The short answer West Virginia CARES (Clearance for Access: Registry & Employment Screening) requires fingerprint-based state and FBI checks with bundled registry screening for direct access personnel at home health, personal care, and other covered providers.
What West Virginia requires
West Virginia
WV CARES statute. W. Va. Code § 16B-15-1 et seq. (recodified in 2024 from § 16-49-1 et seq.) requires covered providers, including home health agencies, personal care and in-home care providers, and hospices, to screen all direct access personnel through WV CARES, which includes a fingerprint-based WVSP and FBI criminal check.
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Bundled registry checks. The WV CARES portal automatically checks required registries — the WV nurse aide registry, adult and child protective services records, sex offender registries, and OIG exclusion databases — before issuing a fitness determination.
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Rap back. Fingerprints are retained for rap back monitoring, notifying employers of subsequent arrests; determinations are portable among covered WV employers.
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Variance process. Applicants with disqualifying offenses may request a variance from the department demonstrating rehabilitation; certain crimes remain permanently disqualifying.
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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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