23215900, 59AER20-1 - Florida Administrative Rules, Law, Code, Register

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Notice: 23215900

Notice of Emergency Rule

Department:

AGENCY FOR HEALTH CARE ADMINISTRATION

Division:

Health Facility and Agency Licensing

Overview

RULE:

59AER20-1

Hospital Screening Requirements for Long-Term Care Facility Residents

SPECIFIC REASONS FOR FINDING AN IMMEDIATE DANGER TO THE PUBLIC HEALTH, SAFETY OR WELFARE:

The Novel Coronavirus Disease 2019 (COVID-19) is a severe respiratory illness that can spread among humans through respiratory transmission.  According to the Centers for Disease Control and Prevention (CDC), people at risk for serious illness from COVID-19 include older adults and people with serious chronic medical conditions. In late 2019, a new and significant outbreak of COVID-19 emerged in China and the World Health Organization declared COVID-19 a Public Health Emergency of International Concern. The CDC also confirmed instances of community spread of COVID-19 in the United States and has issued extensive written guidance to help control the spread of COVID-19. According to the CDC, at the time of this filing, the United States has over 1,000,000 total cases and over 67,000 total deaths. Older adults are at a higher risk of developing serious complications from COVID-19. According to the United States Census Bureau, Florida has the largest percentage of residents age 65 and older in the nation.

On March 1, 2020, Governor Ron DeSantis directed State Surgeon General Scott Rivkees to declare a Public Health Emergency in the State of Florida as a result of COVID-19 pursuant to Executive Order 20-51. On March 9, 2020, Florida Governor DeSantis declared a state of emergency in Florida.  As of May 4, 2020, all counties in Florida have positive cases for COVID-19. As of the date of this filing, there have been 36,897 confirmed cases in Florida as a result of COVID-19 and 1,399 deaths. . 

Elders, older adults, and other residents of long-term care facilities are presenting without COVID-19 symptoms and are being treated by hospitals for various non-COVID-19 reasons. However, after being discharged from the hospital to their long-term care facility residences, the individual develops COVID-19 symptoms and spreads the virus to other residents and staff in the facility where previously there we no positive facility cases. Due to the congregate nature of long-term care facilities, the increased risk of transmission of COVID-19 is high. The highly transmissible nature of COVID-19 combined with the congregate nature of the long-term care facility settings and the close and personal contact that many long-term care facility workers have with the patients puts both residents and staff at a high risk of infection. 

Medical research shows the highly contagious COVID-19 virus can manifest as asymptomatic in positive individuals and the live coronavirus can shed at high concentrations before symptomatic development resulting in spread of the infection. Ensuring hospitals test all long-term care facility residents before discharge to a long-term care facility is essential to protecting the health, safety and welfare of vulnerable residents who are at the highest risk of serious illness or death from the virus.

Long-term care facilities around the state have taken strong measures to ensure protection of their resident populations. While many facilities and hospitals already adhere to similar protocol as outlined by this rule, this emergency rule formalizes a requirement for all hospitals to confirm long-term care residents are negative for COVID-19 before they are discharged from the hospital to any long-term care facility, unless the receiving long-term care facility has a dedicated wing, unit or building with dedicated staff to accept COVID-19 positive residents. The rule is consistent with longstanding direction from Governor DeSantis that facilities and hospitals ensure patients and residents receive the utmost protection and care. The rule memorializes guidance from the Agency Secretary to health care providers related to best practices and measures necessary to ensure resident safety. Finally, the rule gives the Agency the tools necessary to take enforcement action in the event of a failure to comply.

Prompt implementation of this rule is necessary to ensure the health, safety and welfare of residents and staff in Florida’s nursing homes, group home facilities, intermediate care facilities, and assisted living facilities.

REASON FOR CONCLUDING THAT THE PROCEDURE IS FAIR UNDER THE CIRCUMSTANCES:

The procedure used to adopt this emergency rule is fair as the State of Florida is under a declaration of emergency due to the outbreak of COVID-19. This emergency rule is necessary and fair to ensure the health, safety, and welfare of the facility residents, and provides at least the procedural protection given by other statutes, the State Constitution, or the United States Constitution; and takes only that action necessary to protect the public interest under the emergency procedure.

SUMMARY:

This Emergency Rule establishes a requirement for all hospitals to confirm long-term care residents are negative for COVID-19 before they are discharged from the hospital to any long-term care facility, unless the receiving long-term care facility has a dedicated wing, unit or building with dedicated staff to accept COVID-19 positive residents.

THE PERSON TO BE CONTACTED REGARDING THE EMERGENCY RULE IS:

Kimberly Stewart at Agency for Health Care Administration, Division of Health Quality Assurance, Bureau of Health Facility Regulation, 2727 Mahan Drive, MS# 28A, Tallahassee, FL 32308, email Kimberly.Stewart@ahca.myflorida.com or phone 850-412-3492.

PRINT PUBLISH DATE:

5/6/2020 Vol. 46/89

OVERSIGHT COMMITTEE:

Joint Administrative Procedures Committee
Florida Administrative Law Central Online Network (F.A.L.C.O.N.)

RELATED COURT CASES:

Division of Administrative Hearings

FEDERAL eRULEMAKING
WEB PORTAL:

Regulations.gov

HOW TO LINK TO
THIS NOTICE:

http://flrules.org/gateway/ruleno.asp?id=59AER20-1&PDate=5/6/2020&Section=4

REFERENCE MATERIALS:

No reference(s).

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