The short answer Nebraska licenses home health agencies under 175 NAC 14 (rewritten effective 5/5/2024). The chapter requires a staff health screening before any consumer contact (175 NAC 14-010.04(A)(v)) but names no TB test, making Nebraska a health-statement state; Nebraska DHHS TB guidance points agencies to CDC recommendations for testing specifics. Workers' comp is required from the first employee.
What Nebraska requires
Nebraska
Health screening required; no TB test named. 175 NAC 14 (Home Health Agencies, amended 5/5/2024) requires the licensee to implement written policies on staff health status to prevent transmission of disease to consumers and to complete a health screening for each staff member before contact with or direct care for any consumer (14-010.04(A)(v)); each employment record must include post-hire and pre-employment health history screening (14-010.04(B)(iv)). No TB test or screening method is specified anywhere in the chapter.
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CDC-based guidance only. Nebraska DHHS TB Program materials follow CDC screening recommendations for health care workers; no statewide health care worker TB testing statute or regulation was identified, so the content of the required staff health screening is set by agency policy informed by CDC guidance.
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Workers' comp from 1st employee. Nearly every employer with one or more employees must carry coverage, including part-time; the main exemption is small agricultural operations (NE Workers' Compensation Court).
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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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