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 learn whether any errors are reflected on your report.

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:

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 background check procedures through automated workflows and integrations.

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

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. 

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.

Disqualification varies by state laws and employer policies, but common reasons include specific criminal convictions, particularly ones related to fraud, abuse, neglect, or patient safety violations. Other disqualifying factors may include revoked or suspended professional licenses, positive drug tests for controlled substances, patterns of driving violations if transportation is required, and providing false information about education or work history. Some states maintain exclusion lists that automatically disqualify individuals with certain convictions from working in healthcare settings.

Caregiver background checks typically take between three to five business days to complete, though timelines vary based on several factors. Simple checks with readily available records may return results within 24 to 48 hours. More comprehensive screenings that require manual verification, like education or employment history checks, can take up to two weeks.

Delays often occur when you’re verifying information from institutions with slow response times, searching records in multiple jurisdictions, or screening candidates who have lived in several states. Court closures, incomplete candidate information, and high-volume screening periods can also extend background check processing times. Communicating possible timelines to candidates can help them set expectations in advance. Employers can also use healthcare-specific background check solutions that help streamline the verification process.

Whether you can work as a caregiver with a misdemeanor depends on the nature of the offense, state regulations, employer policies, and how much time has passed since the conviction. Many employers evaluate misdemeanors on a case-by-case basis, considering how relevant the crime is to caregiving duties and whether the candidate has demonstrated any evidence of rehabilitation.

Misdemeanors involving violence, theft, fraud, abuse, or drug offenses are more likely to result in disqualification than unrelated offenses like minor traffic violations. Some states have specific lookback periods that limit how far back employers may consider certain misdemeanors. Additionally, fair chance hiring laws in many jurisdictions require employers to conduct individualized assessments rather than automatically rejecting candidates with criminal records.

Many caregiver positions require fingerprint-based background checks, especially when working with vulnerable populations like children, elderly individuals, or people with disabilities. State regulations often mandate fingerprint checks for licensed healthcare professionals, home health aides, and caregivers working in facilities that receive government funding. The fingerprinting process involves submitting prints to state agencies or the FBI, which then search their databases for criminal history records.

While fingerprint checks often more accurately identify the correct individual than name-based searches do, they typically take longer to process and cost more, which is why some employers reserve them for final candidates or positions with the highest security requirements.

The lookback period for caregiver background checks varies by state law, the type of record being searched, and employer policies:

Background check laws continue to evolve, with many jurisdictions implementing fair chance hiring legislation that restricts how employers may consider older or less serious offenses. Employers should consult legal counsel to develop screening policies that comply with applicable federal, state, and local regulations.

Yes, candidates have the right to dispute inaccurate or incomplete information on their background check reports. Under the FCRA, if an employer plans to take adverse action based on background check findings, they must provide the candidate with a pre-adverse action notice that includes a copy of the report and a summary of their rights. This gives candidates an opportunity to review the information and dispute any errors before a final decision is made.

Common reasons for disputes include mistaken identity, outdated records that should have been sealed or expunged, incorrect conviction details, or information belonging to someone else with a similar name. Candidates should contact the background check provider directly to initiate the dispute process, provide supporting documentation, and request that the disputed items be reinvestigated. Employers must wait a reasonable period before making final hiring decisions to allow for the full dispute resolution process.

About the author

Hayley Harrison began her career as a hiring manager at a mid-size regional bank in the Pittsburgh area. She now brings her experience and knowledge of hiring best practices to her work as a freelancer, helping employers refine and improve their processes.