The short answer North Dakota requires criminal background and registry screening for licensed home health agencies and Medicaid Qualified Service Providers, but has no fingerprint mandate for home care workers; QSP enrollment relies on state criminal record and exclusion-database checks repeated at reenrollment.
What North Dakota requires
North Dakota
Licensure and QSP screening. North Dakota HHS requires home health agencies licensed under NDCC ch. 23-17.3 and Medicaid Qualified Service Providers (QSPs) to complete criminal background screening before providing care. QSP enrollment uses state criminal record and exclusion-database checks at enrollment and at reenrollment every two years; fingerprint-based BCI/FBI checks are not required for QSPs, and criminal convictions are reviewed individually as part of enrollment approval.
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Registry checks. Employers must verify the North Dakota Nurse Aide Registry and screen for substantiated vulnerable adult abuse findings and sex offender registry status before hire.
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Disqualifying offenses. NDCC § 12-60-24 governs criminal history record check processing (fingerprint-based checks apply to specific licensed settings such as child care and residential facilities, not home care); HHS provider standards disqualify applicants with offenses involving violence, abuse of vulnerable adults, or theft/fraud, subject to agency review of rehabilitation.
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Private-pay gap. Purely private-pay companion care is lightly regulated in North Dakota; FCRA-compliant vendor screening is the practical standard outside licensure and Medicaid contexts.
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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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