Caregiver background checks and screening, step by step

The steps, in plain terms

1. Apply the same screening standards to every candidate for the same job.
2. Before you order a report from a background check company, give a stand-alone written notice and get written permission.
3. Certify to the company that you followed the FCRA and will not misuse the information.
4. Before you reject someone because of the report, give them a copy of the report and the FCRA summary of rights so they can respond.
5. After the decision, send an adverse action notice with the company’s contact details and the person’s right to dispute the report.
6. Complete any checks or registry steps your state requires, and check the HHS-OIG exclusion list.
7. Keep hiring records as long as your obligations require, then dispose of background reports securely.

This list follows the federal guidance cited below. Your state may add steps or set a required order.

1. The same standards for everyone

It is illegal to check the background of applicants and employees when that decision is based on race, national origin, color, sex, religion, disability, genetic information (including family medical history) or age (40 or older). The EEOC’s example: asking only people of a certain race about their financial histories or criminal records is evidence of discrimination.

2. Criminal records and the job

A policy that excludes people with certain criminal records can violate federal law if it significantly disadvantages people of a particular race, national origin or another protected group and does not accurately predict who will be a responsible, reliable or safe employee. The EEOC’s 2012 guidance on arrest and conviction records looks at the nature of the offense, the time that has passed and the nature of the job, and describes an individualized assessment for people a screen would exclude. In October 2026 the EEOC scheduled a vote on rescinding that guidance, so check its current status; tying any criminal record rule to the job and applying it the same way to everyone remains the safer practice.

Be prepared to make exceptions for problems a background check reveals that were caused by a disability. Some states require agencies to keep people with certain offenses out of caregiving roles; follow your state’s rules as well.

3. Fair Credit Reporting Act steps

When you get a background report from a company in the business of compiling background information, the FCRA applies.

4. The HHS-OIG exclusion list

The HHS Office of Inspector General can exclude individuals and entities from federally funded health care programs, and keeps the List of Excluded Individuals/Entities (LEIE). OIG says anyone who hires someone on the list may be subject to civil monetary penalties, and that health care entities should routinely check the list for new hires and current employees. Check it even if you are private-pay today: the penalty risk is tied to federal health care program payment, such as Medicaid, and your state may require the check too.

5. State checks

Some states require specific background checks, fingerprinting or registry listings for caregivers, sometimes before any client contact. The rules differ by state and license type, so check with your state licensing agency before you set your process.

6. Records and disposal

EEOC rules require covered employers to keep personnel and hiring records, including applications from people not hired, for one year after the record was made or the personnel action was taken, whichever is later, and longer if a discrimination charge is filed. After that, dispose of background reports securely, for example by shredding paper and making electronic files unreadable.