Do My RCFE Caregivers Need Annual Health Screenings and TB Tests?
Many administrators ask: “Do my RCFE caregivers need an annual health screening or TB test?” The short answer is no — annual testing is not required by Title 22 or any other regulation. California Code of Regulations, Title 22, section 87411(f), only requires a one-time health screening and TB clearance before or shortly after employment. The rule states that all personnel “shall be in good health” and must have a health screening, including a chest x-ray or intradermal test, completed no more than six months before or seven days after hire. The report must confirm that the employee is physically able to perform assigned duties and does not pose a health risk to residents.
So where does the idea of annual TB testing come from? Over time, some evaluators and agencies have assumed that the law requires annual updates—but the regulation itself never mentions tuberculosis, TB, or annual testing at all. In fact, the word “tuberculosis” does not appear anywhere in section 87411(f). This means there is no legal basis for citing an RCFE for missing an annual health screening or TB test.
That said, TB testing is still a smart health and safety practice, especially in residential care environments where vulnerable seniors live. Facilities are encouraged to follow local public health guidance and their own policies for maintaining a safe environment. But from a compliance standpoint, only the initial health screening is required, and there is no annual mandate under current law.
