Understanding the New DHEC Regulation Changes for Tuberculosis Screening

In a significant move to enhance public health safety within South Carolina, Governor Henry McMaster signed into law S.558 on May 20, 2024. This new law, codified as Section 44-31-40 of the S.C. Code of Laws, introduces specific tuberculosis (TB) screening requirements for residents admitted to nursing homes or community residential care facilities (CRCFs) from hospitals.

Key Requirements of Section 44-31-40

The new regulation outlines a clear and structured process for TB screening, ensuring that any potential risk is identified and managed promptly. The primary requirements include the following:

  1. Written Declaration from Healthcare Providers:

    • Before admitting a resident from a hospital, the nursing home or CRCF must obtain a written declaration. This declaration, which can be part of a hospital progress note or discharge summary, must confirm that the resident shows no signs or symptoms of active tuberculosis based on a medical examination.

  2. Two-Step Tuberculin Skin Test (TST):

    • First Step: Within three days of the resident's admission, the facility must administer the first step of the two-step TST.

    • Second Step: The second step must be administered within 14 days of the resident's admission.

  3. Alternative Testing Method:

    • Facilities have the option to substitute the two-step TST with a single blood assay for mycobacterium tuberculosis (BAMT), which is another reliable method for TB screening.

  4. Previous Negative Test Documentation:

    • If documentation shows that the resident had a negative tuberculin skin test or a negative single BAMT within the 12 months before admission, the facility can opt to administer a single TST or single BAMT within 14 days of admission.

Scope and Exclusions

It is important to note that Section 44-31-40 specifically addresses residents admitted from hospitals. The regulation does not apply to residents coming from other settings. For residents admitted from non-hospital settings, the screening requirements remain as outlined in Regulation 61-17 Section 1704 for nursing homes and Regulation 61-84 Section 1702—e and -F for CRCFs.

Contact Information for Further Inquiries

The South Carolina Department of Health and Environmental Control (DHEC) has provided contact information for those seeking further clarification on the new regulation:

  • Amber Capers, Director of the Nursing Home Section

    • Email: capersae@dhec.sc.gov

    • Phone: (803) 545-4284

  • JoMonica Taylor, Director of the Community Services Section

    • Email: taylorjj@dhec.sc.gov

    • Phone: (803) 545-4257

The enactment of S.558 represents a proactive approach by the South Carolina government to safeguard the health of residents in nursing homes and CRCFs. By implementing rigorous TB screening protocols, the state aims to prevent the spread of tuberculosis and ensure that vulnerable populations receive the necessary health protections. Facilities must adhere to these new regulations to remain compliant and uphold the highest standards of care.

If you have any questions or need further information about these changes, do not hesitate to contact the designated DHEC contacts. This new law is a testament to South Carolina's commitment to public health and safety, setting a precedent for other states to follow in the continuous fight against tuberculosis.

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