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, shut down dining rooms and screen residents and staff for fevers and respiratory diseases.

Q: Where can I find information about LTC facility outbreaks?

A: The number of confirmed cases and deaths at long term care facilities from January 24, 2020 can be found at: http://dph.illinois.gov/covid19/long-term-care-facility-outbreaks-covid-19. The numbers are provisional and will be updated weekly. LTC facilities will have the most up-to-date information on cases in their facility.

Q: Why is there a disparity sometimes in LTC testing data between local and state health departments?

A: LTC facilities first notify local health departments of cases and there can be a lag in time before the information is reported to the state. Once a case is reported, the focus of the state, local health department, and the LTC facility becomes ensuring steps are taken for appropriate infection control, the need for wearing personal protective equipment (PPE), proper use and donning and doffing of PPE, and isolating and/or quarantining residents. Reporting numbers is not the most important function and can wait while the facility and public health focus on resident safety and care.

Q: Has IDPH issued any LTC citations for deficiencies related to infection control? Staffing shortages?

A: IDPH’s priority is to stop the spread of the virus in facilities to protect the health and safety of residents and staff. Guidance from the federal Centers for Medicare and Medicaid Services is not to issue citations, but rather encourage surveyors to ensure violations are remedied quickly and residents are properly cared for. If warranted, IDPH will use its enforcement powers to hold facilities accountable for uncorrected or egregious violations.

Q: Should LTC staff exposed to COVID-19 patients wear PPE?

A: Once there is a confirmed case in a facility, staff are instructed to wear PPE and residents should wear masks. When entering the room of a patient with known or suspected COVID-19, staff should wear a facemask, gown, gloves, and eye protection. LTC facilities, health care workers, and first responders are priorities for distribution of PPE. As of April 19, 2020, the state has supplied more than 5 million surgical masks, more than 1.5 million N95 masks, about 20,000 gowns, more than 4 million gloves, and almost 200,000 face shields.

Q: Is there a reporting system for LTC supply needs like there is for hospitals?

A: LTC facilities contact their local health departments for PPE needs and IDPH coordinates with the LHDs to ensure the needs are met.

Q: Are LTC facilities legally required to notify residents, family, or staff of COVID-19 cases?

A: A LTC facility must provide notification to staff, residents, the resident’s next of kin or guardians, and IDPH when people working or living in the facility are diagnosed with COVID-19. The notification identifies whether the diagnosed individual is a staff member or
resident.

Q: How soon is an LTC facility to provide notification of a COVID-19 diagnosis to family, to a guardian, or to an agency responsible for a resident’s care?

A: Verbal communication is to be provided immediately upon diagnosis as required by 77 Ill. Admin. Code 300.3210(o).

Q: What other responsibilities does an LTC facility have upon a COVID-19 diagnosis?

A: Each resident of the facility, next of kin, guardian, or emergency contact is to receive written notification of the fact a resident or worker has been diagnosed with COVID-19. Notification also is required to be posted in a conspicuous place near the main entrance
announcing a resident or a staff member has been diagnosed with COVID-19, as is written notification to their local health department.

Q: What is the responsibility for the LTC facility in the event of a COVID-19 resident death?

A: The administration of the facility must notify next of kin, emergency contact, or guardian of the resident who passed away within 24 hours.

Q: IDPH guidance is once a positive test is identified in a facility, no additional testing of residents or staff is needed. Why is that?

A: Advice on testing has continued to evolve as we learn more about COVID-19. Originally, it was important to identify a case in an LTC facility and then instruct management/staff to operate as if there were additional cases and practice appropriate PPE use, including residents wearing masks and isolation of individuals exhibiting systems. With the recent expansion of testing capacity, LTC facilities with no cases have been prioritized and IDPH is urging testing of residents and staff to determine if cases occur to allow for immediate isolation of those who test positive. In facilities where cases already exist, residents who display symptoms are to be treated as if positive, but staff are to be tested to determine who can care for residents and who should be isolated.

Q: In the event of a widespread outbreak of COVID-19 in an LTC facility, what steps must the facility take?

A: Proactively implement infection prevention strategies and practices, including screening staff and residents for symptoms, enhanced environmental cleaning and disinfection, and screening and restriction of visitors. Staff must always wear masks and closely
monitor residents for fever, symptoms or changes in health status. The facility must coordinate with its local health department and IDPH to promptly identify and monitor individuals who had recent contact with COVID-19-positive individuals to prevent further spread.

Q: How does IDPH keep LTC facilities informed about the latest information on COVID-19 infection control procedures, proper use of PPE, cleaning, isolation/quarantine?

A: IDPH conducts weekly webinars to help facilities prepare for and prevent COVID-19 from spreading in their facility. In the event of an outbreak, IDPH staff work remotely to provide guidance and instruction, but if additional assistance is needed, public health staff
will visit the facility.