Is full testing at state care homes possible?

With deaths mounting at the nation’s nursing homes, the White House wants all residents and staff at such facilities tested for the coronavirus in the next two weeks. Florida Gov. Ron DeSantis also wants all residents and staff of long-term care facilities tested.

To date, according to the Florida Department of Health, the state has tested only 6% of that group.

Still, the state has not issued an order saying every resident and worker must be tested, which currently is about 177,000 residents and nearly 300,000 staff members. The only mandate, issued Sunday, is that if state workers show up at a facility, testing of staff is not voluntary at that facility.

But the only facilities that the state has visited so far are those that have shown signs of COVID-19 in the residence.

Andrew Weisman, chief

executive of Nu Vision Management, owner of six nursing homes in Broward County, cast doubt on the feasibility of testing everyone in every home any time soon. Weisman said he has incurred the expense and used a private company, and still has tested only a fraction of his residents and staff.

He has signed up with the health department and is waiting for the agency to come out and test at three of his centers. “We can’t get them here fast enough. We want and need these tests,” Weisman said. “The only way to beat the virus is to know who has it.”

According to the most recent figures released Tuesday, about 3,400 residents and staff members of long-term care facilities in Florida are infected with the new coronavirus, and 745 residents or workers have died.

On Tuesday, the Florida Department of Health began asking long-term care facilities to report how many workers they employ and how many have been tested for COVID-19 since April 11. Also on Tuesday, the health department announced a new email address for long-term care facilities to sign up for testing.

The slow ramp-up of testing at long-term care facilities has led some facilities to use private labs, rather than waiting for Florida health officials to show up.

For two months, administrators at nursing homes and assisted living facilities across the state have been asking state officials to test their staff and residents to make sure that the deadly coronavirus wasn’t penetrating their facilities from staff who were showing no symptoms. But state health officials focused only on testing at homes that already had outbreaks of the virus.

At multiple news briefings, DeSantis has emphasized his desire to get more testing in long-term care facilities.

“Allowing the virus to spread in an environment like a long-term care facility is hugely problematic and we are intent on pulling all the levers we can to stop that from happening,” DeSantis said during a news briefing on Monday.

Last week, the state debuted a mobile unit that will go to homes and process results in 45 minutes. DeSantis said he eventually would like more mobile units.

Kristen Knapp, a spokesperson for the Florida Health Care Association, which represents nursing homes, believes the state has a long way to go to get everyone who works or lives in Florida’s long-term care facilities tested — but doesn’t really know for sure, nor has she seen a definitive plan to make that happen.

“I’m really interested in knowing where we are to date,” Knapp said. “Testing helps us make clinical decisions and staffing decisions. It’s a key component of managing the threat of this virus.”

The Associated Press reported more than 27,000 residents and staff have died from outbreaks of the virus at the nation’s nursing homes and longterm care facilities, according to a tally based on state health departments and media reports. That accounts for about a third of all 80,000 deaths in the U.S. that have been attributed to the virus.

In Florida, much like the rest of the country, nursing home operators have said the lack of testing kits has made it challenging to stop the virus from entering their facilities because they haven’t been able to identity silent spreaders not showing symptoms.

Scott Lipman COO of Marrinson Senior Care Residences, owner of Manor Pines Convalescent Center in Wilton Manors, questioned why the testing focus is only happening now.

“They never offered to test here,” Lipman said. His company hired a private lab to get residents and workers tested after an outbreak occurred. Since mid-April, Manor Pines conducted 1,000 tests of residents and staff at a cost of $80,000, to detect the virus which has infected 67 residents and 28 staff members.

“The problem is once you start testing, you can’t stop,” Lipman said. “The results are only good for the day you took the test. If the results are positive it’s an ongoing process until you feel comfortable.”

Weisman, of NuVision Management, believes the state should quickly buy more rapid tests and start using them at nursing homes. For now, health officials are using mostly tests that take a day or two to get results.

“It’s a lot of buildings for them to cover,” he said. “They are doing the best job they can, but they need to put the tests in our hands and let us do them. We’re motivated.”

A major challenge for the state has been the number of facilities that need to be tested.

Florida has more than 3,800 long-term care facilities, and testing has been conducted in 239 of them so far. DeSantis said Florida has 50 National Guard working in fourperson teams alongside local health officials going out to nursing homes and assisted-living facilities to swab residents and send specimens to labs.

Miami Jewish Health, which operates independent, assisted living and skilled nursing facilities on its campus, detailed its extensive process for getting residents tested during a Tuesday discussion with state health officials.

“We have completed 450 tests on our campus in partnership with city, state and local testing entities,” said Shaun Corbett, chief medical director of Miami Jewish Health. “We understand the rationale behind testing: Identify positive and negative residents and separate them from each other. It’s about preventing transmission and saving lives.”

According to Miami Jewish Health’s website, more than 1,200 physicians, nurses, caregivers and support staff serve over 10,000 clients a year. Thus far, 56 residents and 38 staff have tested positive.

Corbett said the process of testing, isolating, retesting and communicating with families, staff and residents has taken two months, and still, not all staff has been tested. Corbett said he has learned testing is only one component. Results can come back at all hours on any day of the week, and facilities must have a plan in place to react.

Knapp of the Florida Health Care Association said her association is grateful for the testing Florida health officials are doing, but her members want more. “It’s a step in the right direction,” she said.