April 28, 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
Personal Protective Equipment Possibly Headed to Nursing Homes—But We Demand More
Early news reports and LeadingAge’s Washington insiders say the federal government will finally respond to our ongoing demand to make Personal Protective Equipment (PPE) available to aging services providers across the country.
 
Packages containing an indeterminate supply of PPE may begin going out to nursing homes in early May. After repeated pleas from LeadingAge and thousands of advocates during LeadingAge’s National Day of Action for Aging Services, it’s heartening to hear that the government is taking action. More details will be shared as they become available.
 
This is good news for LeadingAge members like Cobble Hill Health Center in New York, which sent repeated appeals for equipment and support to their local Health Department, but still saw shortages so severe that staff resorted to trash bags as protection. ( Read media coverage of their story here ). Does this sound familiar? Please email LeadingAge’s media manager Lisa Sanders if you’re willing to share your story with the press in the fight for greater support for all members.
 
This forthcoming action from the federal government is welcome—but not nearly enough. LeadingAge continues to fight on the Hill and in the media for access and prioritization of PPE to the entire continuum of care, as well as access to testing and additional funding support.
 
PPE Burn Rate Calculator:
From the Illinois Department of Public Health (IDPH): Hospitals, Local Health Departments, Long Term Care Facilities , EMS and many others have been impacted by the shortage of PPE during the COVID-19 pandemic. It is important that all healthcare partners and any public or private organization using PPE know there is a tool available to estimate their PPE availability.
 
The Personal Protective Equipment (PPE) Burn Rate Calculator is a spreadsheet-based model that will help organizations plan and optimize the use of PPE for response to COVID-19.
 
Any organization that uses PPE can access the spreadsheet via the CDC website and download the burn rate calculator here .
 
Once the calculator is downloaded, there will be three tabs: calculator, graph, and instructions. The instructions include how to enter the information. This information is also on the spreadsheet where the data is entered.
 
To use the calculator, enter the number of full boxes of each type of PPE in stock (gowns, gloves, surgical masks, respirators, and face shields, for example) and the total number of patients at your facility. The tool will calculate the average consumption rate, also referred to as a “burn rate,” for each type of PPE entered in the spreadsheet. This information can then be used to estimate how long the remaining supply of PPE will last, based on the average consumption rate. Using the calculator can help facilities make order projections for future needs.
 
PPE Resources:
 
Face Coverings, Sanitizers, Gloves, Contactless Thermometers:
1.800-401.6000
 
Masks, Sanitizers, Face Shields, Wipes, Gloves:
Steve Strauss
5654 N. Elston Ave.
Chicago, IL 60646 USA
Phone: 773.774.8282 
Fax: 773.774.8290
Toll Free: 888.774.8282
 
Faceshields:
Chicago Print Group
Ryan Walsh
708.846.5677
 
Value First – Disposable Gowns – Open to ALL LeadingAge Members:
Value First has been looking for viable suppliers that can meet ALL LeadingAge member PPE needs and believe they have found a good option for disposable gowns. Over the last three weeks, Jostens has converted their manufacturing facilities in South Carolina and Mexico from producing graduation gowns to healthcare gowns. Click here for more detailed information and here for the spec sheets.
 
Please continue reaching out to Terry Romin at 224.230.7365 for the needs of your community. Also, visit the Value First Website or their resource page for up-to-date information for your community.
LeadingAge Illinois to Offer Testimony Before the Bi-Partisan Legislative Medicaid Work Group
The Bi-Partisan Legislative Medicaid Working Group will reconvene on Thursday, April 30 at 1:00 p.m. via conference call. The working group would like to hear from the long term care (LTC) associations and developmental disability providers regarding any priorities for LTC and other facilities in providing services to the States elder and vulnerable populations during the COVID-19 pandemic. 
 
This will include any concerns during the pandemic, legislative changes needed or funding requests that the various health care settings are seeking for relief during the COVID outbreak. LeadingAge Illinois will be offering testimony during this two-hour legislative hearing to express many of our most urgent priorities which include:
 
  • Funding. For increased costs associated with PPE, testing and staff retention, which have increased significantly across the state. The funding increases we are looking at will be for SNF, Assisted Living and Supportive Living.

  • Testing. The Governor and IDPH are beginning to increase testing in LTC Facilities. However, there continues to be conflicting and confusing guidance from IDPH on the overall process and procedures.

