April 24, 2020
Stay Connected - LeadingAge Illinois COVID-19 Resources
Stay up to date on state and federal COVID-19 information and updates by accessing the LeadingAge Illinois COVID-19 Resources page. You can also engage with other Illinois members through our listservs, connecting you with your peers by provider type. We have now added a COVID-19 listserv . Contact LeadingAge Illinois if you’d like more information about the listservs or would like to join one.

TOP STORIES
Temporary Nursing Assistant Program is Now Available in Illinois
The Temporary Nursing Assistance (TNA) Program is now available in Illinois. The 16 hours of training must include: a minimum of eight-hour classroom component, and a minimum of eight hours of on-the-job training, which may include job shadowing and mentoring. The eight-hour classroom education component may be satisfied by successful completion of the American Health Care Association (AHCA) online training program that is located here .
 
This position is only authorized for the duration of the Governor’s COVID-19 Disaster Proclamation, after which time facilities are required to transition to certified staff only (Certified Nursing Assistants). The Health Care Worker Background Check applies to this position. TNAs will report to the facility’s charge nurse or nursing supervisor and may be assigned appropriate tasks by the supervising nurse(s).
 
TNA Information:

If you have any questions, contact Ruta Prasauskas .
CDC Clarifies Elements of Forthcoming Nursing Home Reporting Requirements
The CDC has developed a new COVID-19 module for long-term care providers within the National Healthcare Safety Network (NHSN) system. The long-term care providers module will collect information on resident impact and facility capacity, supplies and personal protective equipment (PPE), staff and personnel impact, and ventilator capacity and supplies.
 
While nursing homes presently report information about COVID-19 cases to state/local health departments per federal regulation, CDC needs information that is simply not available through present reporting mechanisms. With this information, CDC will be able to learn more about the disease and its impact on older adults, how this disease is impacting the healthcare workforce, and the PPE and equipment needs of long-term care providers related to this disease.
 
The collaboration of the two government entities (CMS and CDC) makes this a bit confusing. This information is being collected and utilized by CDC. However, the requirement to report is enforced by CMS. CMS will announce through final rulemaking what data elements nursing homes are required to report in this COVID-19 module. CMS also stated in CMS memo QSO-20-26-NH that enforcement actions may be imposed against nursing homes that fail to comply with this requirement.
 
We note that the COVID-19 reporting module developed by CDC also allows for reporting by assisted living providers. CDC encourages reporting by these providers, as COVID-19 cases in assisted living are said to be increasing. While CMS has no federal authority over assisted living, LeadingAge encourages assisted living members to keep an eye on the state for any reporting requirements that may be imposed. CMS has not commented on frequency or retrospect of reporting. This information will presumably be included in the forthcoming rulemaking.
 
The COVID-19 module will be available on the NHSN system page of the CDC website. CDC is currently developing an expedited enrollment process that can be completed in one day online. This expedited enrollment process will require providers to register the facility with NHSN, but will allow providers to skip the Secure Access Management Systems (SAMS) registration that requires identity verification.
 
The CDC is in the process of developing web-based training and specific form instructions that will be posted on the NHSN system page. Ahead of these resources, they have developed this presentation to share with our members. Additionally, CDC intends to hold recurrent “Office Hours” that will feature a replay of the recorded training, followed by a live Q&A period. Email updates and a User Support Desk will also be available from CDC.
 
It is unclear at this time what support CMS will provide or if we can expect additional guidance once the rulemaking has been published.
Source: LeadingAge
Interview with Ari Shabat, CEO of RESIDE Admissions
In a recent interview, Ari Shabat, CEO of RESIDE Admissions, joins Scott Christiansen, CEO of Root3 Marketing & Business Development to discuss how RESIDE’s remote admissions process puts everything in one place, ensuring the health and safety of your residents and staff. Shabat shares how the long-term care industry, which has been especially vulnerable during COVID-19, can benefit by accessing the RESIDE platform remotely. Request a demo .

 Pictured: Ari Shabat, Founder and Chief Executive Officer of RESIDE Admissions
STATE
IDPH Position on Screening of EMS Workers
The Illinois Department of Public Health (IDPH) informed LeadingAge Illinois that local health departments and emergency responders had contacted IDPH about being required to either be screened and/or change Personal Protective Equipment (PPE) upon entering a long term care facility. 
 
