Guide to Caregiver Background Checks

Gayle Sato
July 07, 2023
6 min read

When hiring caregivers to work with vulnerable clients in their homes or community care facilities, it’s important to conduct a thorough background check to identify those who are qualified. Caregiver background checks can help employers gain insight into professional licensing, education and work experience, comply with state and local regulations, and more.

In the following sections, we’ll take a closer look at caregiver background checks: what they are, why they matter (legally and otherwise), and how to conduct a caregiver background screening that is compliant and thorough.

Get a background check today

What is a background check for caregivers?

A caregiver background check helps home health agencies (HHAs), community care organizations such as nursing homes, home care aide organizations, and private employers including families hiring caregivers for their family members screen prospective caregivers before hiring them to provide direct care to clients in a home or facility. Caregivers who provide personal care and health services may include:

  • Home care aides
  • Personal care aides
  • Elderly care aides
  • Home health aides
  • Specialized home caregivers
  • Hospice care workers

In most states, home health agency employers must meet state requirements for caregiver background checks, which typically include criminal background checks and searches of abuse and neglect registries. Employers may also conduct additional screening, for example to verify past employment and education, or check a candidate’s motor vehicle record (MVR) if driving will be part of the job.

What shows up on a caregiver background check?

Employers can choose from a range of pre-employment background screenings when conducting caregiver background checks. In addition to meeting state requirements regarding background checks for caregivers, employers may choose to conduct additional searches, such as employment or education verification or driving records for employees, contractors, and volunteers who have direct contact with clients.

Pre-employment background screening for caregivers is 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.

What is a caregiver background check? Depending on employer needs, a caregiver background check may include the following searches and screenings:

  1. Criminal record check
  2. Sex offender registry search
  3. Abuse and neglect registry search
  4. Professional license verification
  5. Employment verification
  6. Education verification
  7. Driving record check (MVR)
  8. Pre-employment drug screening

Caregiver background check compliance laws

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 the following background checks. HHAs in states that do not participate in the NBCP must also comply if they want to receive federal funding.

  • A fingerprint-based FBI criminal history search. The FBI search shows federal crimes and crimes that have been reported to the FBI in any state. An FBI search can uncover felony convictions for potentially disqualifying crimes such as healthcare-related fraud, theft, or other financial misconduct; Medicare or Medicaid fraud; or the unlawful manufacture, distribution, prescription, or dispensing of controlled substances.
  • A search of the federal Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE). The OIG list includes individuals who are not allowed to participate in Medicare or Medicaid due to criminal offenses such as Medicare or Medicaid fraud; patient abuse or neglect; certain other felony and misdemeanor convictions; and suspension, revocation, or surrender of their professional license.
  • A search of state abuse and neglect registries in the caregiver’s current state as well as other states where they have worked.

Each state has its own licensing requirements for HHAs and other caregiver organizations, including specific guidelines for caregiver background checks. 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.

California caregiver background checks

As an example of state-specific laws, California employers must contend with various state and local regulations regarding caregivers. Under Cal. Health & Safety Code § 1520, caregiver applicants are required to undergo a fingerprint-based criminal background check. If a misdemeanor or felony conviction is found, the applicant is disqualified unless they obtain an exemption from the California Department of Social Services. For caregivers who wish to receive funding from a county in-home support services (IHSS) program in California, IHSS background check requirements also call for fingerprint-based criminal background checks by the California Department of Justice.

Caregiver background checks in other states

Although specific requirements can vary from state to state, criminal background checks are the baseline. In Michigan, employees and independent contractors who provide direct services to patients or residents must undergo a state and FBI criminal background check as part of their application for employment.

In Virginia, employees of home care organizations must submit a sworn statement disclosing criminal convictions and pending criminal charges prior to employment, and complete a criminal history check within 30 days of employment. While waiting for results of a criminal background check, the employee may not have direct contact with patients unless under the supervision of an employee with clearance.

Get a background check today

Best practices for running caregiver background checks

The best background check for caregivers meets your needs as an employer. This means complying with legal requirements and providing the information you need to evaluate a candidate’s experience, qualifications, and readiness to do the job. Although a caregiver background check may include different elements depending on your jurisdiction–and your situation–here are a few basic screening options to consider:

Criminal record check

Your state may require fingerprint-based criminal records checks conducted through the FBI. You may want to run additional criminal background checks, including a state criminal records search to uncover any criminal convictions in your state that were not reported to the FBI. Searching the sex offender registry and domestic terrorist watch list are additional options, whether required by regulation or not.

Employment history, education, and licensing verification

Employers can verify the candidate’s education and employment history, as well as the current status of their professional licenses to better understand their experience and qualifications.

Neglect, abuse, and sanctions screening

You may want to check the central neglect and abuse registry in your state and in other states where a candidate has lived or worked.  State neglect and abuse registries are centralized databases of child abuse and neglect investigation records that may also include records of abuse of vulnerable adults. If applicable, employers may also check federal and state healthcare sanctions registries, such as the OIG exclusion list, which shows individuals who are not eligible to receive funding from healthcare programs like Medicare. These screenings may or may not be included in a state-required background check.

Driving records

Employers may elect to check a caregiver candidate’s driving record to confirm license type and status, accidents, and moving violations for positions that require driving on the job.

Drug screening

Illegal drug use can compromise a caregiver’s ability to do their work. The Equal Employment Opportunity Commission recommends conducting pre-employment drug screening only after a provisional offer of employment is made.

Ongoing screening

Once candidates are hired, ongoing checks of criminal records and driving records, or periodic drug testing can help keep you up to date.

How to conduct caregiver background checks

You might start by learning about state requirements where you live. In addition to regulations on caregiver background checks, your state may have resources to help. For example, the California Department of Social Services (CDSS) maintains Guardian, a 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. In Georgia, family employers looking to hire personal caregivers for family members may access the Georgia Caregiver Portal to verify the employment eligibility of prospective caregivers.

How to do a background check on a caregiver

While it’s possible to conduct a caregiver background check yourself, many organizations and employers choose to work with a professional consumer reporting agency (CRA), like Checkr. A third-party provider can help you conduct thorough pre-employment background checks that are compliant with federal, state, and local regulations–as well as fair-hiring laws at every level.

Follow these steps to get a caregiver background check with help from a CRA:

  • 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 an adverse action process. If you decide not to hire a candidate, the FCRA requires employers to follow an adverse action process that includes giving the candidate an opportunity to review information in their report and to dispute it.

Get caregiver background checks from Checkr

Working with a professional background check provider, like Checkr, to conduct caregiver background checks can save you time while helping you comply with legal and industry regulations, as well as fair-hiring laws. Checkr offers multiple background check options, including criminal background checks, professional license verification, and healthcare sanctions searches.

Get a background check today


The resources provided here are for educational purposes only and do not constitute legal advice. We advise you to consult your own counsel if you have legal questions related to your specific practices and compliance with applicable laws.

Headshot of Gayle SatoHeadshot of Gayle Sato

About the author

Gayle writes about business topics, specializing in background checks and screening best practices.

Keep reading

Ready to get started?