2019  Coronavirus Disease (COVID-19)

Long-term care facilities (LTCFs), including nursing homes, skilled nursing facilities, and assisted living facilities, provide care to some of the most vulnerable populations, including elderly people and those with chronic medical conditions. Resources below aim to provide interim guidance for the prevention and control of COVID-19 in LTCFs.

Fundamental elements for preparing to care for a resident suspected or confirmed to have COVID-19 include:

• Implement Universal Use of Facemasks for All Healthcare Personnel. CDC has determined that individuals can be infectious prior to the onset of symptoms and many LTCF residents are unable to adequately convey symptoms. Universal use of facemasks while in the facility could prevent transmission between HCP and residents.

  • IDPH SIREN: Interim Recommendations, Universal Masking and Enhanced Environmental Disinfection

  • CDC strategies for optimizing supply of facemasks

• Inventory Personal Protective Equipment. If COVID-19 cases are identified at the facility, contact/droplet precautions should be implemented for all residents. LTCF staff must be provided with the personal protective equipment (PPE) needed to keep themselves and the residents safe, including gloves, gowns, facemasks, and eye protection.

  • CMS 4/2/20 COVID-19 Long Term Care Facility Guidance

  • Donning and Doffing Instructions courtesy of King County, WA

  • PPE Burn Rate Calculator

• Review COVID-19 Transfer Guidance. Transfer of patients with COVID-19 from hospitals to long-term care facilities (LTCFs) should occur when patients are medically stable after acknowledgment of LTCF readiness to accept. LTCFs should not transfer patients with suspect or confirmed COVID-19 infection to hospitals unless medically indicated.

  • HAN Alert Updated 4/17/20: Transfer of Patients among Healthcare Facilities based on COVID-19 Status and Preparing to Receive COVID-19 Patients

• Restrict Visitors per Federal Guidelines. On March 13, 2020, the Centers for Medicare and Medicaid Services (CMS) released a memorandum directing all nursing homes to restrict visitors and non-essentail healthcare personnel, except when medically necessary. 

  • Template letter for family communication

• Reduce Internal Activities. Facilities should cancel large group activities (e.g., enrichment classes) and communal dining.

• Exclusion of Symptomatic Staff.  Screen healthcare workers for fever and respiratory symtoms at the begining of shift. If symptomatic, don a facemask and leave work place.

  • Healthcare Professional Work Restriction Guidance

• Cleaning and Disinfection. LTCFs should be cleaned and disinfected according to CDC guidance using hospital-grade disinfectants. The Environmental Protection Agency has provided a list of products to use against SARS-CoV-2.

  • Cleaning and Disinfection Guidelines: English | Spanish courtesy of King County, WA

• Rapid Identification and Management of Ill Residents. Actively monitor all residents for fever and respiratory symtoms. For Chicago facilities, notify CDPH of any cluster or residents with symptoms of respiratory infection.

  • Surveillance tracking template for residents and staff

  • Recommendations for monitoring of vitals and pulse oximetry

  • COVID-19 Report form

  • Facility Summary Report Form due to CDPH on Mondays and Thursdays

  • Cohorting Guidance

• Establish capacity to collect and submit specimens for COVID-19 testing. Facilities should secure ability to collect nasopharyngeal (NP) specimens and to ship specimens via courier. 

  • Video Link on NP specimen collection

  • Guidance for specimen collection

• Notification of Residents, Family and Staff. Facilities must notify residents, family and staff when COVID-19 cases are identified within the facility

  • Communicating about COVID-19 in Congregate Settings

COVID-19 Infection Control Facility Assessment:

• Complete the following infection prevention and control tool to identify critical resource elements

Guidance Documents for Long Term Care:

IDPH LTC guidance:  

• COVID-19 Infection Control Measures
• COVID-19 Checklist for Facilities

CDC LTC Guidance

• Preparing for COVID-19: Long Term Care Facilities and Nursing Homes

Resource Requests:

For urgent supply needs, such as PPE or staff, CDPH may be able to provide some stop gap support. Facilities should have sufficient PPE to implement contact/droplet precautions for all residents. To request, please please fill out a 213 Resource Request form and email to:

CDPHPHEOC@CITYOFCHICAGO.ORG

For staffing requests, indicate on the 213 resource request form:

• Number and skills of staff requested
• Shift
• Who will be facility POC for coordination

To request nasopharyngeal swabs from the IDPH Laboratory, please complete the online IDPH COVID-19 Nasopharyngeal Swab Request Form

The following short videos are ideal for staff viewing regarding different topics and COVID-19

• • Sparkling Surfaces - https://youtu.be/t7OH8ORr5Ig
  • Clean Hands - https://youtu.be/xmYMUly7qiE
  • Closely Monitor Residents - https://youtu.be/1ZbT1Njv6xA
  • Keep COVID-19 Out! https://youtu.be/7srwrF9MGdw
  • PPE Lessons - https://youtu.be/YYTATw9yav4