The short answer Massachusetts relies on CORI (state criminal offender record) checks for home health and homemaker agency workers, mandatory for EOHHS-contracted and state-funded providers, with nurse aide registry verification; fingerprinting is not required for most home care hires.
What Massachusetts requires
Massachusetts
CORI checks. M.G.L. c. 6, § 172 and EOHHS regulations (101 CMR 15.00) require agencies providing services to elders and people with disabilities, including certified home health and state-contracted homemaker agencies, to run iCORI checks before hiring workers with potential unsupervised client contact.
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Discretionary and mandatory disqualifications. 101 CMR 15.00 divides offenses into tables requiring mandatory disqualification or individualized (discretionary) review, with a documented hiring review and applicant dispute process for discretionary offenses.
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Nurse aide registry. Home health agencies employing aides must check the Massachusetts Nurse Aide Registry maintained by DPH for certification status and abuse/neglect findings.
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No FBI fingerprint mandate. Massachusetts does not require fingerprint-based FBI checks for home care agency staff (fingerprinting is limited to sectors like schools and DCF-licensed programs); out-of-state history is a recognized gap addressed by FCRA-compliant vendor checks.
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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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