-a-week testing. Counties with rates below 5% can test staff only once a month.

Renee Garvin, executive director of the Vi At Aventura, said her facility will have to conduct 200 staff tests two times a week. While she has the antigen testing machine, she lacks enough test kits.

“We called vendors and no one has them. The soonest we could get them is end of September or early October,” she said. “These new orders have come out from CMS but the system isn’t ready to meet the demands.”

Elaine Bloom, CEO of Plaza Health Network in Miami, which operates five long-term care facilities, said the new rules would require her to test 933 employees twice a week, amounting to nearly 2,000 test kits. The machine arrived with 300 swabs, not even enough to do one round of testing.

“We haven’t been able to lock down more supplies,” she said.

Kristen Knapp, a spokesperson for the Florida Health Care Association, an advocacy group for nursing homes, said, “We have heard from members saying they are trying to get more supplies and can’t get them. This is a nationwide testing requirement, not just Florida, and there are 15,000 nursing homes, so that is a challenge everyone is experiencing.”

Knapp said 70 nursing homes in Florida still have not received their antigen test machines from the federal government.

“There may be some more information coming,” Knapp said.

The new CMS rule also requires that nursing homes offer tests to residents when there is an outbreak or a resident shows symptoms, although residents are not required to take a rapid test. In a written statement, the federal agency said, “These efforts are aimed at preventing the virus from entering nursing homes, improving a facility’s ability to detect cases quickly, and stopping transmission.”

CMS did not respond to request for comment about the lack of supplies.

Florida also has required nursing homes to test staff every two weeks for COVID-19, providing the materials for diagnostic testing which averages a two-day turnaround.

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©2020 Sun Sentinel (Fort Lauderdale, Fla.)