Background Check Requirements for Home Care Workers in Maryland

RSA screening statute. Md. Code, Health-General § 19-1902 to 19-1906 requires residential service agencies and other health care facilities to require eligible employees (non-licensed direct care) to undergo either a state and national CJIS criminal history records check (fingerprint) or a private agency background check covering at least the prior 7 years of residence. Source ↗

RSA licensure. Home care in Maryland is delivered through OHCQ-licensed Residential Service Agencies (COMAR 10.07.05), whose survey standards include verification of the required background checks and CNA/home health aide certification through the Maryland Board of Nursing. Source ↗

Board of Nursing certification. CNAs and home health aides must be certified by the Maryland Board of Nursing, which itself requires a CJIS fingerprint check at certification, effectively fingerprinting most aide-level hires. Source ↗

Adverse findings. Employers must act on conviction information relevant to patient safety; MBON discipline and registry annotations bar aides with abuse findings from certified practice. Source ↗

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. Source ↗

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. Source ↗

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. Source ↗

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. Source ↗