IDPH Guidances Relating to the COVID-19 Outbreak

Long -Term Care COVID-19 Testing Requirements

This interim guidance provides updated guidelines and criteria for COVID-19 testing in licensed long-term care (LTC) facilities, as defined by the Nursing Home Care Act, 210 ILCS 45, primarily focusing on skilled nursing and intermediate care facilities.

Given their congregate setting and resident populations served (e.g., older adults often with underlying chronic medical conditions), nursing home populations are at the highest risk of being affected by COVID-19. If infected with SARS-CoV-2, the virus that causes COVID-19, residents are at increased risk of serious illness. The Illinois Department of Public Health (IDPH) is committed to working proactively with LTC facilities to prevent illnesses.

Long Term Care Facilities Guidance

This interim guidance provides guidelines for nursing homes and other long-term care (LTC) facilities regarding restrictions that were instituted to mitigate the spread of COVID-19. The guidance in this document is specifically intended for facilities as defined in the Nursing Home Care Act (210 ILCS 45), and also applies to Supportive Living Facilities, Assistive Living Facilities, Shared Housing Establishments, Sheltered Care Facilities, Specialized Mental Health Rehabilitation Facilities (SMHRF), Intermediate Care Facilities for the Developmentally Disabled (ICF/DD), State-Operated Developmental Centers (SODC), Illinois Department of Veterans Affairs facilities and Medically Complex/Developmentally Disabled Facilities (MC/DD). Modifications for specific categories of LTC facilities and programs are provided in the Appendix.

Long Term Care Facility Resident Monitoring Protocol

Long-Term Care Facility Residents/Patients

All Patients

Obtain vitals (temperature, heart rate, respirations) AND pulse oximetry every eight hours (Q8 hours). Blood pressure can be taken once a day.

Symptom screening to be performed every shift (Q8H) and should include questions about and/or observations of the following:

  • Fever 
  • Shortness of breath (SOB) 
  • Cough 
  • Sore throat
  • Chills or shaking w/chills
  • Muscle pains
  • Headache
  • New loss of taste or smell

Contact the clinical supervisor for any of the following: new-onset fever, SOB, cough, sore throat, or for any decrease in pulse oximetry from resident baseline level or any pulse oximetry reading < 92%. If these symptoms are present, providers should strongly consider transfer to a higher level of care. Monitoring every four hours is appropriate for patients with evidence of clinical deterioration.

Long-term care Frequently Asked Questions

Q: What is being done to protect long-term care (LTC) residents from COVID-19?

A: Administrators have been instructed to restrict visits, cancel group activities, close dining rooms, and screen residents and staff for fevers and respiratory diseases.

Q: Are LTC residents and staff required to be tested for COVID-19?

A:  Yes.  The Illinois Department of Public Health (IDPH) requires every skilled and intermediate LTC facility to test all residents and staff for COVID-19 (starting May 28, 2020).  Each facility must collect specimens and arrange for laboratory testing.  The number of residents and staff tested, and the number of positive, negative, and indeterminate test results are to be reported to public health officials.

Medical Care for Sexual Assault Survivors

Illinois Hospitals Are Ready and Safe for Sexual Assault and Domestic Violence Survivors to Receive Medical Care

Sexual assault and domestic violence survivors come to hospitals to seek important medical and forensic care in their most vulnerable moments. During these tumultuous times, it is imperative that survivors know hospitals remain committed to providing these essential services to survivors who seek them. Hospitals work in collaboration with Illinois Coalition Against Sexual Assault rape crisis centers, the Illinois Coalition Against Domestic Violence, and other advocacy organizations to assist survivors.

Medically Fragile Child Guidance

Planning actions for a home health care agency during an infectious disease pandemic

  • Review your list of clients and ensure it is up to date and includes levels of informal support available to individuals. Providers should consider how to benefit from sharing client health information electronically with local partners (hospitals, local health departments, emergency medical service providers), if they receive a legitimate request.
  • Work with local agencies/facilities to establish plans for mutual aid, taking into account business continuity plans and considering arrangements to support sharing of the workforce between home care providers, local primary and community services, and with the deployment of volunteers, where that is safe to do so.
  • Note the arrangements that local authorities are putting in place to refer vulnerable people self-isolating at home to volunteers who can offer practical and emotional support.
Audience:

Migrant Farmworker Guidance

How can I protect myself, my crew, friends, and family from COVID-19?

  • Wash your hands with soap and water for at least 20 seconds before to eating, during breaks, after using the restroom, and when you return home from work. Wash hands throughout the day when convenient.
  • Cover your coughs and sneezes with a disposable tissue or use the inside of your elbow.  Wash your hands after blowing your nose, coughing, or sneezing.
  • Use a cloth face covering at work and in public when social distancing of 6 feet or more cannot be maintained. When at home, use a mask if you share housing and cannot maintain 6 feet  distance from others. Do not touch the front of the mask. Wash the cloth mask each day after using it.
  • Avoid touching your eyes, nose, or mouth with unwashed hands.
  • Maintain social distance (6 feet). Avoid close contact with people at work, in public, and at home if you live in shared housing.
Audience:

Migrant Labor Camp Guidance

The Illinois Department of Public Health (IDPH) recommends that agricultural employers and migrant labor camp operators implement the following guidance to reduce exposure to and the spread of COVID-19 among migrant and seasonal farmworkers. To lessen the impact of COVID-19 outbreak conditions on these essential workers, their employers, and the public, agricultural employers and migrant labor camp operators should immediately implement preventative measures and create a COVID-19 response plan.

This guidance and the accompanying checklist provide recommendations on how to implement the following measures and prevent the spread of COVID-19 at agricultural housing, transportation, and worksites:

Audience:

Modifications for Other Long-Term Care Facilities and Programs

All categories of long-term care facilities covered by this guidance document should follow the recommendations provided, with modifications for specific categories of facilities and programs as provided below.

Assisted living facilities and other similar arrangements

For Assisted Living Facilities (ALF), Shared Housing Establishments (SHE), Sheltered Care Facilities, and Supportive Living Facilities (SLF), the following modifications are recommended:

Visitation

In CMS Phases 1 and 2, the general visitation rules apply to visitation at these facilities. In CMS Phase 3, facilities should follow these modifications:

Multisystem Inflammatory Syndrome in Children

This document aims to ensure that clinicians are aware of current guidance regarding Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19), including the case definition and guidance on reporting to local health departments.

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