The short answer Mississippi's Minimum Standards of Operation for Home Health Agencies require a pre-employment health screening plus TB evaluation (IGRA or two-step Mantoux) before patient contact, with annual retesting per CDC/MSDH recommendations. Workers' comp is required at 5 or more employees.
What Mississippi requires
Mississippi
TB screening required. Rule 46.27.5 (Employee Health Screening) of 15 Miss. Admin. Code Pt. 16, Subpt. 1, Ch. 46 (Minimum Standards of Operation for Home Health Agencies) requires every patient-contact employee to receive a health screening by a licensed physician, nurse practitioner, or physician assistant upon employment and annually thereafter, with TB evaluation via IGRA or two-step Mantoux prior to patient contact and chest X-ray within 72 hours for new positives.
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Regulation index. MSDH maintains the health facility minimum standards regulations, including home health agency standards.
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Workers' comp at 5+ employees. Mississippi Workers' Compensation Commission: coverage is mandatory for employers with 5 or more regularly employed workers; under 5 is voluntary.
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The federal baseline (applies in every state)
Federal
No federal TB mandate for home care workers. There is no federal law requiring tuberculosis screening of home care or home health workers; TB screening obligations for this workforce are set by each state's facility licensing law. Federal Medicare Conditions of Participation for home health agencies (42 CFR Part 484) require an infection-prevention program but do not prescribe worker TB testing.
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2019 CDC/NTCA baseline screening standard. The 2019 CDC/National Tuberculosis Controllers Association recommendations for U.S. health care personnel call for a baseline (pre-placement) individual TB risk assessment, symptom evaluation, and a TB test (IGRA or TST) for those without documented prior positive results. Routine annual (serial) testing of health care personnel is no longer recommended absent ongoing exposure; instead facilities should provide annual TB education and symptom screening.
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Positive-result workup. Personnel with a newly positive TB test or TB symptoms should receive a chest X-ray and clinical evaluation to rule out active TB disease; those found to have latent TB infection should be offered and encouraged to complete LTBI treatment per CDC guidance.
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OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030). OSHA's Bloodborne Pathogens Standard applies to home care/home health workers with reasonably anticipated exposure to blood or other potentially infectious materials. Employers must maintain a written exposure control plan, provide annual training, and offer the hepatitis B vaccine series at no cost within 10 working days of assignment to covered workers.
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