Guide to Caregiver Background Checks

In this guide, we’ll take a closer look at caregiver background checks: what they are, why they matter, and how to conduct them effectively.

A caregiver background check gathers information about a candidate’s history, such as criminal records and previous work experience, to help employers decide whether the candidate is qualified and eligible for a caregiving position. Examples include:

This process helps employers—including health agencies (HHAs), community care organizations, long-term care facilities, home care aide organizations, and private employers like families—screen prospective caregivers before allowing them to care for patients, clients, or loved ones. 

As a caregiver, you may want to run a background check on yourself to learn what a prospective employer may see during the screening process. Personal background checks can help you prepare for job interviews with potential employers and proactively dispute and correct any inaccurate or outdated information.

Pre-employment background screening for caregivers are typically extensive because of the nature of this type of work. In-home caregivers may enter their clients’ homes where they can work independently and unsupervised. Elderly and disabled clients can be vulnerable to abuse and neglect. The National Institute on Aging estimates that hundreds of thousands of adults over 60 are abused, neglected, or financially exploited every year.

The information that shows up on a caregiver background check depends upon the type of screening conducted; federal, state, local, and industry laws regulating background checks; and the employer’s background screening policy. 

Here’s what may be reported on different types of caregiver background checks:

• Criminal background checks may show misdemeanor and felony convictions, arrest records, and pending criminal cases.
• Sex offender registry checks search registries from every US state, the District of Columbia, and tribal territories and may report the offender's date of registration and current status.
• Healthcare sanctions checks screen healthcare professionals against important primary sources for exclusions, debarments, sanctions, and disciplinary actions.
• Professional license verification confirms a candidate holds the professional license or certification necessary to be eligible for the role. 
• Employment verification reports a candidate’s prior employment, including positions held and dates of employment.
• Education verification reports schools attended, dates of attendance and any credentials or degrees the candidate earned.  
• Driving record (MVR) checks show license type and status, suspensions, revocations, and motor vehicle-related offenses and convictions, like DUIs.
• Drug testing can identify current or past use of certain prescription and illicit substances or alcohol.

You might start by learning about state requirements where you are hiring. In addition to regulations on caregiver background checks, many states have resources to help.

For example, employers conducting caregiver background checks in California may use the California Department of Social Services (CDSS) Guardian system for conducting self-service background checks for caregivers through its Care Provider Management Bureau. The CDSS also maintains the Home Care Aide Registry, a listing of individuals who have completed a criminal background check administered by the CDSS and TrustLine, a registry of child care providers who have passed a criminal background screening.

The following are further guidelines for how employers and individuals can choose to conduct caregiver background checks.

While it’s possible to conduct a caregiver background check on your own, many organizations and employers choose to work with a consumer reporting agency (CRA), like Checkr. Qualified third-party providers often offer healthcare background checks and can help you conduct thorough pre-employment background checks that are compliant with federal, state, and local laws and industry regulations. Partnering with a CRA can also enable faster, more streamlined through automated workflows and integrations.

If you’re an employer, consider the following steps:

• Choose a provider that’s accredited by the Professional Background Screening Association (PBSA), the only organization that accredits CRAs.
• Get information and authorization from the candidate. The federal Fair Credit Reporting Act (FCRA) requires employers working with a CRA to provide the candidate with proper disclosure of their intent to conduct a background check and receive written permission from the candidate prior to doing so.
• Conduct the checks you need to meet state requirements, industry standards, and your own needs as an employer. Consider working with a CRA to determine a list of screening options that best fits the job.
• Follow the adverse action process. If you decide not to hire a candidate, the FCRA requires employers to follow the adverse action process that includes giving the candidate an opportunity to review information in their report and to dispute it.

As a caregiver, you can choose to run a background check on yourself by requesting records on your own or working with a third-party provider, like Checkr. Using a professional service often simplifies the process and gives caregivers access to the same types of checks employers typically run. Checkr’s personal background checks may include an SSN trace, sex offender registry check, global watchlist search, criminal or civil searches, and driving record checks.

There is no federal law that requires caregiver background checks. However, home health agencies that want to receive Medicare or Medicaid funding must comply with state laws regarding home care background checks.

The Centers for Medicare & Medicaid Services (CMS) has awarded more than $65 million to 28 states to develop comprehensive national background check programs for direct patient access employees. States that participate in the National Background Check Program (NBCP) require HHAs to conduct a fingerprint-based FBI criminal history search, a search of the federal Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE), and a search of state abuse and neglect registries in the caregiver’s current state as well as other states where they have worked. HHAs in states that do not participate in the NBCP must also comply if they want to receive federal funding.

Here’s a look at other legal considerations that may impact the caregiver background check process.

The federal FCRA requires employers who work with a consumer reporting agency (CRA) to conduct background checks to provide written disclosure of the intent to perform a background check and written candidate consent. Employers that choose not to hire an individual based on information reported during a background check must follow the adverse action process under the FRCA.

Each state has its own licensing requirements for HHAs and other caregiver organizations, including specific guidelines for caregiver background checks.  For example, Statute § 111.335 prohibits organizations performing a Wisconsin caregiver background check from discriminating against candidates based on arrest and conviction records though criminal history relevant to a position may be considered.

Your state may require you to verify the current status of a candidate’s professional licenses, or to search state board disciplinary actions against the candidate. Some states require data sharing between present and future employer(s) to confirm the candidate has not received any negative reports, related to information found in a background check, during their time with the present employer. To learn more about laws and regulations in your state, check the website of your state’s department of health or department of social services. Your legal counsel can advise on what laws and regulations apply to your hiring. 

Review the answers to these frequently asked questions about the caregiver background check process.

The content and format of a caregiver background check depend on the types of checks performed and the procedures of the background check provider. Checkr simplifies charge language so background check reports are user-friendly and easy to review.

An individual with a felony conviction can sometimes become a caregiver, but eligibility generally depends on state laws, the nature of the conviction, and the specific caregiving role. Some states automatically disqualify candidates from caregiving roles based on specific offenses, including certain felony convictions.

Disqualification as a caregiver varies by employer policies, state and local laws, and industry regulations. Common disqualifiers may include: 

• A history of criminal convictions, particularly those related to fraud and patient safety
• Providing inaccurate information about education, work history, or professional licenses
• Revocation or restriction of a professional license or certification
• Testing positive for a controlled substance on a drug test

You can typically rely on professional license verification, reference checks, and employment history to prove you are a caregiver. If you’re privately employed by an individual or a family, a letter of reference may be sufficient. A pay stub or letter from a long-term care facility, agency, or other employer may also be adequate proof. Satisfactory requirements may also depend on the organization’s screening and hiring policies. 

Partnering with Checkr to conduct caregiver background checks can help streamline your hiring process while helping you comply with legal and industry regulations. Checkr offers multiple background check options, including criminal background checks, professional license verification, education verification, and more to meet your hiring needs.

With pre-built integrations, an online candidate portal, and dedicated support, Checkr enhances the candidate experience for faster hiring and onboarding. Get started with Checkr today.

About the author

Hayley Harrison writes about a wide range of business topics and best practices, including background checks, candidate experience, and recruitment and retention. Her work includes educational articles, e-books, and blog posts.