Tip: Tuberculosis Testing?
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We recently received a question regarding tuberculosis (TB) testing in California assisted living and residential care facilities, so we thought we would review the requirements with you.
Residents
California DSS/CCL regulations (RCFE – 87458, ARF – 80069) require that residents have a TB test as part of the initial medical assessment prior to admission. Residents with active communicable tuberculosis are of course prohibited from residing in the facility.
Staff
Staff must also be screened for tuberculosis. RCFE (elderly residents) regulation 87411 requires the screening be completed “not more than six months prior to or seven days after employment.” General Regulation (adult and group home residents) 80065 requires the testing be completed “not more than one year prior to or seven days after employment or licensure.”
Cal/OSHA
You should also be aware that Cal/OSHA standards require that increased-risk environments, such as our facilities, perform regular TB testing of employees in accordance with CDC recommendations. Specifically, the CDC Interim Tuberculosis Control Enforcement Guidelines state: “In general, all employees in increased-risk environments must receive PPD testing at least annually. In the healthcare industry, where exposure potential is particularly high, the required testing frequency can be more frequent, depending upon the degree of risk of transmission of TB in the specific workplace for the category of work being performed.”
This tip was provided by Advanced Healthcare Studies – your source for operational and training products and services.
Sincerely,
Josh Allen, RN
Advanced Healthcare Studies, LLC
Once a healthcare worker has received their two-step PPD do subsequent tests need to be tow-step also?
What options are there for an elderly person who needs dementia care/housing if they have been diagnosed with a positive TB test?
How far in advance of admission to an RCFE can a new resident have a Tb test &/or CXR & still be valid per regs?
I thought it was 6mos for both, but there is some question on it. Thanks
Hello Terri. According to regulation 87458 the physician report (including TB test) must be made within the last year prior to admission.
How often do caregivers working in a RCFE need to be re-tested for TB?:
If a resident has been resided in your facility for a year and has already gotten a negative TB test, then gets on hospice care… do they need an updated TB test yearly?
How often do TB test need to be updated in an RCFE?
In ref to TB test for volunteers, if a person is volunteering time to the facility,i.e.comes in to play the piano or other instrument for a short period of time, reads a story, calls Bingo, gives a church service, are they required to submit to a TB test? These volunteers come on a weekly basis but are supervised and have no other interaction with the residents Some are piano students accompanied by a parent. Others give a chair exercise class.
I am new at this administration role but I cannot find anything in Title 22 that says Caregivers/Nurses have to be retested once they are hired. As a nurse, I would say that if someone were exposed to someone with active TB that that would warrant periodic testing for a period.
TB is a reportable disease to the County Health department (619-515-6770) so I believe the physician there would guide you in treatment of staff member and or patient. Most people who develop active TB need to be hospitalzed for a period of time to be diagnosed and started on the antibiotics. I do not remember how long you must be on the TB drugs but in the “old days” a person needed to have a negative sputum test for AFB (acid fast bacillus)
Aidah… RCFE regulations do not require the resident’s TB test be repeated unless the resident’s physician determines otherwise.
Bill… no, the volunteer you describe would not require a TB test. Regulation 87411 states: “A signed statement shall be obtained from each volunteer affirming that he/she is in good health.”
Kathleen… whether or not to repeat TB testing of employees is a tricky one in California. RCFE regulations do not require it, but the California Aerosol Transmissible Diseases (ATD) standard does in some situations. I have heard conflicting reports about whether the ATD regulations apply to an RCFE. CALA recently stated that in their interpretation it does not. You can review the ATD regulations here: http://www.dir.ca.gov/title8/5199.html
Can someone please give me a list of In services that are needed for staff yearly for an RCFE? Thank you so much! hope you all had a wonderful new year.
Aidah… this blog post should help you with that:
http://www.careandcompliance.com/blog/continuing-education/tuesday-tip-annual-inservice-training-requirements_12-16-2008/
On admission to an RCFE can a negative TB results from 8 months prior be used? Or would one have to have been given within the last 6 months?