  • Executive Order Expiration/Regulatory Relief. We will be working with the Illinois General Assembly to urge that many of the issues be extended beyond when the Executive Orders expire as COVID infections and issues will likely exist in long term care well past the removal of the emergency declaration. That is why we are testifying before the Medicaid Work Group, because most of these decisions on continued regulatory relief will be in the hands of the legislature after the declaration is expired.

  • Liability Relief. The Governor’s office provided civil liability relief for “health care facilities” in his Executive Order on April 1, 2020. However, the order did not include Assisted Living establishments, Life Care Communities and Supportive Living Programs, which are congregate living facilities that face the same challenges, the same risks and are expected to follow the same protocols as other health care facilities. We will be urging the Medicaid Work Group and the legislature to include these three additional settings under the civil liability relief Executive Order.

  • IDPH Communication. We strongly feel IDPH has not been expeditious in their responses to the profession, nor have they been proactive in coordinating a strategy for COVID prevention and treatment in long term care settings. In a time where cases and protocols are changing rapidly, sometimes daily, the profession needs quick and clear guidance for the state regulatory agency without lengthy delays.
Start Using RESIDE Admissions Software in 3 Simple Steps
The admissions process has always been challenging for facilities to manage and overly complicated for residents and families to complete. Before COVID-19, more than 90% of all long-term care facilities still used an outdated paper admissions process. RESIDE’s platform provides an unparalleled, revolutionary antidote to an age-old problem. The transition from your paper process to RESIDE is easy and can be done in three simple steps. Request a demo.
 
Holly Kasnetz is the VP of Strategy and Implementation at RESIDE Admissions.
STATE
COVID-19 Control Measures for Long Term Care Interim Guidance
On April 20, the Illinois Department of Public Health (IDPH) made updates to monitoring (VS and pulse oximetry), reevaluating DNR status, and return to work for Health Care Personnel (HCP) information .
 
Residents:
All residents should be screened for symptoms AND temperature, heart rate, respirations (Vital signs) AND pulse oximetry every 8 hours (Q8 hours). Blood pressure may be taken once a day.
 
NOTE: Contact 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%. The clinical supervisor should alert the provider to strongly consider transfer to a higher level of care. Monitoring every 4 hours is appropriate for patients with evidence of clinical deterioration.
 
If patients have been screened and their testing is POSITIVE for COVID-19 OR if patients have signs/symptoms of a respiratory viral infection: Obtain Vitals (temperature, heart rate, respirations) AND pulse oximetry every 4 hours (Q4hours) {twice a shift}. Blood pressure can be taken every 8 hours.
 
Updated Employee Monitoring Tool includes additional symptoms added.
IDPH Adopts Emergency Rules Change on Health Care Worker Background Checks
The Illinois Department of Public Health (IDPH) recently adopted an emergency rule change to the Health Care Worker Background Check Code, effective April 10 for a maximum of 150 days. The change extends the timeframe for healthcare employees, students or applicants to have their fingerprints collected by a livescan vendor from 10 working days to 30 working days after signing an authorization and disclosure form allowing IDPH to perform a criminal background check.
SLP Notice of Involuntary Discharge Information
During the COVID-19 emergency, the Fair Hearings staff of the Illinois Department of Healthcare and Family Services (HFS) are prioritizing immediate discharge appeal hearings. To assist with this process, Supportive Living providers will need to include specific information regarding the reason for immediate discharges. 
 
The “Reason” section of the HFS 3731 Notice of Involuntary Discharge form should provide information that explains the reason for an immediate discharge. For example, instead of stating, “resident is a danger to others,” the provider should include as much specific information as possible to further describe any incidents or provide further details explaining why the immediate discharge is necessary. This would include things such as, “resident physically assaulted another resident” with additional detail or explanation, or “resident attempted suicide,” or “resident has been continually non-compliant with Executive Order #10 (the stay at home order) by going out for non-essential activities and refusing to self-quarantine despite education by staff.” 
 
Additional detail beyond these examples that describe the reasons for the immediate discharge is strongly advised, particularly if the individual poses a direct threat to the health and safety of staff or other residents (or an immediate and severe risk to property).   
 
