Non-compliance with CDC TB Screening Guidelines for New Hires
Penalty
Summary
The facility failed to adhere to the Centers for Disease Control and Prevention's (CDC) guidelines for tuberculosis (TB) screening and testing of new employees. According to the CDC's guidance, all U.S. healthcare personnel should undergo TB screening upon hire, which includes a baseline individual TB risk assessment, TB symptom evaluation, a TB test (either a blood test or skin test), and additional evaluation for TB disease as needed. The facility's policy also mandates TB screening for new employees, including a symptom evaluation, an individual TB risk assessment, and a screening test for those without documented prior TB disease or latent TB infection. However, the facility did not follow these guidelines for two of the five new hires reviewed. Employee 5, a nurse aide hired in September 2024, had a TB skin test completed in September 2023 but did not have a TB test upon hire as required. Similarly, Employee 6, another nurse aide hired in December 2024, had a TB skin test completed in September 2024 but also did not have a TB test upon hire. During an interview, the Nursing Home Administrator stated that the facility was not requiring another skin test if one had been done within a year of hire, which is not in compliance with the CDC's guidelines.
Plan Of Correction
1. CDC recommendations were not followed for screening, testing and surveillance for TB. DON provided TB testing and assessment and symptom evaluation for Employee #5 and Employee #6. 2. Human Resources Director or Designee will complete a comprehensive review of all new hire staff from the last 30 days to ensure TB testing, assessment and screening for symptoms is current. 3. Human Resources Director or Designee will provide re-education to management staff regarding CDC guidelines and the facility policy on "Tuberculosis Screening." 5. Human Resources Director or Designee will complete an audit of new hire employees 3x per week for 3 months to ensure compliance. 6. Findings will be reported to the QAA Committee to determine the need for further audits.