HHA Background Checks
MADE MISTAKES IN THE PAST?
Introduction
We all make mistakes in our lives and, for the most part, learn from our bad decisions and move forward.
Whether it’s taking a dare to stuff a chocolate bar in your backpack or glancing over to a classmate trying to get a correct answer on a test.

But, some more serious mistakes (i.e. crimes) could certainly be considered life-changing and affect us and others for the rest of our lives.
And the real world?
The fact is many folks never learn and continue to commit criminal activities.
HHA’s Vital Role and Behavior
Applying for and working as a home health aide (HHA) may be the most important position you will have.
There is no margin of error for an aide’s “bad behavior”.
HHA’s take care of the most vulnerable individuals in our society. These include the elderly, people with disabilities or convalescents. They take care of these people either within their homes or in a skilled nursing facility (also known as a nursing home).
Most of the time home health aides are not supervised in person during their care of the client. In some cases, aides are involved in the kind of care which enables them to interact with clients in their most private of moments such as getting dressed, bathing, etc.
You must appreciate the fact that your future employer needs to hire the right person for the right job.
Home health aides (including personal care aides) must be trained, kind, patient, emphatic, and understanding. Besides, they need to be honest, ethical, decent and morally upright.
Oh yes, and above all, they should not have any criminal tendencies or inclinations.
If an agency hires the wrong person to be a home health aide, then they are setting up the most vulnerable members of society for avoidable acts of crime and / or abuse. Factor in the cost of lawsuits and tarnished brand and it is essential that only the right folks are hired.
HHA Background Checks
Though not fool proof, a way to ensure that the right individuals are hired is through an exhaustive screening process which weeds out all the wrong individuals.
A critical component of the hiring process is a caregiver background check.
Background checks provide employers with a fairly good measure of how much they can trust potential and current employees. They are not unique to the healthcare industry. Others such as child care and educational settings, financial institutions, and any other area that puts a person in contact with financial temptation or vulnerable populations use them.

When it comes to home health agency employees, there is no federal requirement that workers pass a background check, and state laws are extremely varied.
With the demand very high for home health aides very high, some hiring agencies may be tempted to cut corners and not perform a background on candiates.
This can be illegal and, at the very least, may be expensive and very costly in the degradation of the brand.
What is a HHA Background Check?
A background check is a process a home health agency (or any other employer of aides) uses to verify that a person is who they claim to be. In particular, that they are not convicted criminals!
There are many variations of background checks – ranging from verifying an identity to full scope (e.g. FBI check, fingerprinting, personal, etc.).
No matter the format, background checks allow an employer to check a person’s criminal record, education, employment history, and other past activities to confirm their validity.
Most common types background checks:
- Employment
- Criminal
- E-Verify
- Fingerprint
- Credit
- Personal
- Professional Licenses
What’s Included in a HHA Background Check?
Because background checks vary in scope they also vary in price.
For a home health agency, they will focus on such items/events as:
These are designed to make sure only the right individuals get entrusted with the most vulnerable members of society.
Makes sense, doesn’t it?
How to do a Background Check on a Caregiver
Background checks are a straightforward process. Candidates just have to submit their name, address and Social Security number for the agency’s background check program to do all of the legwork.
Some agencies will also ask candidates for fingerprints so they can confirm identities in case there is any confusion later on with other government records or databases that may be established by law enforcement officers at some point down the line when it becomes necessary.
What is Included in The Background Process
Background checks are often the most time-consuming step in getting hired as a caregiver.
Some potential employers will only hire applicants with clean backgrounds, while others look at every applicant they can find and weigh their criminal history against other factors; for example: whether or not it was committed more than 5 years ago if there were no subsequent convictions.
In California, sexual assault crimes like rape and child molestation usually disqualify an applicant outright regardless of how long ago the crime took place. For those who don’t have any felonies on their record but do come up positive under certain screenings (like sex offender registries), this is when waivers become necessary to get around these barriers – which some states require before approving applications.
Caregiver background checks can go deeper than just a criminal history. They may also investigate driving records for repeated offenses, careless driving or anything that could indicate an applicant is not a safe driver. Credit reports are sometimes reviewed as well and contain information on payment history, outstanding debts, judgments and liens (among other things).
These factors might be disqualifying to certain agencies but this varies from one company to the next so it’s important to research in advance what each agency requires before applying!
