Illinois General Assembly - Full Text of HR0298
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Full Text of HR0298  102nd General Assembly




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2    WHEREAS, Illinois nursing homes have been severely
3impacted by COVID-19, with outbreaks causing high rates of
4infection, morbidity, and mortality; and
5    WHEREAS, Illinois' long-term care facilities have been
6ground zero in the fight against the COVID-19 pandemic,
7representing a shockingly high share of COVID-19 deaths; over
810,300 long-term care facility residents have died of
9COVID-19, while 78,400 nursing home residents have been
10confirmed COVID-19 positive and the numbers continue to rise;
12    WHEREAS, The toll of separation and lack of physical
13contact on nursing residents has led to feelings of
14loneliness, abandonment, despair, and fear, and these feelings
15are only pushing the pandemic's death toll higher; and
16    WHEREAS, Isolation and loneliness are associated with a 50
17percent increased risk of developing dementia, a 32 percent
18increased risk of stroke, a 29 percent increased risk of
19coronary heart disease, and a nearly fourfold increased risk
20of death among heart failure patients; and
21    WHEREAS, The updated visitation guidance by the Centers



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1for Medicare & Medicaid Services (CMS), dated on March 10,
22021 and April 27, 2021, emphasized that facilities must allow
3end-of-life and compassionate care visits regardless of
4community positivity rates, an outbreak, or vaccination
5status, and any nursing home must facilitate in-person
6visitation consistent with applicable CMS regulations; and
7    WHEREAS, CMS guidance states a facility should not
8restrict visitation for all residents as long as there is
9evidence that the transmission of COVID-19 is contained to a
10single area (e.g. unit) of the facility; facilities should
11continue to adhere to CMS regulations and guidance for
12COVID-19 testing, including routine staff testing, testing of
13individuals with symptoms, and outbreak testing; and
14    WHEREAS, Nursing home residents must be able to exercise
15their right to in-person visitation; facilities must be held
16accountable for facilitating in-person visitation for nursing
17home residents and families when safe to do so in compliance
18with guidance by CMS and the Centers for Disease Control
19(CDC); and
20    WHEREAS, CMS guidance confirms nursing home residents are
21entitled to receive compassionate care visits, including but
22not limited to end of life visits, in accordance with CMS and
23CDC guidance; and



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1    WHEREAS, CMS guidance states "compassionate care visits,
2and visits required under federal disability rights law,
3should be allowed at all times, regardless of a resident's
4vaccination status, the county's COVID-19 positivity rate, or
5an outbreak"; and
6    WHEREAS, CMS defines compassionate care visits to include,
7but not be limited to:
8        (a) end-of-life situations;
9        (b) a resident, who was living with their family
10    before recently being admitted to a nursing home and is
11    struggling with the change in environment and lack of
12    physical family support;
13        (c) a resident who is grieving after a friend or
14    family member recently passed away;
15        (d) a resident who needs cueing and encouragement with
16    eating or drinking, previously provided by family and/or
17    caregiver(s), and is experiencing weight loss or
18    dehydration; and
19        (e) a resident who used to talk and interact with



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1    others and is experiencing emotional distress, seldom
2    speaking, or crying more frequently (when the resident had
3    rarely cried in the past); and
4    WHEREAS, In addition to family members, compassionate care
5visits can be conducted by any individual that can meet the
6resident's needs, such as clergy or lay persons offering
7religious and spiritual support; and
8    WHEREAS, The Illinois Department of Public Health guidance
9states essential caregivers meet an essential need for the
10resident by assisting with activities of daily living or
11positively influencing the behavior of the resident; the goal
12of such a designation is to help ensure high-risk residents
13continue to receive individualized, person-centered care; and
14    WHEREAS, The Illinois Department of Public Health states a
15facility should establish policies and procedures for how to
16designate and utilize essential caregivers that include
17visitation parameters and a process for communication with
18residents and families; and
19    WHEREAS, Illinois nursing home residents and their loved
20ones and family members continue to be wrongly denied access
21to in-person visitation, compassionate care, and end-of-life
22visits, as well as essential caregiver visitation based on



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1facilities' purported but unsupported or unverifiable or
2undocumented assertions that visitation is denied because of
3something related to COVID-19; and
4    WHEREAS, Over a year into the COVID-19 pandemic, thousands
5of Illinois nursing home residents, their loved ones, and
6family members continue to be separated; the responsibility to
7attest and report the denial of end-of-life, compassionate
8care, and essential caregiver visitation remains the sole
9responsibility of impacted, vulnerable nursing home residents
10or their loved ones; and
11    WHEREAS, Family members and the loved ones of nursing home
12residents fear reporting the facility because their resident
13could be subjected to potential harm, neglect, or abuse; in
14abundance of fear, they do not contact state or federal
15nursing home regulators to report denied end-of-life,
16compassionate care, or essential caregiver visitation;
17therefore, be it
20we urge Illinois long-term care facilities to uphold and
21adhere to federal and state laws, rules, regulations, and
22guidance on a resident's standards of care, rights,
23protections, and inalienable right to be treated with respect,



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1dignity, and quality care; and be it further
2    RESOLVED, That Illinois long-term care facilities shall be
3held fully accountable, be investigated, and subjected to
4remediation for failure to reinstate end-of-life,
5compassionate care, and essential caregiver visitation without
6adequate reasons related to clinical necessity or resident
7safety; and be it further
8    RESOLVED, That the Illinois Department of Public Health
9shall review whether a facility is in compliance with the
10federal and state law, regulations, rules, and guidance, and
11will work swiftly with the facility to quickly address any
12constraints when a long-term care facility claims barriers to
13reinstating end-of-life, compassionate care, and essential
14caregiver visitation; and be it further
15    RESOLVED, That we urge the Illinois Department of Public
16Health to continue listening to long-term care resident
17advocates, aging advocates, the Illinois Long-Term Care
18Ombudsman, and representatives from essential caregiver
19organizations to address the inequity of access to
20end-of-life, compassionate care, and essential caregiver
21visitation in Illinois.