Pennsylvania Home Care Background Checks: Act 169, Chapter 611, and the FBI Rule

Pennsylvania requirements at a glance

PA Department of Aging, Criminal history background check ↗ · 28 Pa. Code Ch. 611 ↗

Who Act 169 covers

The Older Adults Protective Services Act (35 P.S. § 10225.101 et seq., as amended by Act 169 of 1996) applies to facilities and agencies serving older adults, and the Department of Aging's guidance names home care agencies, home care registries, and home health agencies specifically. The obligation attaches to applicants for direct care roles; purely administrative staff who never provide care are outside the statute, though many agencies check them anyway.

The two-year residency test is the piece agencies most often get wrong. It is not about citizenship or where the applicant was born. If an applicant moved to Pennsylvania 18 months ago from Ohio, they need both the PATCH check and the FBI fingerprint check. If they have lived in Pennsylvania continuously for the last two years, PATCH alone satisfies Act 169.

PA Department of Aging ↗

Timing and provisional hires under Chapter 611

28 Pa. Code § 611.55 requires the agency to have the criminal history report before the individual provides care, with one exception: you may employ someone provisionally, under supervision, while results are pending, for up to 30 days for Pennsylvania residents and 90 days for out-of-state applicants. To use the provisional window you need:

1. Applications for the required checks already submitted.

2. Supervision of the provisional hire during the window.

3. A signed disclosure from the applicant stating they have not been convicted of a prohibitive offense.

Surveyors check the dates. A PATCH result dated after the caregiver's first client visit, with no provisional-hire documentation, is a citation.

28 Pa. Code § 611.55 ↗

Prohibitive offenses and what changed after Peake

Section 10225.503 of the Act lists convictions that bar employment, including criminal homicide, aggravated assault, sexual offenses, felony drug violations, and theft-related offenses. As written, the statute imposed lifetime bans for most of them.

In Peake v. Commonwealth (Pa. Cmwlth. 2015), the court held the lifetime bans unconstitutional as applied. The Department of Aging now directs employers to conduct an individualized assessment for applicants with older convictions rather than applying an automatic lifetime bar. In practice, that means documenting the offense, how long ago it occurred, its relevance to caregiving, and evidence of rehabilitation before deciding. Agencies that still apply blanket lifetime bans face exposure from the applicant side; agencies that hire without documenting the assessment face exposure from the survey side.

35 P.S. § 10225.503 ↗ · PA Department of Aging guidance ↗

Registry and exclusion checks

Pennsylvania does not maintain a home care abuse registry, so there is no state registry search equivalent to Texas's EMR or Wisconsin's caregiver registry. Three related checks still apply:

• Nurse Aide Registry. Any employee working as a nurse aide must be verified against the Department of Health's registry, which flags substantiated findings of abuse, neglect, or misappropriation. pa.gov ↗
• Exclusion lists. Agencies billing Medicaid, including OLTL waiver providers, must screen the HHS OIG List of Excluded Individuals/Entities and Pennsylvania's Medicheck list at hire and monthly. Payments tied to an excluded person are recoverable and carry civil monetary penalties. oig.hhs.gov ↗
• Child-serving workers. If a caregiver serves minors, the separate child protective services scheme applies: Act 34 (PSP), Act 151 (ChildLine child abuse history), and FBI fingerprints where required under 23 Pa. C.S. § 6344. These are distinct clearances from Act 169 and have their own renewal cycle. pa.gov ↗

Using a third-party screening vendor

If you run checks through a background screening company rather than directly through PATCH, the federal Fair Credit Reporting Act adds process requirements: a standalone written disclosure, the applicant's written authorization, and, before rejecting anyone based on the report, a pre-adverse action notice with a copy of the report and the FTC's Summary of Rights, followed by an adverse action notice. The vendor's report does not replace the PATCH and FBI checks required by Act 169; it supplements them.

FTC, Background checks: what employers need to know ↗

Frequently asked questions

Does every caregiver need an FBI fingerprint check in Pennsylvania?

No. Only applicants who have not been Pennsylvania residents for the two consecutive years before applying. Long-term residents need the State Police (PATCH) check only.

Can a caregiver start working before the PATCH result comes back?

Yes, provisionally, for up to 30 days (90 if the applicant is from out of state), if the check has been submitted, the caregiver is supervised, and they've signed a disclosure that they have no prohibitive offenses.

Is a conviction from 20 years ago an automatic disqualifier?

Not automatically. After Peake, the Department of Aging directs employers to do an individualized assessment for older convictions instead of applying a lifetime ban. Document the assessment.

Does Pennsylvania have a caregiver abuse registry we have to search?

No home care registry exists. Check the Nurse Aide Registry for anyone working as an aide, and the OIG and Medicheck exclusion lists if you bill Medicaid.

Do office staff need Act 169 checks?

The statute covers applicants for direct-care positions. Administrative staff with no client contact are outside it, though checking them is common practice and required by some payers.

We use a screening vendor. Does their report satisfy Act 169?

Only if the vendor is actually running the PATCH and, where required, FBI checks through the state process. A commercial database search alone does not.