Rule 15-16-1-48.11.7 - Employee Testing for Tuberculosis1. Each employee, upon employment by a licensed entity and prior to contact with any resident, shall be evaluated for tuberculosis by one (1) of the following methods: A. IGRA (blood test) and an evaluation of the employee for signs and symptoms of TB by a licensed physician, physician's assistant, nurse practitioner, or registered nurse; orB. A two-step TST administered and read by certified personnel and an evaluation of the employee for signs and symptoms of TB by a licensed physician, physician's assistant, nurse practitioner or registered nurse.2. The IGRA/Mantoux testing and the evaluation of signs and symptoms may be administered on the date of hire, or administered/read no more than 30 days prior to the employee's date of hire; however, the employee must not be allowed contact with a resident, or work in areas of the facility where residents have access until receipt of the results of the IGRA/assessment or at least the first of the two-step TST has been administered/read and assessment for signs and symptoms completed.3. If the TST is administered, results must be documented in millimeters. Documentation of the IGRA/TST results and assessment must be documented in accordance with accepted standards of medical/nursing practice and must be placed in the employee's personnel file no later than seven (7) days of the employee's date of employment. If an IGRA is performed, results and quantitative values must be documented.4. Any employee noted to have a newly positive IGRA, a newly positive TST or signs and symptoms indicative of TB that last longer than three (3) weeks (regardless of the size of the TST or results of the IGRA), shall have a chest x-ray and be evaluated for active TB by a licensed physician within 72 hours. The employee shall not be allowed to work in any area where residents have routine access until evaluated by a licensed physician, physician's assistant, or nurse practitioner and approved to return to work. Exceptions to this requirement may be made if the employee is asymptomatic; andA. The employee is currently receiving or can provide documentation of having received a course of TB prophylactic therapy approved by the MSDH TB Program for; orB. The employee is currently receiving or can provide documentation of having received a course of multi-drug chemotherapy approved by the MSDH TB Program; orC. The employee has a documented previous significant TST reaction or IGRA reaction.5. For employees noted to have a previous positive to either TST or the IGRA, annual re-evaluation for the signs and symptoms must be conducted and must be maintained as part of the employee's annual health screening. A follow-up annual chest x-ray is NOT required unless symptoms of active TB develop.6. If using the Mantoux method, employees with a negative TST and a negative signs and symptoms assessment shall have the second step of the two-step TST performed and documented in the employee's personnel record within 14 days of employment.7. The IGRA or the two-step protocol is to be used for each employee who has not been previously skin tested and/or for whom a negative test cannot be documented within the past 12 months. If the employer has documentation that the employee has had a negative TST within the past 12 months, a single test performed 30 days prior to employment or immediately upon hire will fulfill the two-step requirements. As above, the employee shall not have contact with residents or be allowed to work in areas of the facility to which residents have routine access prior to reading the skin test, completing a signs and symptoms assessment, and documenting the results and findings.8. Facilities shall comply with recommendations from the Centers for Disease Control and/or the MSDH regarding baseline employee TB testing and annual employee TB education. Employees exposed to an active infectious case of TB shall be treated as contacts and be managed appropriately. Employees found to have a significant TST reaction and a chest x-ray not suggestive of active TB, shall be evaluated by a licensed physician, physician's assistant, or nurse practitioner for treatment of latent tuberculin infection.9. All employees should receive TB education annually. TB education should include information on TB risk factors, signs and symptoms of TB disease, and TB infection control policies and procedures.10. The facility should keep documentation of such education and update annually.15 Miss. Code. R. 16-1-48.11.7
Miss. Code Ann. § 43-11-13