Odd that a prospective employee with a hx of a positive Mantoux would not speak up until after the skin test -- not only is there no point
to doing further Mantoux tests once you're positive (the results will always be positive), but it's potentially dangerous
to the person (I was clearly instructed to not allow
anyone to ever give me another skin test). That whole situation sounds fishy -- you're probably better off having not hired her!
I don't know for sure, but it seems to me that you might be opening the agency up to charges of discrimination if you give skin tests to potential employees for no charge, but expect people to pay for CXRs if needed (it's not their fault
that they can't just take the skin test ...). As I said, I've never run into that practice anywhere I've worked over the decades, and it would certainly be a "deal breaker" for me
in deciding about a new job. But I am a known positive and always tell people that right up front.
On the other hand, though, I can see that a "new dx" situation could be considered different -- just as, for example, if you did a UA for a drug screen and the results came back that the person had an acute UTI, it wouldn't be the facility's responsibility to treat
the UTI ... You would just pass on the info and advise the person to seek treatment.
You may also want to check on your legal responsibilities re: TB being a reportable disease -- your policy may need to incorporate something about reporting new positives to the health department, and that may get the facility "off the hook" in terms of further screening.