Zagaria MAE - Evidence suggests that institutionalized seniors are at a greater risk for reactivation of latent TB and for the acquisition of new TB infection compared with their community-dwelling counterparts. Patients in long-term care facilities and acute-care institutions should be under surveillance, control, and reporting for TB, according to CDC recommendations. Initial skin testing and subsequent annual testing should be performed on all new employees and new residents in long-term care facilities. The initial comprehensive assessment of all elderly patients should include the two-step purified protein derivative (PPD) screening.