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

Current through Register Vol. 51, No. 14, July 12, 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.