Recommendation for Tuberculosis (TB) Screening in Long-Term Care Homes and Retirement Homes

Admission and Transfer Screening of New Residents

As per the Retirement Homes Act, 2010 and the Fixing Long-Term Care Act 2021, all new residents must be screened for tuberculosis within 14 days of admission unless the resident has already been screened in the 90 days prior to admission and the documented results of this screen are available to the Home.

• New residents who are admitted to a Long-Term Care Home (LTCH) or Retirement Home (RH) and residents who are transferred from other LTCH or RH must have a documented screening for symptoms of active TB completed by a nurse, nurse practitioner or physician prior to and on admission, using the Active Tuberculosis (TB) Disease Screening for Residents of Long-Term Care Homes and Retirement Homes form.
• If the symptom screening is positive, the resident should receive a posteroanterior and lateral chest x-ray and be referred for a TB medical assessment as soon as possible.
• Routine tuberculin skin testing (TST) on, or prior to, admission and periodic TSTs (such as annually) are not recommended for residents.

Recommendations for Staff and Volunteers

Staff and volunteers at long term care homes and retirement homes should undergo baseline TB screening including:

• An individual risk assessment that identifies their risks for TB, including temporary or permanent residence in a high-incidence country, prior TB, current or planned immune suppression or close contact with someone who has had infectious TB since the last Mantoux test (TST).
• A symptom evaluation using the Active Tuberculosis (TB) Disease Screening for Staff and Volunteers in Long Term Care Homes and Retirement Homes form.
• A TST for those without documented prior TB disease or latent TB infection. A TST is the preferred diagnostic test for pre-employment and periodic testing (if indicated) for latent TB infection among health care workers.

Reporting Requirements for Tuberculosis:

Under the Health Promotion and Protection Act, R.S.O. 1990, c. H.7, diagnoses of TB infection (LTBI) and cases of suspect and confirmed active TB disease are reportable to Public Health. To report a case of TB infection or disease, please call the Eastern Ontario Health Unit at 613-933-1375 or 1-800-267-7120 and ask to speak to the Infectious Diseases Team.