Nursing Homes
On October 22, 2020 at Governor DeSantis’ direction, Florida Division of Emergency Management Director and State Coordinating Officer Jared Moskowitz issued Emergency Order 20-011 that lifts restrictions for visitation to nursing homes, assisted living facilities (ALFs), adult family-care homes, adult group homes and other long-term care facilities.
Emergency Order 20-011 requires all visitors to wear PPE pursuant to the most recent CDC guidelines, and those not making physical contact still must wear a mask. Per the Emergency Order, to accept general visitors, the facility must meet the following:
- No new facility-onset of resident COVID-19 cases within 14 days other than in a dedicated wing or unit that accepts COVID-19 cases from the community;
- No new facility-onset of staff COVID-19 cases within 14 days in the event that a staff person was in the facility in the 10 days prior to the positive test;
- Sufficient staff to support management of visitors;
- Adequate PPE for facility staff;
- Adequate cleaning and disinfecting supplies; and
- Adequate capacity at referral hospitals for the facility.
Preparedness Checklist for Nursing Homes, Assisted Living Facilities and Long-Term Care Facilities
Nursing homes and other long-term care facilities can take steps to assess and improve their preparedness for responding to coronavirus disease 2019 (COVID-19). This checklist should be used as one tool to develop a comprehensive COVID-19 response plan, including plans for:
- Rapid identification and management of ill residents.
- Considerations for visitors and consultant staff.
- Supplies and resources.
- Sick leave policies and other occupational health considerations.
- Education and training.
- Surge capacity for staffing, equipment and supplies, and postmortem care.
Long-term care facilities can use this tool to self-assess the strengths and weaknesses of current preparedness efforts. This checklist does not describe mandatory requirements or standards; rather, it highlights important areas to review to prepare for the possibility of residents with COVID-19.
Things facilities should do now
Educate Residents, Healthcare Personnel, and Visitors
- Share the latest information about COVID-19.
- Review CDC’s Interim Infection Prevention and Control Recommendations for Patients with Confirmed Coronavirus Disease 2019 (COVID-19) or Persons Under Investigation for COVID-19 in Healthcare Settings.
- Educate and train HCP.
- Reinforce sick leave policies. Remind HCP not to report to work when ill.
- Reinforce adherence to infection prevention and control measures, including hand hygiene and selection and use of personal protective equipment (PPE). Have HCP demonstrate competency with putting on and removing PPE.
- Educate both facility-based and consultant personnel (e.g., wound care, podiatry, barber) and volunteers. Including consultants is important because they often provide care in multiple facilities and can be exposed to or serve as a source of pathogen transmission.
- Educate residents and families including:
- Information about COVID-19 and vaccines.
- Actions the facility is taking to protect them and their loved ones, including visitor restrictions.
- Actions residents and families can take to protect themselves in the facility.
Provide Supplies for Recommended Infection Prevention and Control Practices
We are preparing to distribute safe and effective vaccines to Florida’s most vulnerable populations beginning in late 2020 or early 2021. Currently, the best way to prevent illness is to avoid being exposed to the virus (and avoid exposing other people). Here’s how:
- Hand hygiene supplies:
- Put alcohol-based hand sanitizer with 60–95% alcohol in every resident room (ideally both inside and outside of the room) and other resident care and common areas (e.g., outside dining hall, in therapy gym).
- Make sure that sinks are well-stocked with soap and paper towels for handwashing.
- Respiratory hygiene and cough etiquette:
- Make tissues and facemasks available for coughing people.
- Consider designating staff to steward those supplies and encourage appropriate use by residents, visitors, and staff.
- Make necessary Personal Protective Equipment (PPE) available in areas where resident care is provided. Put a trash can near the exit inside the resident room to make it easy for staff to discard PPE prior to exiting the room, or before providing care for another resident in the same room. Facilities should have supplies of:
- Facemasks.
- Respirators (if available and the facility has a respiratory protection program with trained, medically cleared, and fit-tested HCP).
- Gowns.
- Gloves.
- Eye protection (i.e. face shield or goggles).
- Consider implementing a respiratory protection program that is compliant with the OSHA respiratory protection standard for employees if not already in place. The program should include medical evaluations, training, and fit testing.
- Environmental cleaning and disinfection:
- Make sure that EPA-registered, hospital-grade disinfectants are available to allow for frequent cleaning of high-touch surfaces and shared resident care equipment.
- Refer to List N on the EPA website for EPA-registered disinfectants that have qualified under EPA’s emerging viral pathogens program for use against SARS-CoV-2.
See more information about preparing for COVID-19 at long-term care facilities, assisted living facilities and nursing homes.
Related Outreach Materials
The virus most likely originally emerged from an animal source and now spreads from person-to-person. Like the common cold, it is spread by droplets, often generated when a person sneezes or coughs.
Respiratory swabs (nose and throat) are collected by a health care provider and sent to a private laboratory or one of the state public health laboratories for COVID-19 testing.
To be tested for COVID-19 an order from a healthcare provider may be required. Your healthcare provider can either collect a sample for testing in their office or provide an order to obtain testing at an alternative testing site. Some testing sites require an order from a healthcare provider, and for an appointment to be scheduled in advance, though there are a number of sites that will test regardless of symptoms and without an appointment.
The locations of COVID-19 testing are decided and coordinated by local communities. Learn about state-supported testing sites.
We are preparing to distribute safe and effective vaccines to Florida’s most vulnerable populations beginning in late 2020 or early 2021. After that, vaccines will become available to other Floridians. Review the facts about COVID-19 vaccines.
There is no specific antiviral treatment recommended for COVID-19 infection. People infected with COVID-19 should receive supportive care to help relieve symptoms. Learn about COVID-19 treatment. Review the facts about COVID-19 vaccines.
The U.S. Environmental Protection Agency (EPA) released a list of EPA-registered disinfectant products that have qualified for use against SARS-CoV-2, the novel coronavirus that causes COVID-19. The list of disinfectant products can be found at https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2.
The length of time that the virus survives likely depends on factors. These factors could include the type of material or body fluid containing the virus and various environmental conditions such as temperature or humidity. Researchers at the Centers for Disease Control and Prevention and other institutions are designing standardized experiments to measure how long COVID-19 can survive in situations that simulate natural environmental conditions.