IDPH stated that in some instances, the EMS personnel were allegedly told by facility staff that these requests were based on State regulations. However, IDPH reports that there is no such guidance and IDPH is stressing the need to prevent delays in responses to emergency situations. While looking to see if any State guidance or regulation contradicts the current IDPH position, IDPH cites existing federal CMS guidance on the issue:
 
Federal CMS Guidance memo QSO-20-14 excerpt:
Guidance for Limiting the Transmission of COVID-19 for Nursing Homes
For ALL facilities nationwide:
Facilities should restrict visitation of all visitors and non-essential health care personnel, except for certain compassionate care situations, such as an end-of-life situation. In those cases, visitors will be limited to a specific room only.
 
Facilities are expected to notify potential visitors to defer visitation until further notice (through signage, calls, letters, etc.). Note: If a state implements actions that exceed CMS requirements, such as a ban on all visitation through a governor’s executive order, a facility would not be out of compliance with CMS’ requirements. In this case, surveyors would still enter the facility, but not cite for noncompliance with visitation requirements.
 
For individuals that enter in compassionate situations (e.g., end-of-life care), facilities should require visitors to perform hand hygiene and use Personal Protective Equipment (PPE), such as facemasks. Decisions about visitation during an end of life situation should be made on a case by case basis, which should include careful screening of the visitor (including clergy, bereavement counselors, etc.) for fever or respiratory symptoms.
 
Those with symptoms of a respiratory infection (fever, cough, shortness of breath, or sore throat) should not be permitted to enter the facility at any time (even in end-of-life situations). Those visitors that are permitted, must wear a facemask while in the building and restrict their visit to the resident’s room or other location designated by the facility. They should also be reminded to frequently perform hand hygiene.
 
Exceptions to restrictions:
  • Health care workers: Facilities should follow CDC guidelines for restricting access to health care workers. This also applies to other health care workers, such as hospice workers, EMS personnel, or dialysis technicians, that provide care to residents. They should be permitted to come into the facility as long as they meet the CDC guidelines for health care workers. Facilities should contact their local health department for questions, and frequently review the CDC website dedicated to COVID-19 for health care professionals.

  • Surveyors: CMS and state survey agencies are constantly evaluating their surveyors to ensure they don’t pose a transmission risk when entering a facility. For example, surveyors may have been in a facility with COVID-19 cases in the previous 14 days, but because they were wearing PPE effectively per CDC guidelines, they pose a low risk to transmission in the next facility, and must be allowed to enter. However, there are circumstances under which surveyors should still not enter, such as if they have a fever.
 
Federal CMS Guidance 04/02/2020 excerpt:
  • Long-term care facilities should immediately implement symptom screening for all.

  • In accordance with previous CMS guidance, every individual regardless of reason entering a long-term care facility (including residents, staff, visitors, outside healthcare workers, vendors, etc.) should be asked about COVID-19 symptoms and they must also have their temperature checked. An exception to this is Emergency Medical Service (EMS) workers responding to an urgent medical need. They do not have to be screened, as they are typically screened separately.
IDPH Releases General COVID-19 Testing Guidance
The Illinois Department of Public Health (IDPH) released general testing guidance this week. Anyone with COVID-19-like illness or symptoms can get a test, even without a doctor’s order.
 
Symptoms remain a cough, shortness of breath and fever and risk factors include:
  • Contact with someone confirmed to have COVID-19
  • A compromised immune system or a serious chronic medical condition
 
Testing is also available for those with or without symptoms who work in a health care facility. A list of testing sites can be found online on the State of Illinois Coronavirus webpage or the IDPH Coronavirus webpage
 
As LeadingAge Illinois reported last edition, testing at long term care facilities began rolling out this week. LeadingAge Illinois has continuously communicated with IDPH and with administration on testing. The State’s first efforts are going to focus on ‘clean’ facilities in hot spot areas, in an effort to prevent outbreaks from occurring in additional facilities.

These focused hot spot areas are reported to initially include facilities in Cook County and the suburban collar counties (i.e., DuPage, Kane, Lake & Will counties), though they will looking at other areas of the state where the numbers are beginning to climb (metro areas specifically). IDPH is testing residents and staff. We continue to seek additional details from IDPH and will keep members updated. 
Illinois Department on Aging Update
The Illinois Department on Aging (DoA) gave an update on their activities since the Governor declared a State Emergency due to the COVID-19 pandemic. Since March, the Department has sent 84 guidance documents to providers with another going out today. DoA gave an update during this morning’s Older Adult Services Advisory Committee (OASAC) and Illinois Coalition on Aging joint meeting.  Jason Speaks of LeadingAge Illinois, John Larson, CEO of Cantata Adult Life Services and Sherry Barter Hamlin, CEO of Voyage Senior Living , are appointed members of OASAC and attended today’s meeting.
 
