The short answer The District requires criminal background checks, including FBI fingerprint checks, for unlicensed personnel of home care agencies and home support agencies under the Health-Care Facility Unlicensed Personnel Criminal Background Check Act.
What District of Columbia requires
District of Columbia
Unlicensed Personnel Act. D.C. Code § 44-551 et seq. requires home care agencies and other covered facilities to obtain a criminal background check, including a fingerprint-based FBI national check processed through the Metropolitan Police Department, for unlicensed persons who provide direct patient care.
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Disqualifying convictions. The Act bars employment of persons convicted within the previous 7 years of enumerated offenses including murder, assault, sexual offenses, theft, fraud, illegal use of a weapon, and abuse or neglect of a vulnerable adult.
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Registry checks. Agencies must verify the D.C. Nurse Aide Registry (administered through DOH/Board of Nursing contractors) for certification status and abuse findings before employing aides.
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Licensing oversight. DC Health licenses home care agencies and home support agencies and verifies background check compliance during surveys; Medicaid providers add OIG exclusion screening.
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The federal baseline (applies in every state)
Federal
No universal federal mandate. There is no federal law requiring criminal background checks for private-pay home care workers; requirements are set state by state. HHS OIG found wide variation in state home health background check requirements, and Medicare Conditions of Participation for home health agencies defer to state law on screening.
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National Background Check Program (ACA Section 6201). Section 6201 of the Affordable Care Act created the CMS National Background Check Program, which awarded grants to more than 25 states to build fingerprint-based, comprehensive background check systems for direct patient access employees of long-term care providers, including home health agencies and personal care providers.
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FCRA obligations. When an agency uses a consumer reporting agency (third-party background check vendor), the federal Fair Credit Reporting Act requires a standalone written disclosure, the applicant's written authorization, and the pre-adverse action / adverse action notice process (copy of the report and Summary of Rights) before rejecting a candidate based on the report.
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OIG exclusion list (LEIE). Home care providers that bill Medicare or Medicaid must not employ or contract with individuals excluded from federal health care programs. HHS OIG maintains the List of Excluded Individuals/Entities (LEIE); CMS and state Medicaid agencies expect screening at hire and monthly thereafter, and payments tied to excluded persons are subject to recovery and civil monetary penalties.
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