The purpose of this study was to describe the current tuberculosis (TB) surveillance practices in health care facilities in accordance with the Ontario Hospital Act. Data for this survey were collected by means of a mailed questionnaire received from 51 health care facilities and schools of nursing in Northeastern Ontario. With some minor changes, most institutions followed standard TB surveillance practices based on the Ministry of Health legislation. Alterations in surveillance practices generally reflected the literature update in terms of cost-effectiveness. It was also discovered that some institutions (33.3%) failed to account for the relative risk for pregnant employees/students with skin testing and X-Ray screening.