Rollout marred by ‘mediocre’ response
Lack of information has tainted process at long-term care facilities
Florida’s COVID-19 vaccination program was supposed to give top priority to residents in long-term care facilities, but critics say the process has been marred by confusion, delays and a lack of information — even as healthy 65-year-olds are able to get vaccines through county health departments.
“This is an unacceptable situation to all of us,” Steve Kramer, president and CEO of The Mayflower at Winter Park, wrote in a Dec. 29 letter to residents. “We have independent-living residents, some in compromised health, that have no idea when, or if, they will be getting vaccinated. And our skilled nursing and assisted living residents will not receive the vaccine for at least another week and a half.”
While the Florida Department of Health has taken charge of vaccination clinics operated in the counties — an option open to anyone 65 and older — the job of administering the vaccine program at more than 3,000 Florida nursing homes and assisted living facilities has been contracted to Walgreen’s and CVS Health with questionable results.
“So far, to be quite honest, I think the federal contract on the long-term-care facilities has been a mediocre experience,” said Jared Moskowitz, director of Florida’s Division of Emergency Management, the state’s top official overseeing the vaccine distribution.
“If the federal contract is not getting the job done, the state will step in and finish skilled-nursing and long-term care facilities,” he added.
On Dec. 16, the state launched a pilot vaccination program at nursing homes in Broward and Pinellas counties, inoculating staff and residents at 112 facilities in just five days, Moskowitz noted. After that, the private companies took charge.
As of Wednesday, according to self reports from the state’s facilities, residents and staff at 287 of the state’s 700 nursing homes and only 34 of 2,400 assisted living facilities have received vaccines.
Across the state, more than 8,100 long-term care residents and staff have died of the coronavirus, some 38 percent of the state’s total deaths.
While those in nursing homes are the most vulnerable because of other health challenges, infection outbreaks have also hit assisted living facilities, including several in Central Florida.
On Dec. 20, a federal Centers for Disease Control and Prevention advisory committee on immunization practices recommended that long-term care residents be the first to receive the vaccine, alongside health-care workers. Florida Gov. Ron DeSantis also vowed to make longterm care residents a top priority, holding a news conference in mid-December at a long-term care center outside Fort Lauderdale where 90 nursing home residents became among the nation’s first to be vaccinated.
But since that promising start, administrators, residents and family members complain they’ve had trouble getting answers.
“The whole thing is completely ludicrous,” said Martha Williamson, 76, who lives in a Central Florida continuing care retirement community she didn’t want to name, noting the issue isn’t limited to a single facility.
“All these people who are not in any kind of institution are getting vaccinations if they are willing to drive to the Orange County Convention Center or the Oviedo Mall, and, meanwhile, how does that affect people who are in institutions who can’t use a computer or, if they can, they can’t navigate this [appointment website,] and they may not be in any kind of condition to be driven to the convention center and wait three hours with no toilets [available]?” she said. “Imagine an incontinent old person sitting there for three hours.”
Neither CVS Health nor Walgreens would provide information on how many vaccines their programs have administered, which facilities they’ve worked with or even which Florida cities they’ve worked in so far.
“We don’t break out the number . ... We don’t break out the markets that we’re in. It’s just for privacy reasons,” said CVS Health spokeswoman Tara Burke — although federal health privacy laws are only aimed at protecting the release of an individual patient’s personal health records. “We will tell you we continue to work with the state as they activate populations under the federal program.”
The company called its effort to vaccinate longterm care residents and staff in 12 states, including Florida, “herculean” and said it expected to complete the process by about Jan. 11.
But even the state’s professional association for nursing homes, the Florida Health Care Association, cannot find out which facilities have already gotten the vaccine and when the rest are scheduled to receive it, said communications director Kristen Knapp.
She added, though, that nursing homes that have begun the process report that it went smoothly.
“We do know we’ve got facilities that are getting scheduled January 5th and 6th,” she said. “You know, there are 700 nursing homes. And so depending on the number of residents, and number of staff, it’s a process to get that many people vaccinated. Every resident and caregiver has to be monitored for side effects for 15 minutes after they receive the vaccine. This is something that takes time.”
Steve Bahmer, president and CEO of LeadingAge Florida, which represents some 500 senior facilities with varying levels of care, agreed, calling the process “monumentally complex.” But he also said he has no more than anecdotal information on which facilities are getting the vaccine and that continuing care retirement communities — which offer a range of living options from independent apartments to skilled nursing — have been trying to get all residents vaccinated at the same time.
So far, he added, that has rarely happened.
“We have been making the case for six or seven weeks now that the continuing care retirement community environment is unique, given that it has all levels of care on a single campus, and that it makes sense and is just much more efficient to vaccinate all levels of care at one time,” Bahmer said. “They all live in congregate settings. They may have their own apartments and houses, but they often intermingle,” leading to greater risk of exposure for a vulnerable population.
At Westminster Towers in Orlando, spokesman Wes Meltzer said residents of the 120-bed skilled nursing facility last week became among the region’s first to receive the vaccine, alongside the facility’s staff.
“We are actively awaiting vaccines for assisted living and independent living in the very near future,” he added, though he didn’t have a more specific date. “Honestly, we’re glad that our residents and our team members on the front lines are a priority, because this helps keep everyone safer.”
Linda Warren, whose 99-year-old father, Bill Warren, is awaiting his first vaccination shot at Westminster’s Winter Park skilled nursing facility next week, said she will be relieved when the process is completed.
But it may not answer her prayers. While the vaccines are reported to be highly effective, those who are inoculated may still be able to catch and spread the virus.
“I was under the impression that once they got the second dose, I would be able to take him out for a ride and just get him out of his room for a while,” she said. “But then I found out the vaccine doesn’t (always) keep them from getting the virus — it just lessens the severity of it. So I’m not sure what we’ll be able to do.”