HR0298 102ND GENERAL ASSEMBLY

HR0298 LRB102 18474 LAW 26601 r

HOUSE RESOLUTION

WHEREAS, Illinois nursing homes have been severely impacted by COVID-19, with outbreaks causing high rates of infection, morbidity, and mortality; and

WHEREAS, Illinois' long-term care facilities have been ground zero in the fight against the COVID-19 pandemic, representing a shockingly high share of COVID-19 deaths; over 10,300 long-term care facility residents have died of COVID-19, while 78,400 nursing home residents have been confirmed COVID-19 positive and the numbers continue to rise; and

WHEREAS, The toll of separation and lack of physical contact on nursing residents has led to feelings of loneliness, abandonment, despair, and fear, and these feelings are only pushing the pandemic's death toll higher; and

WHEREAS, Isolation and loneliness are associated with a 50 percent increased risk of developing dementia, a 32 percent increased risk of stroke, a 29 percent increased risk of coronary heart disease, and a nearly fourfold increased risk of death among heart failure patients; and

WHEREAS, The updated visitation guidance by the Centers for Medicare & Medicaid Services (CMS), dated on March 10, 2021 and April 27, 2021, emphasized that facilities must allow end-of-life and compassionate care visits regardless of community positivity rates, an outbreak, or vaccination status, and any nursing home must facilitate in-person visitation consistent with applicable CMS regulations; and

WHEREAS, CMS guidance states a facility should not restrict visitation for all residents as long as there is evidence that the transmission of COVID-19 is contained to a single area (e.g. unit) of the facility; facilities should continue to adhere to CMS regulations and guidance for COVID-19 testing, including routine staff testing, testing of individuals with symptoms, and outbreak testing; and

WHEREAS, Nursing home residents must be able to exercise their right to in-person visitation; facilities must be held accountable for facilitating in-person visitation for nursing home residents and families when safe to do so in compliance with guidance by CMS and the Centers for Disease Control (CDC); and

WHEREAS, CMS guidance confirms nursing home residents are entitled to receive compassionate care visits, including but not limited to end of life visits, in accordance with CMS and CDC guidance; and

WHEREAS, CMS guidance states "compassionate care visits, and visits required under federal disability rights law, should be allowed at all times, regardless of a resident's vaccination status, the county's COVID-19 positivity rate, or an outbreak"; and

WHEREAS, CMS defines compassionate care visits to include, but not be limited to:

(a) end-of-life situations;

(b) a resident, who was living with their family before recently being admitted to a nursing home and is struggling with the change in environment and lack of physical family support;

(c) a resident who is grieving after a friend or family member recently passed away;

(d) a resident who needs cueing and encouragement with eating or drinking, previously provided by family and/or caregiver(s), and is experiencing weight loss or dehydration; and

(e) a resident who used to talk and interact with others and is experiencing emotional distress, seldom speaking, or crying more frequently (when the resident had rarely cried in the past); and

WHEREAS, In addition to family members, compassionate care visits can be conducted by any individual that can meet the resident's needs, such as clergy or lay persons offering religious and spiritual support; and

WHEREAS, The Illinois Department of Public Health guidance states essential caregivers meet an essential need for the resident by assisting with activities of daily living or positively influencing the behavior of the resident; the goal of such a designation is to help ensure high-risk residents continue to receive individualized, person-centered care; and

WHEREAS, The Illinois Department of Public Health states a facility should establish policies and procedures for how to designate and utilize essential caregivers that include visitation parameters and a process for communication with residents and families; and

WHEREAS, Illinois nursing home residents and their loved ones and family members continue to be wrongly denied access to in-person visitation, compassionate care, and end-of-life visits, as well as essential caregiver visitation based on facilities' purported but unsupported or unverifiable or undocumented assertions that visitation is denied because of something related to COVID-19; and

WHEREAS, Over a year into the COVID-19 pandemic, thousands of Illinois nursing home residents, their loved ones, and family members continue to be separated; the responsibility to attest and report the denial of end-of-life, compassionate care, and essential caregiver visitation remains the sole responsibility of impacted, vulnerable nursing home residents or their loved ones; and

WHEREAS, Family members and the loved ones of nursing home residents fear reporting the facility because their resident could be subjected to potential harm, neglect, or abuse; in abundance of fear, they do not contact state or federal nursing home regulators to report denied end-of-life, compassionate care, or essential caregiver visitation; therefore, be it

RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE ONE HUNDRED SECOND GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that we urge Illinois long-term care facilities to uphold and adhere to federal and state laws, rules, regulations, and guidance on a resident's standards of care, rights, protections, and inalienable right to be treated with respect, dignity, and quality care; and be it further

RESOLVED, That Illinois long-term care facilities shall be held fully accountable, be investigated, and subjected to remediation for failure to reinstate end-of-life, compassionate care, and essential caregiver visitation without adequate reasons related to clinical necessity or resident safety; and be it further

RESOLVED, That the Illinois Department of Public Health shall review whether a facility is in compliance with the federal and state law, regulations, rules, and guidance, and will work swiftly with the facility to quickly address any constraints when a long-term care facility claims barriers to reinstating end-of-life, compassionate care, and essential caregiver visitation; and be it further

RESOLVED, That we urge the Illinois Department of Public Health to continue listening to long-term care resident advocates, aging advocates, the Illinois Long-Term Care Ombudsman, and representatives from essential caregiver organizations to address the inequity of access to end-of-life, compassionate care, and essential caregiver visitation in Illinois.