What is a Senior Caregiver Background Check?

America's population is aging, but only some need or want to transition to a nursing home in their old age. Many more people today want to continue living at home, and that may require the presence of a home health aide. What should families and healthcare agencies alike know about the background check process for caregivers today?

With an increasingly aged population, the United States faces a major demographic shift in the coming years as millions of Americans continue to reach retirement age every year. Not only are people living longer, but there is an increased desire for independence and "aging in place" rather than transitioning to group living. Long-term care for senior citizens will likely become of the most pressing concerns by the end of the next decade.

There are many reasons for this shift, from the erosion of traditional family support to the reality that many aging individuals want to continue living in familiar surroundings. However, that desire for independence can clash with the physical realities of aging. From the risks of developing age-related mental illnesses such as dementia to the challenges of limited mobility, many conditions could make independent living difficult or impossible. As a result, a rapidly growing healthcare sector is devoted specifically to acting as in-home caregivers for senior citizens.

Some families plan to engage in a private hiring process for selecting such caregivers. In other cases, they may turn to an agency that provides selection and placement of in-home caregivers. In either case, this is not a task to take lightly—there are serious risks associated with allowing bad actors to gain access to vulnerable seniors. A caregiver background check is an essential part of the hiring process, and so too is having a plan for ongoing monitoring after you employ a candidate.

What goes into effective criminal background checks for healthcare workers, and how can your family or business do everything possible to ensure you make a smart choice? Let's explore the elements of a smart process.

Remember To Follow All Relevant Employment Laws

Before beginning to select candidates for a screening process, you must review the rules and regulations that may apply to you. For example, for agencies that receive federal funding through Medicare or Medicaid, there is a mandatory screening process that you must participate in even if your state does not require it. The Affordable Healthcare Act established these guidelines and created the National Background Check Program or NBCP. 

Home healthcare services may need to submit to state-level implementations of the NBCP by law even if they do not directly receive federal funds. Many employers will take these steps in addition to your other screening efforts. Therefore, you should always review what the laws in your state say about healthcare background checks. The steps you must take could vary significantly from state to state.

Before beginning any hiring efforts, you should ensure that a compliant process is ready. However, there are other considerations to make regarding federal law. Remember that if you intend to use background checks for employment purposes, you will be subject to laws such as the Fair Credit Reporting Act. Job candidates will need to receive a notice of your intent to screen them, and they must give consent to a background check. There are additional FCRA notification guidelines you must follow if a background check's results make you decide to move on to another candidate.

Follow Procedures for National Background Check Program Compliance

What's involved in the NBCP? There are several important elements to consider. The first is an FBI fingerprint background check; all caregivers must submit their fingerprints for analysis at the FBI. This check will reveal any convictions for federal crimes and may match crimes reported by the states to the FBI. However, as not all state police systems feed into the FBI database, there may be additional criminal information available that this check does not report.

Caregivers must also have their names checked against several different registries established to track those who have abused patients, committed fraud or engaged in other forms of wrongdoing. You must check the Office of the Inspector General's List of Excluded Individuals and Entities and any state-level abuse registries. You should check both the registry in your current state and all states where they previously worked as a licensed health aide.

Always review your state and federal NBCP obligations before hiring a caregiver.

Additional Important Elements in the Background Check Process

To be as thorough as possible, agencies and private employers need to consider other additional elements for their background checks. What are these other elements, and why are they important?

  • Name/alias verification. Using an individual's Social Security number, you can verify who they are and uncover any additional aliases they may have used in the past. This important step will help build confidence when you assess other records that may use those aliases.
  • Understanding how to interpret criminal records. Remember, not everything may appear in an FBI background check. Using a professional background check service that compiles updated records from systems nationwide is a quick and simple way to look for evidence that might be cause for concern, such as a violent felony or fraud charge.
  • Drug testing. Since home health aides may access an individual's medications, including pain medication, a drug test may be an important element of your risk assessment. In some states, it may also be a requirement.
  • License and educational verification. Some states already require you to verify licenses as part of the NBCP. Regardless, verifying that an individual has the proper licenses to work in home health care in your state is always advised.

By incorporating these elements into your process with the support of a proven and professional background check supplier, you can develop greater confidence in the safety and suitability of candidates. However, your efforts should continue after the pre-employment background check.

The Need for Ongoing Criminal Monitoring in Home Healthcare

Alongside other safety guardrails, ongoing monitoring helps protect you against what you can't expect. Ongoing monitoring services periodically re-check an individual's criminal record after hiring. This effort can alert you to a change in someone's status, such as when they face new charges following an arrest. 

There's no telling when or even if someone will offend or re-offend in the future. Ongoing monitoring provides an important line of defense, allowing risky individuals to continue working with a vulnerable population. When you receive an alert of a status change, you can make a swifter decision to begin gathering the facts—and to terminate the employee if necessary. When someone's safety at home is at stake, taking these extra steps is essential for establishing peace of mind.

Set the Stage for Safer Golden Years

No screening program can be 100% effective 100% of the time, and there is, unfortunately, no crystal ball that lets us predict when someone might choose to commit a crime in the future. However, by conducting careful and thorough screening of home health aides, it is possible to reduce risks and increase the likelihood of a successful partnership. By following the law and emphasizing the importance of continued compliance and updated knowledge, it's possible to foster a safer, more productive environment in home health care.

At backgroundchecks.com, we've compiled extensive information on best practices to support employers on their journey to deploying effective screening programs. Please explore our Learning Center today for more information about criminal background checks for healthcare workers and other important topics.

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Michael Klazema

About Michael Klazema The author

Michael Klazema is the lead author and editor for Dallas-based backgroundchecks.com with a focus on human resource and employment screening developments

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