CNA background checks: Requirements and employer guide

Knowing about the background check process for CNAs will prepare you to perform pre-employment screenings that can help you make more informed hiring decisions. Here's what you need to know about CNA background checks.

A CNA background check is a pre-employment screening that reviews public and private records to verify a certified nursing assistant candidate's credentials, criminal history, and eligibility to work with patients. Healthcare employers often run background checks when hiring CNAs for long-term care facilities, hospitals, home health agencies, and other care settings.

Depending on the employer’s policies and government regulations, CNA background checks may cover:

Employers conduct CNA background checks for several key reasons, including verifying candidates’ qualifications, protecting their patients, and satisfying the requirements for funding.

Conducting a background check for CNA license status can confirm whether a candidate is eligible to work as a certified nursing assistant. Many states require CNAs to obtain a license or certification from the state board of nursing, the department of public health, or a similar agency. A background check lets you know whether a candidate possesses the necessary license or certification, along with the necessary work experience, training, and skills to perform their assigned job duties.

Ensuring that your patients receive care in a safe environment is an essential responsibility for healthcare providers. A background check can help you determine if anything from a candidate's history suggests that they may pose a risk to patients. This is especially important for CNAs who work with vulnerable populations, such as senior citizens and individuals with disabilities. For CNAs in home health care, driving record checks are also a helpful tool for verifying a candidate’s driving history.

Healthcare employers must comply with laws requiring background checks. Providers that receive federal funding may need to perform healthcare sanctions checks, such as Office of Inspector General (OIG) checks, to identify candidates with sanctions for patient neglect or healthcare fraud.

Non-compliance can result in penalties. Employers must also follow federal and state background check laws, including the Fair Credit Reporting Act (FCRA).

Performing background checks can give you confidence that a candidate is qualified for a CNA position and is able to adhere to your organization's standards of care. Maintaining your standards of care can also help to improve patient outcomes and overall patient satisfaction.

Healthcare organizations that receive government grants must comply with laws and regulations, including those that require background checks, to continue to benefit from funding.

CNA background check requirements vary by state and local health department regulations. Common requirements include:

Background screening for CNAs is typically more comprehensive than other industries because CNAs work with vulnerable populations. If you're unsure of the requirements in your area, consult your legal counsel.

When performing a CNA background check, employers must comply with federal, state, and local laws. Here’s a review of some key laws that regulate the background check process.

Federal CNA background check laws apply to healthcare employers in every state:

Many states have state-specific requirements for CNA background checks that employers must comply with in addition to federal laws. A state can establish its own laws about which types of background checks an employer must conduct before hiring a candidate for a CNA position and specify what types of findings automatically disqualify candidates. These requirements may vary depending on the role and may also contrast with other states. Your legal counsel can help you determine what laws are applicable where you are hiring.

Here's a look at examples of requirements in a few states:

What shows up on a CNA background check depends on which screenings the employer chooses, any relevant compliance regulations, and the employer’s screening policy. A CNA background check may include a criminal background check, education verification, employment verification, professional license verification, healthcare sanctions checks, MVR checks, drug testing, and health screenings.

Education verification confirms that a candidate's education history matches the information provided on their application or resume. The verification can provide information about enrollment dates, the degrees or certificates awarded, and more. Running an education verification check can help determine whether a candidate has the necessary training required for a CNA position.

Employment verification uses employment records to confirm the work experience listed on a candidate's application or resume. The verification may include job titles and employment dates. As an employer, this screening shows you whether a candidate has relevant hands-on experience that can help them succeed in your open position.

Professional license verification confirms whether a candidate has an active CNA license or certification in a particular state. If your state requires professional licensing for CNAs, performing a verification can help you confirm that a candidate is eligible for employment.

A healthcare sanctions check determines if a candidate has any previous exclusions, debarments, sanctions, or disciplinary actions. Compliance regulations may prohibit you from hiring individuals who have a history of these sanctions.

A healthcare sanctions check searches primary sources like the List of Excluded Individuals/Entities (LEIE). This list is published by the US Department of Health and Human Services Office of Inspector General and the System for Award Management (SAM). The SAM database is maintained by the US General Services Administration (GSA) and identifies individuals on the exclusion list for federal contracting opportunities.

