Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 1
Subtitle 07 - HOSPITALS
Chapter 10.07.10 - Home Health Agencies
Section 10.07.10.15 - Tuberculosis Screening
Universal Citation: MD Code Reg 10.07.10.15
Current through Register Vol. 51, No. 19, September 20, 2024
A. Certification of paid and unpaid personnel under Regulation.09E shall occur not later than 10 days after the beginning of service. Certification shall be accomplished in one of the following four ways as specified in §A(1)-(4), of this regultion:
(1) If the individual has
documentation of a negative tuberculin test by the Mantoux method within the
past 24 months and has, by history, no contact with a person with tuberculosis
in a communicable form following this documentation or no symptoms consistent
with tuberculosis, the individual shall be considered to be a negative
tuberculin reactor and to be free from tuberculosis in a communicable form.
Further skin testing is not necessary, except for epidemiologic diagnostic
purposes which may be required by the local health officer or the
Department.
(2) If the individual
does not have documentation of a negative tuberculin test by the Mantoux method
within the past 24 months and does not have a history of having had a positive
tuberculin test by the Mantoux method, the following procedure shall be done:
(a) Five tuberculin units (TU) of purified
protein derivative (PPD) shall be administered intradermally and the results
read 48-72 hours following the administration of the test;
(b) An individual with induration of 5-9
millimeters and no history of contact with a person with tuberculosis in a
communicable form or an individual with induration of 0-4 millimeters shall be
considered to be a negative tuberculin reactor and to be free from tuberculosis
in a communicable form;
(c) An
individual with induration of 5-9 millimeters and a history of contact with a
person with tuberculosis in a communicable form or an individual with
induration of 10 millimeters or more shall be considered to be a positive
tuberculin reactor and shall be handled as described in §A(3)(a)-(c), of
this regulation.
(3) If
the individual is a positive tuberculin reactor as defined in §A(2)(c), of
this regulation, or if the individual has a history of a positive tuberculin
test by the Mantoux method without documentation of having received an adequate
course of therapy, as defined by the local health officer, for tuberculosis
disease or received adequate prophylaxis, as defined by the local health
officer, for tuberculosis infection, the following procedure shall be done:
(a) If the individual does not have
documentation of a negative chest X-ray within the past 12 months, the
individual shall be evaluated by a chest X-ray. If the chest X-ray is negative,
the individual shall be considered to be free from tuberculosis in a
communicable form and shall have a repeat chest X-ray in 12 months, unless
isoniazid therapy is instituted, in which case the second chest X-ray is
unnecessary.
(b) If the individual
has documentation of a negative chest X-ray within the past 12 months, the
individual shall be considered to be free from tuberculosis in a communicable
form and shall have a repeat chest X-ray 12 months after the individual's most
recent documented chest X-ray unless isoniazid therapy has been instituted, in
which case the second chest X-ray is unnecessary.
(c) If the individual has had two successive
negative chest X-rays 12 months apart, no further chest X-rays are necessary
and the individual shall be considered to be free from tuberculosis in a
communicable form unless the individual has symptoms consistent with
tuberculosis.
(4) If the
individual has documentation of an adequate course of therapy, approved by the
local health officer, for tuberculosis disease or adequate prophylaxis,
approved by the local health officer, for tuberculosis infection, further chest
X-rays are not necessary and the individual shall be considered to be free from
tuberculosis in a communicable form unless the individual has symptoms
consistent with tuberculosis.
B. The agency shall instruct each employee and volunteer in the signs and symptoms of active tuberculosis and advise the individual to seek immediate medical care should the individual detect these signs or symptoms.
C. If the individual meets any of the following criteria in this section, the agency shall have written policies and procedures, acceptable to the Department, for the evaluation, management, and surveillance of this individual. The criteria include:
(1) A history of tuberculosis or
tuberculosis infection without documentation of adequate treatment as defined
and determined by the local health officer;
(2) Current treatment for tuberculosis
disease or tuberculosis infection;
(3) Chest X-rays consistent with tuberculosis
without documentation of adequate treatment as defined and determined by the
local health officer; or
(4)
Symptoms consistent with tuberculosis or a history of contact with a person
with tuberculosis in a communicable form within the past 12 months.
D. The following records shall be maintained by the agency:
(1) Results of
Mantoux tests, recorded in millimeters of induration with dates of
administration, dates of reading, and results of tests;
(2) Results of X-rays required in
§A(3)(a)-(c), of this regulation; and
(3) Documentation of any Mantoux test, chest
X-ray, chemotherapy, and chemoprophylaxis which is the basis for the
certification that the individual is free from tuberculosis in a communicable
form.
Disclaimer: These regulations may not be the most recent version. Maryland may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
