Rule 15-16-1-49.20.2 - Tuberculosis (TB) Admission Requirements to Rule Out Active Tuberculosis (TB)
1. The following are to be performed and documented within 30 days prior to the client's admission to the "Licensed ICF-IID": a. TB signs and symptoms assessment by a licensed Physician, Physician's Assistant or a Licensed Nurse Practitioner, andb. A chest x-ray taken and a written interpretation.2. Admission to the ICF-IID shall be based on the results of the required tests as follows: a. Clients with an abnormal chest x-ray and/or signs and symptoms assessment shall have the first step of a two-step Mantoux tuberculin skin test (TST) placed and read by certified personnel OR an IGRA (blood test) drawn and results documented within 30 days prior to the patient's admission to the "Licensed ICF-IID". Evaluation for active TB shall be at the recommendation of the MSDH and shall be prior to admission. If TB is ruled out and the first step of the TST is negative, the second step of the two-step TST shall be completed and documented within 10-21 days of admission. TST administration and reading shall be done by certified personnel. If an IGRA (blood test) is done, TST (first and/or second step) is not done.b. Clients with a normal chest x-ray and no signs or symptoms of TB shall have a baseline IGRA test (blood test) OR a TST performed with the initial step of the two-step Mantoux TST placed on or within 30 days prior to the day of admission. IF TST is done, the second step shall be completed within 10-21 days of the first step. TST administration and reading shall be done by certified personnel. If an IGRA (blood test) is done, a TST is not done (first or second step).c. Clients with a significant TST OR positive IGRA (blood test) upon baseline testing or who have documented prior significant TST shall be monitored regularly for signs and symptoms of active TB (cough, sputum production, chest pain, fever, weight loss, or night sweats, especially if the symptoms have lasted longer than three weeks) and if these symptoms develop, shall have an evaluation for TB per the recommendations of the MSDH within 72 hours.d. Clients with a non significant TST or negative IGRA (blood test) upon baseline testing shall have an annual tuberculosis testing within thirty (30) days of the anniversary of their last test. Note: Once IGRA testing is used, IGRA testing should continue to be used rather than TST testing.e. Clients with a new significant TST or newly positive IGRA (blood test) on annual testing shall be evaluated for active TB by a nurse practitioner or physician or physician's assistant.f. Active or suspected Active TB Admission. If a client has or is suspected to have active TB, prior written approval for admission to the ICF-IID is required from the MSDH TB State Medical Consultant.g. Exceptions to TST/ IGRA requirement may be made if: i. Client has prior documentation of a significant TST/ positive IGRA.ii. Client has received or is receiving a MSDH approved treatment regimen for latent TB infection or for active TB disease.iii. Client is excluded by a licensed physician or nurse practitioner/physician assistant due to medical contraindications.15 Miss. Code. R. 16-1-49.20.2
Miss. Code Ann. § 43-11-13