Observe the history and physical exam for several applicants and answer the following:

*1.Name of Contractor Completing Survey:(Required.)

*2.Some TB history questions are open-ended (e.g., 'Have you ever had a chest x-ray?' or “Have you ever been treated for a lung infection?”)(Required.)

True

False

*3.TB history questions include a review of typical TB signs and symptoms (e.g., cough, weight loss, night sweats, etc.)(Required.)

True

False

*4.Physical exam includes auscultation of the lungs anteriorly and posteriorly in multiple locations on bare skin.(Required.)

True

False

*5.Additional comments about TB related history and physical exam: (open comment)(Required.)

Inquire about lab testing by meeting with a panel physician and lab director and answer the following:

*6.What IGRA test type is used?(Required.)

*7.Which lab runs the IGRA test?(Required.)

*8.What is the IGRA test turnaround time (TAT)?(Required.)

*9.Is the panel noting any issues with IGRA testing or supply chain?(Required.)

*10.What molecular test is used for TB diagnosis?(Required.)

*11.Which lab runs the molecular test?(Required.)

*12.What is the molecular test turnaround time (TAT)?(Required.)

*13.Is the panel noting any issues with molecular testing or supply chain?(Required.)

*14.Additional comments about TB lab related issues (open comment):(Required.)

Inquire about chest x-rays by meeting with panel physician and radiologists/radiology

*15.For calendar year 2024, what is the percentage of abnormal chest x-rays for applicants aged 15 and older (number of abnormal chest x-ray/applicants 15 yrs of age or older x 100)?(Required.)

*16.You routinely review your x-ray processes and procedures.(Required.)

True

False

*17.Your facility ensures x-ray equipment is well maintained and calibrated.(Required.)

True

False

*18.X-ray techniques are reviewed to ensure optimal image quality.(Required.)

True

False

*19.Applicants are properly prepared and positioned during x-ray acquisition.(Required.)

True

False

*20.Workstation monitors used for x-ray interpretation are of high quality.(Required.)

True

False

*21.Image viewing software used at the facility is optimized for radiological review.(Required.)

True

False

*22.Ambient light in the radiograph reading room is appropriately controlled.(Required.)

True

False

*23.Noise level and activity in the reading room kept to a minimum to avoid distractions.(Required.)

True

False

*24.All radiologists familiar with the Technical Instructions.(Required.)

True

False

*25.All radiologists enter results into the eMedical system.(Required.)

True

False

*26.Radiologists know who to contact with questions, abnormal chest x-ray results, etc.(Required.)

True

False

*27.Additional comments about radiology related issues (open comment):(Required.)