Also, on the fax coversheet submitted to Sara Reardon at HFS, the Department asks providers to identify the resident’s location or where they will be going (ex: remaining in the building, hospital, nursing facility, family or unknown). If unknown, you are asked to provide a copy of the relocation information that was provided to the resident or their designated representative. 
 
Finally, while immediate discharge appeal hearings are now the priority, it would also be helpful to include additional detail in 30-day discharge notices. 
MCO Provider Resolution Process
The Illinois Department of Healthcare and Family Services (HFS) recently issued a notice to providers on the MCO Provider Resolution Process. It is third in a series of notices regarding the implementation of the new provider MCO resolution portal.
Considerations for Healthcare Providers in Healthcare Settings
The Illinois Department of Public Health (IDPH) recently released considerations for healthcare providers in any healthcare settings.
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.

Yesterday’s update included:
 
Cases:
  • 1,980 new cases (45,883 total)
  • 50 new deaths (1,983 total in 42 counties)
 
Testing:
  • 227,628 tests run
  • 12,676 on April 27
 
Hospitalizations:
Patients in hospital with COVID-19 or Assumed to Have COVID-19:
  • April 6: 3,680
  • April 10: 4,020
  • April 14: 4,283
  • April 19: 4,599
  • April 27: 4,672 (net increase of 73 in one week)
 
COVID Occupied ICU Beds:
  • April 6: 43% of 2,700
  • April 10: 40% of 2,900
  • April 14: 40% of 3,000
  • April 19: 40% of 3,100
  • April 27: 34% of 3,600
 
Ventilators:
Number of hospitalized COVID-19 patients in hospital on ventilators:
  • April 10: 27%
  • April 14: 25%
  • April 27: Of the current 4,672 in hospital with COVID-19/assumed to have COVID-19, 763 are on ventilators (23% of total ventilator inventory in use by COVID-19 patients). This is the same as April 19. It is a downward trend from 29% on April 6.
 
New COVID-19 Symptoms:
CDC added 6 new symptoms last week:
  • Chills
  • Repeated shaking with chills
  • Muscle pain
  • Headache
  • Sore throat
  • Loss or taste or smell
 
The initial three symptoms of COVID-19 were fever, cough and difficulty breathing. A fourth symptom was added later as shortness of breath.
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
CMS Freezes Health Inspection Rating and Issues FAQs
LeadingAge has a detailed analysis of the April 24 CMS memo and FAQ. Among many other topics, CMS provided a framework for making decisions about visiting healthcare workers and essential personnel. The framework requires nursing home staff to ask three questions:
  • What are the resident’s needs?;
  • What services are necessary to meet those needs?; and
  • Who are the individuals who can meet those needs?
 
While it is good to have the framework articulated so clearly, LeadingAge cautions that it should not result in restrictions of critical and necessary services.
More SBA Funding
Late last week, another $310 billion was appropriated for the Paycheck Protection Program and $10 billion for the Economic Disaster Injury Loan $10,000 advance program. The same eligibility criteria apply- for members; that means 501(c) not for profit organizations with 500 or fewer employees, subject to affiliation rules including those applying to ownership and management. Organizations with more employees than the 500 limit are still ineligible for both PPP and the EIDL.
 
For PPP, there was so much demand from the first round, and applicants who didn’t get funds, that it’s likely that almost all of the new money will go to loans for those who already applied. There are an estimated three million applications outstanding, and the first round provided about 1.6 million loans. Members who applied last time should check their application status ASAP.
OTHER NEWS
New Resources on Advance Care Planning
Click here for an excellent guide to resources for advance care planning . The list was curated and annotated so LeadingAge members can find the resources right away. This resource guide will be useful to providers all across the continuum. It includes conversation guides, information about POLST, and a “trusted decision maker form” – recognizing that many people cannot access a notary, witness, or even a printer, during the COVID crisis.
Housing Calls
Be sure to take part in these upcoming calls for housing members:
 
LeadingAge Housing Advisory Group:
May 4
11:30 a.m.
 
LeadingAge Illinois Monthly HUD Member Call:
May 13
12 p.m.
RSVP to Jason Speaks
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
LeadingAge is hosting daily live online updates each weekday afternoon. Subscribe to "LeadingAge Need to Know" via communications preferences in your MyLeadingAge account to receive email updates. Register for live online updates 5 days/week at 2:30 p.m. through May. You can find an archive of all member updates here

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 30, 2020
10:15 a.m.
Sponsored by: