Provider Guidance for Testing

Background

Health care providers are strongly encouraged to test for SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), when patients present with any signs or symptoms consistent with COVID-19 or have had a known exposure to a person with COVID-19 infection. Due to the nonspecific clinical presentation of COVID-19 and the potential for co-infection with other pathogens, every symptomatic person should be evaluated on a case-by-case basis and testing decisions should be based on the patient’s personal health history. Because many COVID-19 cases have been observed in persons who originally discounted their symptoms due to other existing health conditions, e.g., allergies, prompt and early diagnosis of COVID-19 infection is strongly recommended to prevent further transmission.

Interim Guidance on Antigen Testing for COVID-19 in Long-Term Care

This interim guidance addresses the use of COVID-19 antigen testing in long-term care (LTC) facilities and is aligned with guidance released by the Centers for Disease Control and Prevention (CDC). The U.S. Food and Drug Administration (FDA) has granted emergency use authorization to antigen point-of-care (POC) testing systems to detect the presence of SARS-CoV-2 viral protein.

2020 General Election Guidance Voting Information for Nursing Homes and Other Long-Term Care Facilities

This guidance provides important information for nursing homes and other long-term care facilities (collectively, “LTC”) to provide safe access to voting for their residents during the November 3, 2020 General Election.

The Illinois Department of Public Health (IDPH) had limited visitor access to LTC facilities to protect the residents from COVID-19 since March 9, 2020 when Governor JB Pritzker issued a disaster proclamation due to the rapid spread of the COVID-19 virus. The disaster proclamation was most recently renewed September 18, 2020 and declared that COVID-19 constitutes a “public health emergency under Section 4 of the Illinois Emergency Management Act.”

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:

Outdoor Visitation Guidance for Long-Term Care Facilities

Long-term care facilities (LTCF) may allow outdoor visitation for residents under certain conditions. Visits must be limited to two visitors at a time per resident. The maximum number of residents and visitors permitted in the outdoor space at one time is predicated on the size of the outdoor space. The LTCF must ensure  a minimum distancing of 6 feet is achievable in the outdoor space when determining the maximum number of residents and visitors who can simultaneously occupy the outdoor space. The LTCF must clearly communicate and enforce social distancing of 6 feet between the resident and visitors. The facility must establish the maximum number of visitors allowed in a single day.

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.

Restoring Illinois – Protecting Our Communities FAQs

On May 5, Gov. JB Pritzker released Restore Illinois, a five-phased plan to reopen our state, guided by health metrics and with distinct business, education, and recreation activities characterizing each phase. Beginning Friday, June 26, each region in the state entered Phase 4 of the plan. For more information about Restore Illinois and Phase 4, see below.

About the Plan

Who put the plan together?

Governor Pritzker worked closely with medical and public health experts at the Illinois Department of Public Health (IDPH) and received feedback from public health and hospital partners as well as local elected officials, mayors, and businesses who have been in regular communication with the administration.

Workplace Health and Safety Guidance for Employees and Staff of Businesses

Practice Social Distancing

Pursuant to Executive Order, your employer must comply to the greatest extent feasible with social distancing requirements. This means that your employer should:

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.

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