New Jersey Administrative Code › Title 8 - HEALTH › Chapter 43G - HOSPITAL LICENSING STANDARDS › Subchapter 20 - EMPLOYEE HEALTH › Section 8:43G-20.2 - Employee health services

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Each new employee shall receive an initial
				health evaluation, which includes at least a documented history, which may be
				performed by a registered professional nurse, physician or other qualified personnel
				(defined as a licensed physician assistant or a certified nurse
				practitioner/clinical nurse specialist), and a physical examination.
(b) Employee health records shall be maintained
				for each employee. Employee health records shall be confidential, and kept in the
				employee health office separate from personnel records.
(c) The employee health record shall include
				documentation of all medical screening tests performed and the results.
(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 Infection Exposure Control Plan (TB plan), according to
				the guidelines set forth in "Guidelines for Preventing the Transmission of
Mycobacterium tuberculosis
in Health-Care Facilities, 2005."
MMWR.
2005; 54(RR-17); 1-141, incorporated herein by reference, as
				supplemented and amended.
1. With respect to newly
				hired employees, the facility shall establish policies and procedures that will
				identify a new employee's baseline status of exposure to
Mycobacterium
				tuberculosis
. Upon employment, the facility shall either draw blood for an
				interferon gamma release assay (IGRA) or administer a two-step Mantoux tuberculin
				skin test, using five tuberculin units of purified protein derivative, to all
				employees. Employees are defined, for the purpose of this subsection, as full and
				part-time employees, volunteer staff and primary care providers who are salaried by
				the facility and/or who have clinical privileges to provide medical care at the
				facility.
i. Employees whose IGRA result is
				"positive" have latent TB infection. A "negative" IGRA result indicates the employee
				has no latent TB infection. Employees whose IGRA result is "indeterminate" shall
				repeat the IGRA.
ii. Employees whose
				initial Mantoux tuberculin skin test result is "negative" (less than 10 millimeters
				(mm) of induration or less than five mm of induration if the individual is
				immunosuppressed) shall be administered a second test in one to three
				weeks.
iii. Employees whose first or
				second IGRA result is "positive" or whose first or second Mantoux tuberculin skin
				test result is "positive" (greater than 10 mm of induration or greater than five mm
				of induration if the individual is immunosuppressed) shall be referred for a medical
				evaluation to determine whether there is evidence of latent tuberculosis infection
				or active tuberculosis disease.
(1) The medical
				evaluation shall include, but is not limited to, a chest X-ray.
(2) The facility shall not permit an employee
				whose IGRA or Mantoux tuberculin skin test result was positive to begin working
				unless and until the employee submits written medical clearance to the
				facility.
iv. Exceptions to
				the requirements in (d)1 above are as follows:
(1)
				Employees who provide documentation of negative results of a single Mantoux
				tuberculin skin test performed within the 12 months preceding the start of
				employment shall receive only one Mantoux tuberculin skin test upon hire.
(2) Employees with prior documentation of negative
				results of two Mantoux tuberculin skin tests performed within 12 months preceding
				the start of employment, and without signs and symptoms of active tuberculosis,
				shall not be required to be tested upon hire; however, a Mantoux tuberculin skin
				test shall be required within 12 months of the last Mantoux tuberculin skin
				test.
(3) Employees who provide
				documentation of positive IGRA or Mantoux tuberculin 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.