Requirements for Background Checks
There are no Federal laws requiring home health aides to undergo a background check before getting hired, or even after they have been hired in 2021.
Further, no Federal laws or regulations exists that prohibit employers from hiring individuals who have been convicted of crimes or who have had a finding concerning abuse, neglect, mistreatment of beneficiaries, or misappropriation of beneficiary property.
NOTICE!
But, as a condition of participation in Medicare, agencies must comply with State laws.
State requirements for background checks vary what sources of information must be checked, which job positions require background checks, and what types of convictions prohibit employment.
Types of HHA Background Checks
There are two (2) kinds of background checks that States need employers of home health aides to use: Statewide and Federal Bureau of Investigation (FBI).
- Statewide background checks are conducted by a State law enforcement agency (i.e. state police) and include information for crimes committed within that State.
- FBI background checks are also conducted by a State law enforcement agency, which provides identifying information and a set of fingerprints to the FBI to match against criminal background information maintained in its database.
Does Require a HHA Background Check?
Forty-one (41) states require home health agencies to conduct background checks; ten (10) states have no requirements though several have plans to implement changes.
The table below (HHA Background Check Requirements by State) shows the requirement for home health aides.
HHA Background Check Requirements by State
State | Background Check? |
---|---|
Alaska | FBI and Statewide for Certain Individuals |
Alabama | NONE |
Arkansas | Statewide for All Individuals and FBI for Certain Individuals |
Arizona | Statewide for All Individuals |
California | Statewide for Certain Individuals |
Colorado | Statewide for All Individuals and FBI for Certain Individuals |
Connecticut | NONE |
District of Columbia | FBI and Statewide for All Individuals |
Delaware | FBI and Statewide for All Individuals |
Florida | FBI and Statewide for All Individuals |
Georgia | NONE |
Hawaii | NONE |
Iowa | Statewide for Certain Individuals |
Idaho | FBI and Statewide for All Individuals |
Illinois | FBI and Statewide for All Individuals |
Indiana | Statewide for All Individuals and FBI for Certain Individuals |
Kansas | Statewide for Certain Individuals |
Kentucky | Statewide for All Individuals and FBI for Certain Individuals |
Louisiana | Statewide for Certain Individuals |
Massachusetts | Statewide for All Individuals |
Maryland | Statewide for All Individuals |
Maine | Statewide for All Individuals |
Michigan | FBI and Statewide for All Individuals |
Minnesota | Statewide for All Individuals and FBI for Certain Individuals |
Missouri | Statewide for All Individuals |
Mississippi | FBI and Statewide for All Individuals |
Montana | NONE |
North Carolina | FBI and Statewide for Certain Individuals |
North Dakota | NONE |
Nebraska | FBI and Statewide for Certain Individuals |
New Hampshire | Statewide for All Individuals |
New Jersey | NONE |
New Mexico | FBI and Statewide for Certain Individuals |
Nevada | FBI and Statewide for All Individuals |
New York | FBI and Statewide for All Individuals |
Ohio | FBI and Statewide for Certain Individuals |
Oklahoma | FBI and Statewide for All Individuals |
Oregon | Statewide for All Individuals |
Pennsylvania | Statewide for All Individuals |
Rhode Island | Statewide for Certain Individuals |
South Carolina | FBI and Statewide for Certain Individuals |
South Dakota | NONE |
Tennessee | Statewide for Certain Individuals |
Texas | Statewide for Certain Individuals |
Utah | FBI and Statewide for All Individuals |
Virginia | Statewide for All Individuals |
Vermont | Statewide for Certain Individuals |
Washington | Statewide for All Individuals |
Wisconsin | Statewide for All Individuals |
West Virginia | NONE |
Wyoming | NONE |
Next Steps
If an agency is going to conduct a background check they must obtain prior written authorization from applicants and employees. And, you as the applicants or employee, must be notified it will be conducted.
Checklist for HHA Background Check
The home health agency must explicitly describe the scope of the check; they must also let the person know that any information may result in adverse employment action (i.e. not being hired as an applicant, being terminated as an employee).
As an applicant or employer, know the laws of the state and make sure you document everything accordingly.
Be wary of written notices, timeframes of when folks need to be notified, second notices if a person is not hired/terminated, allowing individuals to dispute the findings, copy of the background check, etc.).