The short answer Nevada requires TB surveillance and screening tests for employees of all medical facilities, which includes licensed agencies to provide nursing in the home, under NAC 441A.375, and its medical-facility workplace violence law (NRS 618.7311 through .7318) was expanded in 2021 to cover home nursing agencies. Workers' comp is required from the first employee.
What Nevada requires
Nevada
TB screening required. NAC 441A.375 requires medical facilities to maintain TB surveillance of employees and contractors providing direct services, with a required TB screening test, annual retesting unless the medical director documents lower risk, and chest radiograph documentation for prior positives; home health agencies are medical facilities covered by this rule.
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Workplace violence law reaches home health. NRS 618.7311 through .7318 (AB 348, 2019) require covered facilities to maintain a workplace violence prevention and response plan, train staff, and report incidents to Nevada OSHA; scope was expanded July 1, 2021 to include agencies that provide nursing in the home.
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Workers' comp from 1st employee. Coverage is required for every employer with one or more employees (Nevada Division of Industrial Relations).
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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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