A background check for healthcare workers usually combines a criminal record search (often fingerprint based because state law requires it), a check of your professional license or certification, and a search of the federal OIG exclusion list and similar sanction lists, and many employers add a drug test. Child care, school and caregiver jobs follow a similar pattern, with child abuse registry checks added.
Care jobs get the deepest screening of almost any private work because the people you serve cannot easily protect themselves. The good news is that the process is predictable. Once you know the pieces, you can line up documents before HR asks and avoid the weeks of waiting that catch most new hires.
Quick answers
Criminal search
County and state records, and in most states an FBI fingerprint check for patient or child contact roles.
Exclusion lists
The HHS OIG List of Excluded Individuals and Entities (LEIE), the federal SAM exclusions, and state Medicaid lists.
License check
Status and discipline with the state board, or the state nurse aide registry for CNAs.
Extra for child care
Child abuse and neglect registry and sex offender registry searches, usually in every state you lived in recently.
Who pays
Usually the employer. Some home care agencies ask you to cover fingerprints, so ask first.
Medical records
Not part of a background check. Health screenings like a TB test are separate.
What a background check for healthcare workers includes
| Check | What it looks at | Who usually gets it |
|---|---|---|
| County and statewide criminal | Court cases where you lived and worked | Everyone |
| Prints run through state and FBI files | Arrests booked under any name | Roles with patient, resident or child contact in most states |
| OIG exclusion list | People barred from federal health programs | Everyone at a provider that bills Medicare or Medicaid |
| SAM and state Medicaid exclusions | Federal contract and state program bars | Most hospitals and large providers |
| License or certification | Active status, restrictions, discipline | Nurses, therapists, pharmacists, techs, doctors |
| Nurse aide registry | Certification and findings of abuse, neglect or theft | CNAs and nursing home aides |
| Drug test | Recent drug use, separate from the report | Most hospitals and many home care agencies |
| Employment and education | Past jobs, degrees, training | Most clinical roles |
For how each kind of search works, see types of background checks.
OIG background check: what the exclusion list means
The HHS Office of Inspector General can bar a person or company from getting paid by federal health programs, often after a conviction for Medicare or Medicaid fraud, patient abuse or certain drug crimes. Those people go on the List of Excluded Individuals and Entities. According to the OIG exclusions page, anyone who hires a person on the list may face civil money penalties, and OIG advises providers to check the list for new hires and current staff.
That is why an "OIG SAM background check" shows up on almost every hospital, clinic and nursing home screening, often rechecked every month. A hit is rare. When it happens, it is often a name match with someone else, which the screener clears by comparing date of birth and license number.
If you really are excluded, no provider that bills federal programs can pay you for patient services until OIG reinstates you. Reinstatement is not automatic when the exclusion period ends. You have to apply.
CNA, nurse and nursing home background checks
Nursing homes must check the state nurse aide registry before hiring an aide, and most states also require a fingerprint check for anyone with resident contact. For licensed nurses, the employer looks up your license with the state board and may see discipline or pending complaints.
- Before you apply: open your own license or registry entry on the state board's site and read it the way a hiring manager would.
- If you hold licenses in several states: list them all. A lapsed license in another state is easier to explain than to have found.
- If a case is pending: tell HR before the check, briefly and in writing.
Do say: "My RN license in [State] shows a past consent agreement from a medication documentation error. It was closed with no restriction, and I can send the board letter."
Do not say: "There is nothing on my record" when the board site shows an action.
Healthcare background check requirements by state
Each state decides which care workers need fingerprints and which offenses disqualify them. Some have formal screening levels. Florida, for example, requires Level 2 screening for many health and care jobs in Chapter 435, and shares results through the Agency for Health Care Administration's clearinghouse. California runs care facility and caregiver checks through Live Scan fingerprints, covered on our California background check page.
Under these laws a disqualifying offense can block a care job even if a private employer would hire you, but many states offer an exemption or waiver process after time has passed. The state agency named in the denial letter explains how to apply.
Childcare, daycare and teacher background checks
Child care staff usually face the most layers. Federal child care funding rules push states to require comprehensive checks for staff at licensed providers: a state criminal search, an FBI fingerprint check, the national and state sex offender registries, and the state child abuse and neglect registry, in each state where you lived recently. Daycare workers, preschool teachers and many after school staff fall under these rules.
Teachers, substitute teachers and other school employees get state and FBI fingerprint checks through the state education department or the school district. Many states re-screen school staff on a schedule or keep prints on file to receive new arrest notices.
If you have lived in more than one state in the past five years, write down each address with move in and move out months before you start. Child care checks have to reach every one of those states, and missing dates are the top cause of delay.
Nanny and caregiver background checks
Families who hire a nanny, babysitter or home caregiver directly can use a background screening company too. The FCRA still applies: the family must tell you in writing and get your permission before ordering a report, and must follow the adverse action steps if the report changes their mind. The FTC and EEOC explain those rights in their joint guide for job applicants.
A typical nanny check covers identity, county criminal records, sex offender registries and a driving record if you will drive the children. Families also call references closely, so pick ones who have seen you with kids.
Hi [Parent name], I am happy to do a background check. Please send me the consent form from the screening company, and let me know if you will also check my driving record, since I would be driving [Child name] to school. Thanks, [Your name]
How long care screenings take and how to speed them up
A hospital screening with fingerprints often clears in three to ten business days. It runs longer when a fingerprint record needs review, a license is in another state, a school is slow to confirm a degree, or you lived in several states. Use our background check timer to estimate yours.
- Bring your license numbers, registry numbers and certificate copies to the offer meeting.
- Book fingerprints the same day you get the request.
- Ask HR which items are still pending if you hear nothing after a week.
Care sector rules shift from state to state, so treat this overview as background reading rather than legal advice. Your state licensing agency can explain its rules, and for a denial or exemption question, a nonprofit law center or an attorney who represents nurses and aides can look at the paperwork.
Questions people ask
What is an OIG background check?
That label means the screener searched the HHS Office of Inspector General's list of people and companies excluded from federal health programs. Providers that bill Medicare or Medicaid run it on new hires and usually recheck it monthly. A match can stop a provider from paying you for patient care.
What shows up on a hospital pre employment background check?
Typically criminal records, exclusion list results, license status, employment and education verification, and sometimes a fingerprint result. A drug test is usually separate. Your patient chart and health history stay out of it.
Do CNAs need a fingerprint background check?
Nearly everywhere, yes, for jobs in nursing homes and other care settings. Employers also check the state nurse aide registry for your certification and any findings.
How should a family screen a nanny it wants to hire?
Use a background screening company that follows the FCRA, give the candidate a written notice, and get written permission. Follow the adverse action steps if you decide not to hire based on the report. Call references too.
Can I work in healthcare with a misdemeanor?
Often, yes. It depends on the offense, how long ago it was and the state's list of disqualifying crimes for that role. Read misdemeanors on a background check for what usually happens.
What is a medical background check for employment?
The phrase usually means a background check for a medical job, not a review of your health history. Health screenings such as a TB test or drug test happen separately, and the ADA keeps employers from asking health questions before they have made you an offer.