N.J. Admin. Code § 8:43A-3.7

Current through Register Vol. 56, No. 9, May 6, 2024

Section 8:43A-3.7 - Employee health

(a) The policy and procedures manual of the facility shall include policies and procedures to ensure that physical examinations of employees are performed upon employment and subsequently and shall specify the circumstances under which other persons providing direct patient care services shall receive a physical examination and the content and the frequency of the examinations for employees and other persons providing direct patient care services.

(b) Each employee who cannot document the result of a previous rubella screening test shall be given a rubella screening test using the rubella hemagglutination inhibition test or other rubella screening test approved by the Department. Each new employee who cannot document the result of a previous rubella screening test shall be given the rubella screening test upon employment. An employee who can document seropositivity from a previous rubella screening test or who can document inoculation with rubella vaccine shall not be required to have a rubella screening test.

1. Each employee tested shall be informed in writing by the facility of the results of his or her rubella screening test.

2. Each employee's personnel record shall contain documentation of all tests performed and the results.

3. A list shall be maintained of all employees who are seronegative and unvaccinated, to be used in the event that an employee is exposed to rubella and a determination is needed as to whether or not the employee may continue to work.

(c) Each employee born in 1957 or later shall be given a measles (rubeola) screening test using the hemagglutination inhibition test, or other rubeola screening test, within six months of the effective date of this chapter. Each new employee born in 1957 or later shall be given a measles (rubeola) screening test upon employment. An employee who can document receipt of a live measles vaccine on or after the first birthday, physician-diagnosed measles, or serologic evidence of immunity shall not be required to have a measles (rubeola) screening test.

1. Each employee tested shall be informed in writing by the facility of the results of his or her measles (rubeola) screening test.

2. Each employee's personnel record shall contain documentation of all tests performed and the results.

3. A list shall be maintained of all employees who are seronegative and unvaccinated.

(d) The facility shall establish policies and procedures for the detection and control of the transmission of Mycobacterium tuberculosis that include, but are not limited to, developing a Tuberculosis Exposure Control Plan (TB plan), according to the guidelines set forth in "Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005," incorporated herein by reference, as amended and supplemented, published in the Morbidity and Mortality Weekly Report, at MMWR 2005; 54 (No. RR-17) (December 30, 2005) published by the Coordinating Center for Health Information and Service, available at http://www.cdc.gov/mmwr/PDF/rr/rr5417.pdf and at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5417a1.htm, pursuant to the Occupational Safety and Health Act of 1970 Public Law 91-596, incorporated herein by reference, as amended and supplemented.

1. For newly hired employees, the facility shall establish policies and procedures that will identify a new employee's baseline status of exposure to Mycobacterium tuberculosis and upon employment, the facility shall administer a two-step Mantoux tuberculin skin test, using five tuberculin units of purified protein derivative, to all employees.

i. The licensee shall administer a second Mantoux test in one to three weeks after the first Mantoux test to employees with a "negative" (less than 10 millimeters of induration or less than five millimeters of induration if the individual is immunosuppressed) result following the first Mantoux skin test.

ii. The licensee shall refer employees with a "positive" (greater than or equal to 10 millimeters of induration or greater than or equal to five millimeters of induration if the individual is immunosuppressed) result following either the first or second test for a medical evaluation to determine whether there is evidence of latent tuberculosis infection or active tuberculosis disease, which medical evaluation shall include, but not be limited to, a chest X-ray.

(1) The facility shall permit employees with positive Mantoux test results to begin working after the employee has submitted written medical clearance to the facility.

iii.

(d)1i and ii above are subject to the following exceptions:

(1) Employees who provide documentation of negative results of a single Mantoux skin test performed within the 12 months preceding the start of employment shall receive only one Mantoux skin test upon hire.

(2) Employees with prior documentation of negative results of two Mantoux skin tests performed within 12 months of preceding start of employment, and without signs and symptoms of active tuberculosis, shall not be required to be tested upon hire; however, a Mantoux skin test shall be required within 12 months of the last tuberculin skin test.

(3) Employees who provide documentation of positive Mantoux skin test results shall be exempt from screening.

(4) Employees who provide documentation of having received and completed appropriate medical treatment for active tuberculosis disease or latent tuberculosis infection shall be exempt from screening.

2. The facility shall establish policies and procedures for the periodic screening of employees for Mycobacterium tuberculosis that contain at least the following requirements:

i. The facility shall administer a Mantoux skin test to all tuberculin-negative employees at least annually;

ii. The frequency of testing shall be determined by the level of risk assigned by the facility's TB plan; and

iii. The facility shall maintain records of the results of employee Mantoux tuberculin testing.

3. Questions regarding tuberculosis control may be directed to the Tuberculosis Control Program.

(e) The policy and procedure manual of the facility shall address employee safety and shall include procedures for the care of employees who become ill at the facility or who are injured at the facility.

N.J. Admin. Code § 8:43A-3.7

Amended by R.2004 d.299, effective 8/2/2004.
See: 35 N.J.R. 2838(a), 36 N.J.R. 3529(a).
Rewrote (d).
Amended by R.2008 d.24, effective 1/22/2008.
See: 39 N.J.R. 2309(a), 40 N.J.R. 702(a).
In (a), substituted "and" for ". Policies and procedures" following "subsequently" and "and" for ". Policies and procedures shall specify" following "examination", and inserted "for employees and other persons providing direct patient care services"; and rewrote (d).

Amended by 53 N.J.R. 703(a), effective 5/3/2021