Facility Tuberculosis (TB) Risk Assessment Instructions and Worksheet for Health Care Settings Licensed by MDH - Updated 4/2026

Sep 2, 2026

Instructions and a structured worksheet for completing TB facility risk assessments for Minnesota Department of Health (MDH) licensed health care settings. Covers acceptable assessment options, use of CDC Appendix C for risk classification, and requirements for how often assessments must be performed by risk level and license type/address. Provides TB incidence inputs and guidance on county-specific reporting, then details determining risk classification and TB screening/testing expectations for health care personnel, including baseline, serial, and post-exposure protocols under updated CDC guidance.

LanguageEnglish

CategoryForms

FormatDOCX

Pages13

Reading Time5 min

AccessFree to download

Background

Assessment options and classification

Frequency requirements

Instructions

Incidence of TB

Determining TB risk classification

TB screening and testing for health care workers

Facility Tuberculosis (TB) Risk Assessment Instructions and Worksheet for Health Care Settings Licensed by MDH* Updated 4/2026 Background Health care settings licensed by MDH (*boarding care homes, home care providers, hospices, nursing homes, outpatient surgical centers, and supervised living facilities) may use either of the following options to meet the “perform a TB facility risk assessment” requirement: this worksheet, or “Appendix B: Tuberculosis (TB) Risk Assessment Worksheet” published by the Centers for Disease Control and Prevention (CDC) in “Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005”. Use CDC’s HYPERLINK "https://www.health.state.mn.us/diseases/tb/rules/mmwrc.pdf" Appendix C to determine facility risk classification. All documents are located on the MDH webpage for HYPERLINK "https://www.health.state.mn.us/diseases/tb/rules/healthcare.html" Prevention and Control of TB in Health Care and Other Congregate Settings (https://www.health.state.mn.us/diseases/tb/rules/healthcare.html). Changes were made to the facility risk assessments starting in 2019 that differed from prior years to reflect updated 2019 guidance from CDC: Starting June 10, 2019, serial (annual) TB testing is no longer required for MDH licensed health care settings with low and medium risk level classification. The level of infection control measures including respiratory protection plan employed by your facility should match the risk classification of your setting. The MDH Manual Regulations for Tuberculosis Control in Minnesota Health Care Settings, July 2013 is being updated. Until the new version is available, use the July 2013 guidance to remain in regulatory compliance with MDH Licensing and Certification. Please note, many of the links within the 2013 manual are broken so please use the webpage for access to forms. Settings should perform a facility risk assessment on an annual basis if risk classification is medium or higher. Low risk classification settings should perform a facility risk assessment every two years. The CDC version of the facility risk assessment or an internally developed form that incorporates all CDC variables should be used by health settings that are a hospital or emergency department or other setting with airborne infection isolation (AII) room(s). This document is updated annually to reflect current TB case rates and numbers. Data for 2026 will be available by April 2027. A separate Facility TB Risk Assessment Worksheet is required for each type of license. A separate Facility TB Risk Assessment Worksheet is recommended for each physical address. If you have questions, please contact the MDH TB Program at 651-201-5414 or email HYPERLINK "mailto:sarah.gordon@state.mn.us" sarah.gordon@state.mn.us. Instructions Incidence of TB Incidence is the number of people who are diagnosed with active TB disease in a geographic area during a given year. Do not include patients with latent TB infection (LTBI) or suspected active TB disease that was ruled out. National case rate for 2025: 3.0 per 100,000 population. Minnesota case rate for 2025: 2.8 per 100,000 population. County data for Minnesota: Health care settings in Hennepin, Olmsted, and Ramsey counties: record the county’s case rate**. **These preliminary case rates were calculated using 2020 Census population estimates; to be recalculated after updated population estimates are available June 2026. Health care settings outside of Hennepin, Olmsted, and Ramsey counties: record the number of cases. MDH does not calculate TB incidence rates for other counties. Health care settings that serve persons from multiple counties should record the rate or number for each county. Cases of Active TB Disease by County, Minnesota, 2025 Determining TB risk classification ***Settings or occupations with increased risk of TB exposure from patients prior to diagnosis TB screening of health care workers Effective June 10, 2019

FAQs

What options can MDH-licensed facilities use to meet the TB facility risk assessment requirement?

Facilities can use this worksheet or use the CDC “Appendix B: Tuberculosis (TB) Risk Assessment Worksheet” from the 2005 CDC Guidelines. Appendix C from CDC is used to determine facility risk classification.

How often must a facility perform the TB facility risk assessment based on risk classification?

Facilities with medium or higher risk classification perform the assessment annually. Low risk classification settings perform a facility risk assessment every two years.

Is annual TB testing required for all MDH licensed facilities after June 10, 2019?

Annual TB testing is not required for MDH licensed health care settings with low or medium risk level classification. Increased occupational exposure settings should consider annual TB testing and some may use quarterly or biannual screening based on risk.

Sep 2, 2026

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