Department updates included:
 
Adult Day:
  • Adult Day Services (ADS) Sites were closed as a precaution during this emergency. 
  • 399 congregate dining sites have been closed and moved to home-delivered meals.  
  • DoA has asked CMS for funding to continue to pay ADS providers during the closure. Providers are currently still being paid.
  • ADS providers are working remotely and supporting clients with meals, checking in via phone and making sure medications are being taken. 
  • 25 ADS sites were closed during a previous State Budget crisis and the Department does not want to see closures due to this emergency. 
 
Home Care:
  • DoA has increased in-home hours. 
  • DoA has loosened requirements for in-home workers during the emergency to make sure there are enough staff to care for seniors in the home and meet demands. 
  • Pre-service training requirements have been taken off at this time. Workers will still be required to get training, but not before services are provided during the emergency. 
  • DoA has ensured adequate Personal Protective Equipment (PPE) for home care workers through collaborating with the Illinois Emergency Management Agency (IEMA). Federal reimbursement for PPE is being sought. 
 
Federal Funding / Waivers:
  • CMS has allowed states to amend programs to give them more flexibility and funding as a result of COVID-19. 
  • In coordination with the Illinois Department of Healthcare and Family Services (HFS), an application was submitted to CMS for waivers. Many other states have applied as well. 
  • Federal funds coming from the Coronavirus Relief bills have been dispatched quickly by DoA. 
 
Volunteers:
  • The Department has connected 400 volunteers with seniors during the emergency. 
 
Home-Delivered Meals:
  • Over 45,000 meals per day are going out to seniors. 
  • Federal funding allowed the Department to utilize $8 million for services that include meals. 
 
Emergency Senior Services:
  • Department issued $7 mill to Case Coordination Units (CCUs) who are doing remote screenings, assessments and reassessments. 
Illinois Housing Development Authority Resources
The Illinois Housing Development Authority (IHDA) remains open with most staff working remotely from home. The IHDA has a resources page for housing providers. The page includes information on Multifamily Finance, Asset Management, Rental Assistance and more. 
Governor Pritzker Daily Press Conferences
Governor JB Pritzker is conducting daily press 2:30 p.m. conferences on COVID-19. Click here to listen daily.

On Thursday, the Governor announced that he is extending the state’s Stay at Home Order until May 30. The extension will be signed next week and include some modifications to the existing order. The Governor and medical experts who spoke at Thursday’s briefing stated that social distancing and the precautions taken in the original order have helped flatten the curve.  
 
As part of the new order language, individuals will be required to wear a face-covering or a mask when in a public place where they can’t maintain a six-foot social distance. This includes children age two and older, if they can medically tolerate a covering. 

The Illinois Department of Public Health (IDPH) will also be issuing guidance to surgical-centers and hospitals to allow for certain elective surgeries for non-life-threatening conditions, starting on May 1. Facilities will need to meet specific criteria, including proper PPE, ensuring enough overall space for COVID-19 patients remains available, and testing of elective surgery patients to ensure COVID-19 negative status.
 
Other items from Thursday’s briefing included:
 
Cases:
  • 1,826 new cases (36,934 cases total)
  • 123 new deaths (1,688 total)
  • 96/102 counties in the state have cases. 
 
Hospitalizations:
  • 4,877 in hospital with COVID-19 (1,268 in ICU/766 on ventilators).
  • August, 2019: Illinois averaged 26,000 available hospital beds.
  • Today: Over 31,000 hospital beds. Beds occupied by COVID patients have remained constant over the past week and not increased which is a positive. 
  • August, 2019: 2,000 ventilators.
  • Today: Over 3,200
 
Workforce:
  • Over 5,000 out-of-state and former healthcare workers have applied for temporary licenses to help combat COVID-19. 

