On May 8, 2020, Governor Ron DeSantis announced the state’s latest tool to combat what, at the time, was a virus almost exclusively attacking the elderly and vulnerable.
“This is a secure location that will exclusively care for stable COVID-positive patients who reside at other long-term care facilities,” the Governor said outside Dolphin Pointe in Jacksonville where the 146-bed nursing home became the state’s first designated COVID isolation center.
Over the next few months, Florida would add 22 additional nursing homes to its map of COVID isolation centers. The facilities were contracted by the state Agency for Health Care Administration (AHCA) to house elderly seniors who tested positive for COVID-19. The purpose of the centers was to “halt the spread of the virus” in long-term care facilities, according to the state.
“To be able to isolate that cluster so it doesn’t spread, we think that’s been something that’s been very effective,” Governor DeSantis said at the time.
Nearly one year later, we’ve also learned the program wasn’t cheap.
According to AHCA, the 23 nursing homes were paid at least $51million in state and federal reimbursements to serve as COVID isolation centers in Florida for approximately 4- 6 months. Roughly half of the centers received at least one million dollars in the deal that ended last October.
Records show Dolphin Pointe was not just the state’s first isolation center but it also received the most in government reimbursements. According to AHCA, the facility received just over $7.8 million in state and federal reimbursement dollars for serving as an isolation center.
“That’s a lot of coin. $7.8 million is a lot of money for a nursing home,” said Brian Lee, a former Florida ombudsman, and active senior advocate. He’s also been an outspoken critic of the state’s isolation center program.
“I don’t know what was special about those homes. I still don’t know what was special, what was different. It almost looks as though they crafted these isolation centers to incentivize or, at least, to be a financial incentive to subsidize or help these nursing homes financially,” Lee said.
State contracts reveal in addition to normal Medicaid reimbursement fees which, typically, range between $200-$300 per day, COVID isolation centers in Florida were paid an additional $375 per patient, per day.
Empty beds were no exception.
“Paying for non-services in a facility, that’s pretty shocking,” said Lee.
Some were paid, we’ve learned, even after the last COVID patient left.
For example, according to the state’s contract with Dolphin Pointe, the facility was reimbursed its typical Medicaid rate for four months after the last COVID patient was discharged from the center under the state’s contract in October.
“Though the contract was for 146 beds, there were very few months the state paid to reserve all 146 beds,” said Geoff Fraser, owner of Clear Choice Health Care, a group that manages Dolphin Pointe and two other nursing homes that served as isolation centers in Florida last year.
Fraser declined our request for a video interview, but in an email, he said the facility’s reported $7.8 million in COVID isolation center reimbursement payments “sounds possible given the time frame and duration,” which lasted about six months.
Fraser explained the extra payments helped cover higher costs of care, including “marked up” PPE costs and staff wages they had to “nearly double just to try to pull in staff in such a short period of time,” he explained.
It’s not clear how many patients Dolphin Pointe or any of the state’s 23 former COVID isolation centers cared for. AHCA has only said that, statewide, 4,047 people were cared for in an isolation center. Despite repeated requests, AHCA did not break down the number of patients by the facility. Nor has it detailed how often facilities were paid for empty beds or how long patients stayed in a center. But, if a total of 4,047 people were served by an isolation center last year, that means each patient cost taxpayers, on average, at least $12,600.
“I’m not shocked by the number just because long-term care is expensive,” said Eric Carlson, an attorney for the advocacy group, Justice For Aging. He says it’s not the money that stands out but the facilities that cashed in on the crisis here in Florida and around the country.
“The providers that sign up for programs like this are not the creme de la creme,” he said about similar programs he’s seen nationwide.
Here in Florida, some of the isolation centers that received the most money in reimbursements also had questionable histories. Oakbridge HeathCare in Lakeland and Countryside Rehab on Florida’s west coast have both had histories of problems ranging from the adequacy of care to a lack of proper COVID infection control, as noted in a Countryside inspection report last year. Both were also on the state’s nursing home watch list when the state added them to its map of COVID isolation centers.
Records show each facility received well over $4million in reimbursement payments for serving as isolation centers.
Their parent company, Consulate Health Care, did not respond to our requests for comment.
Recent inspection reports also reveal how some of these former state isolation centers are still being flagged for problems, including Dolphin Pointe. In March, state inspectors cited the facility for a lack of proper supervision and staff competency issues which, according to inspectors, placed residents in “immediate jeopardy.” Those issues have since been corrected, according to recent inspection reports.
“It just goes to show that this industry continues to be ripe with problems, staffing issues, deficiencies, fines, even after these designations,” said Lee.
We are not familiar with any state plans to bring back COVID isolation centers. We asked Dolphin Pointe’s management company if the facility would sign on to be a state isolation center again, Fraser replied in an email, “I am not sure. I believe this was a good use of taxpayer dollars and I believed it helped save a lot of lives,” he said. A spokesperson from AHCA added, “These facilities and their staff played a vital role in protecting the well-being of Florida’s most vulnerable citizens.
The following is a chart reflecting the COVID isolation payments made to facilities Florida’s Agency for Health Care Administration contracted with to serve as COVID isolation facilities. According to AHCA, the table reflects the total amount of COVID-19 isolation payments made to each of the facilities since April 2020.
source: AHCA
