The short answer Utah's Home Health Agency Rule requires a TB test within two weeks of hire (Mantoux or FDA-approved blood test). Workers' comp is mandatory for essentially every employer with one or more workers.
What Utah requires
Utah
TB screening (licensing rule). Utah Admin. Code R432-700-10 (Health Surveillance) requires employees to be tested for tuberculosis by the Mantoux method or other FDA-approved in-vitro serologic test in accordance with Rule R388-804, within two weeks of initial hiring, suspected exposure, or symptom onset; known positives are exempt from skin testing.
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Official rule. The Home Health Agency Rule (R432-700) is published by the Utah Division of Administrative Rules.
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Workers' comp from 1st employee. With few exceptions, every Utah employer with one or more workers under any contract of hire must carry coverage; no minimum threshold (Utah Labor Commission).
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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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