Saturday's briefing will mention stories from seniors receiving services from the Illinois Department on Aging.
SIREN Notifications
To get the most up-to-date guidance from the State of Illinois, you can register to receive SIREN - State of Illinois Rapid Electronic Notifications .  SIREN provides regional, State and Federal partners with a comprehensive information sharing, collaboration, alerting and notification solution. If you have difficulties registering please contact SIREN .
Source: SIREN
FEDERAL
Next Round of Provider Relief Funds Begin April 24
HHS announced Wednesday that it will begin distributing the next round of CARES Act Provider Relief Funds and providers will begin seeing the new payments as early as today.  Click here to learn more. 
Another Relief Package Passes
The U.S. House overwhelmingly passed (388-5) the next Coronavirus relief package this week. The Senate had earlier unanimously passed the package. The Paycheck Protection Program and Health Care Enhancement Act is a $480 Billion interim funding package aimed at providing support to small businesses, hospitals and allowing for nationwide COVID-19 testing.
 
The package comes as about 80% of small businesses report they are in need of relief.
 
The Package includes:
  • $384 billion more for the Paycheck Protection Program (small business loans),
  • $75 billion in emergency relief for hospitals, and
  • $20 billion to ramp up testing. 
 
Figures were also released recently on the assistance funds from the U.S. Small Business Administration:
 
Paycheck Protection Program in Illinois as of April 16:
  • 69,893 approved loans
  • $15,972,578,071 total borrowed
 
SBA Emergency Injury Disaster Loan (EIDL) in Illinois as of April 19:
  • 793 approved loans
  • $168,341,900 total
 
Emergency Injury Disaster Loan Advances (EIDLA) in Illinois as of April 19:
  • 27,550 approved loans
  • $123,101,000 total
Affordable Housing Update
HUD held a call this week that included Vice President Mike Pence, HUD Secretary Ben Carson and Federal Housing Administrator Brian Montgomery.  LeadingAge was thanked for their advocacy during the call. You can hear more about the work of LeadingAge on HUD issues in the next LeadingAge Illinois HUD Member Call on May 13 at 12 p.m.
OTHER NEWS
New Resources Help Make Decisions about Provider Relief and Other Funds
The first   tool , a calculator developed by LeadingAge Wisconsin, allows providers to evaluate the array of available COVID-19 funds, determine their eligibility and estimated amounts their organization may receive under each. A separate  explainer   document outlines how to use the tool.

The second resource entitled,  “CARES ACT Provider Relief Fund Background, Considerations & Frequently Asked Questions”  assists providers in evaluating their acceptance of the terms and conditions for use of the recently received Provider Relief Funds. Members will recall that HHS requires providers to attest to the terms and conditions for these funds within 30 days of receipt which for many providers will be May 10.
 
These resources will be updated as additional information becomes available from HHS and as additional funds are made available through Congressional action.
Source: LeadingAge
Value First – Ideas to Honor Your Nurses
Our nursing and healthcare teams have been busy caring for everyone. May 6-12 is the week to show our nurses that we care about them. American Solutions for Business is a Value First/Vizient provider who has put together an offering to help you show them some love. Contact information and a few ideas from their many in stock items are listed here to place your orders. You do not need to be a Value First member to take advantage of this offer.
 
Please continue reaching out to Value First for the needs of your community. Also, visit the Value First Website or their resource page for up-to-date information for your community.
Contact: Terry Romin at 224.230.7365
Recognize Your Heroes
During this time of crisis, it is important that we recognize the heroes working in your organizations that are making a difference in the lives of residents. To all those on the front lines keeping Illinois seniors safe, LeadingAge Illinois says "Thank you"! Tag your staff or organization on our Facebook page here to say thank you or share your own post to the Facebook page .
LeadingAge Live Online Coronavirus Daily Member Update
Today – April 26 (7 days/week)
2:30 p.m. daily
Everyone must register again for this new series of live online updates. When you register, you will be automatically signed up for every update through April 26. After you register, you will receive an email confirmation with your unique weblink, which you can use every day. There will be no telephone option.
 
Also, if you’re a member of both LeadingAge Illinois and LeadingAge National, stay connected with other LeadingAge National Members and share information and resources through the MyLeadingAge Member Community: COVID-19 . This is a place to connect with your peers to share and discuss everyday practices related to the coronavirus. Take a moment now to log into your my.leadingage.org account and join the group to stay connected. LeadingAge also has a COVID-19 webpage with the latest updates, information and resources for members.
EDUCATION
Upcoming:
 
April 28, 2020 10:15 a.m.
 
April 30, 2020
10:15 a.m.
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