(1) The boarding home must ensure each staff person, except for volunteers and contactors, is screened for tuberculosis, as follows:
(a) Except when a staff person provided the boarding home with documentation of a previous positive Mantoux skin test, a staff person hired before September 1, 2004 must have had:
(i) A tuberculin skin test by the Mantoux method within six months preceding the date of employment in the boarding home; and
(ii) A second tuberculin skin test within one to three weeks after a negative Mantoux test if the staff person was thirty-five years of age or older at the time of hiring.
(b) A staff person hired on or after September 1, 2004 must have a baseline two-step skin test initiated within three days of being hired unless the staff person meets the requirements in (c) or (d) of this subsection. The skin tests must be:
(i) Given no less than one and no more than three weeks apart;
(ii) By intradermal (Mantoux) administration of purified protein derivative (PPD);
(iii) Read between forty-eight and seventy-two hours following administration, by trained personnel; and
(iv) Recorded in millimeters of induration.
(c) A staff person needs to have only a one-step skin test within three days of being hired if:
(i) There is documented history of a negative result from previous two-step testing; or
(ii) There was a documented negative result from one-step skin testing in the previous twelve months.
(d) A staff person does not need to be skin tested for tuberculosis if he/she has:
(i) Documented history of a previous positive skin test consisting of ten or more millimeters of induration; or
(ii) Documented evidence of adequate therapy for active disease; or
(iii) Documented evidence of adequate preventive therapy for infection.
(e) If a skin test results in a positive reaction, the boarding home must:
(i) Ensure that the staff person has a chest X ray within seven days;
(ii) Report positive chest X rays to the appropriate public health authority; and
(iii) Follow precautions ordered by a physician or public health authority.
(2) The boarding home must:
(a) Keep in the boarding home for the duration of the staff person's employment, and at least two years following termination of employment, records of:
(i) Tuberculin test results;
(ii) Reports of X-ray findings; and
(iii) Physician or public health official orders.
(b) Provide staff persons with a copy of the records specified in (a) of this subsection:
(i) During the time the staff person is employed in the boarding home, limited to one copy per report; and
(ii) When requested by the staff person.
(3) The boarding home must ensure that caregivers caring for a resident with suspected tuberculosis comply with the WISHA standard for respiratory protection.
[Statutory Authority: RCW 18.20.090. 06-24-073, § 388-78A-2480, filed 12/4/06, effective 1/4/07; 06-01-047, § 388-78A-2480, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. 04-16-065, § 388-78A-2480, filed 7/30/04, effective 9/1/04.]