The short answer Kentucky bars home health providers from employing people with certain felony convictions based on a mandatory name-based state criminal record check, and offers the voluntary KARES fingerprint/FBI screening portal for long-term care and in-home providers, along with nurse aide abuse registry and Caregiver Misconduct Registry checks.
What Kentucky requires
Kentucky
Statutory bar. KRS 216.789 prohibits nursing pools, home health agencies, and assisted living providers from employing persons with felony convictions involving abuse/neglect of an adult, sexual crimes, drug offenses, or theft, based on a criminal record check under KRS 216.787.
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KARES program. The Kentucky Applicant Registry and Employment Screening (KARES) program (906 KAR 1:190), built under the CMS National Background Check Program, is a voluntary program: long-term care and in-home service employers that opt in receive fingerprint-based FBI checks and automated registry checks through a single web portal, in addition to — not in place of — the mandatory name-based, state-only checks under KRS 216.533, 216.712, 216.787, and 216.789.
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Registry checks. Employers must check the Kentucky Nurse Aide Abuse Registry and the Caregiver Misconduct Registry (validated findings of abuse, neglect, or exploitation by non-certified caregivers) before hire.
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Rap back monitoring. For employers participating in the voluntary program, KARES retains fingerprints for continuous rap back notification, alerting enrolled employers to subsequent arrests of cleared employees.
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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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