A Fraud and Abuse Control Information Systems (FACIS®) check is a more comprehensive type of healthcare sanctions check that may be required to satisfy state and federal regulations. There are four FACIS screening levels—1, 1M, 2, and 3—that search various primary sources and lists. More comprehensive search results are returned with each level, so employers may choose different search levels depending on the type of position being filled and federal or state requirements for screening. Checkr offers level 1M and level 3 screenings to help your organization meet state and federal requirements for healthcare background checks.

A motor vehicle record (MVR) check searches state-level driving history, such as license status and class, to determine the candidate's eligibility for driving-related positions. You may wish to conduct an MVR check if your open position involves transporting patients or staff, delivering home medical equipment, or driving a company vehicle.

Drug testing can detect the presence of illicit substances, certain prescription drugs, and alcohol in jurisdictions where testing is permitted. Conducting pre-employment or ongoing drug testing can help you adhere to your organization's drug-free workplace policy. In some cases, requiring these drug tests may be necessary to comply with the federal Drug-free Workplace Act of 1988 and state or local laws.

After extending an offer of employment, your organization may require a health screening and physical exam. This type of check can help you determine if a candidate is physically and mentally capable of performing their job duties. In some cases, medical screenings include testing for communicable diseases, such as tuberculosis (TB), and a review of vaccination history.

Employer policies and compliance regulations typically dictate what disqualifies a CNA candidate. Common disqualifying factors include:

Some states mandate automatic disqualification for specific convictions. Employers may also establish additional disqualifying offenses that go beyond legal requirements.

The turnaround time for a background check depends on the scope of the check, the availability of records, and whether you use a background check provider to conduct the search. Manual searches can require significant time and labor, especially when records aren't available online.

Contacting agencies, employers, and schools directly adds delays. Some databases also require registration before you can access them, which may take even longer.

Using a background check company, like Checkr, can help speed up the background check process for CNAs. Checkr's modern platform delivers fast, accurate results with 89% of all criminal background check results available in under an hour. Customized adjudication filters help simplify compliance and streamline review of reports. Reduced manual tasks and increased accuracy helps your team complete CNA background screening checks faster and keep candidates moving through your hiring funnel.

You can conduct a CNA background check independently or partner with an FCRA-certified background check provider. If you’re conducting checks yourself, follow these steps:

This manual process can be time-consuming and expensive, particularly when database access requires you to pay a subscription.

By partnering with a CRA, like Checkr, you can reduce costs and wait times associated with manual searches. Our advanced background check technology automates searches in thousands of databases and prepares easy-to-read reports available through one centralized dashboard.

Working with a background check provider can also simplify communication with candidates throughout the CNA background check process. Checkr’s candidate portal makes it easy for candidates to provide personal information, check the status of checks, and access multilingual live support to keep the process moving quickly. The portal also allows candidates to view their background check timelines and progress, creating an overall better experience.

Performing CNA background checks enables you to learn more about candidates’' criminal, education, work, and license history so that you can make more informed hiring decisions while complying with legal requirements.

Checkr makes the process simpler, faster, and more accurate with streamlined workflows and advanced technology. We offer a full suite of screenings for CNA background checks, including criminal history, healthcare sanctions checks, and professional license verification. Plus, over 100 ATS and HRIS integrations and a flexible API let you seamlessly integrate Checkr into your existing tech stack. Get started with Checkr today.

If you have additional questions about the CNA background check, these answers may help.

It depends on the specific offense, your organization's policy, and state regulations. Some felony convictions are automatic disqualifiers, while others may not be. Consult your legal counsel to understand any requirements in your area.

It depends on your organization's policy and state law—some misdemeanors may preclude employment, while others don't. Consult your legal counsel to comply with any applicable regulations around hiring candidates with a misdemeanor.

Many healthcare organizations conduct background checks during the initial hiring process and may perform periodic re-screening based on employer policy, state requirements, or changes in job responsibilities. Some states mandate ongoing checks at regular intervals, such as annually or biennially. Consult your legal counsel to determine re-screening requirements in your jurisdiction.

A professional license verification confirms whether a candidate holds an active, valid CNA license or certification in a specific state. A healthcare sanctions check searches databases like the OIG's LEIE and FACIS to identify any exclusions, debarments, or disciplinary actions that may prohibit employment in healthcare settings. Both screenings serve different compliance purposes and may be required depending on your state regulations and employer policies.

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.