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Background Checks for Healthcare Staffing Agencies

Facilities may require a staffing agency to background check every worker it places. When you use an outside company to run those checks, a federal law called the Fair Credit Reporting Act (FCRA) sets the steps you must follow. State and city laws can add more. This guide walks through the FCRA steps, fair-chance laws, state fingerprint checks, and other common searches. It is not legal advice.

Updated October 3, 2026 · Checked against the official sources listed at the end

When the FCRA applies

The FTC says employment background checks are also known as consumer reports. They can include criminal records and credit reports. When you get them from a company in the business of compiling background information and use them for hiring, retention, promotion, or reassignment, you must follow the FCRA.

The FTC and the EEOC also say that any time you use background information to make an employment decision, however you got it, you must follow federal anti-discrimination laws. That means applying the same standards to everyone.

The FTC enforces the FCRA for employers.
Some states restrict the use of consumer reports, usually credit reports, for jobs. Review your state's laws too.

Step 1: Standalone disclosure and written authorization

Before you get a report, the FCRA requires a clear and conspicuous written disclosure that a consumer report may be obtained for employment purposes. The law says it must be in a document that consists solely of the disclosure (15 U.S.C. 1681b(b)(2)).

The FTC says this notice cannot be part of a job application. You may add minor related information, like a short description of consumer reports, only if it does not confuse or distract from the notice.

You also need the person's written permission. The authorization can be on the same document as the disclosure.

If you want to run checks again during the worker's employment, the FTC says the authorization should say so clearly and conspicuously.
You must also certify to the background check company that you gave the disclosure, got permission, and will not misuse the information in violation of equal opportunity laws.

Step 2: Pre-adverse action notice and waiting period

Before you reject an applicant, reassign or terminate a worker, deny a promotion, or take any other adverse action based in whole or part on the report, the FCRA says you must give the person a copy of the report and a written description of their rights (15 U.S.C. 1681b(b)(3)).

That description is the Consumer Financial Protection Bureau's "A Summary of Your Rights Under the Fair Credit Reporting Act." The FTC says the company that gave you the report should have given you a copy.

This step gives the person a chance to review the report and tell you if something is wrong.

The FCRA does not set a specific number of days. An FTC staff report says some reasonable period of time must pass between the pre-adverse action notice and the adverse action, and that the minimum will vary with the circumstances.

Some state and city laws do set a number. California's Fair Chance Act and New York City's Fair Chance Act each require at least five business days for the person to respond in certain cases (see below).

Send the notice before you make a final decision.
Include the full report you relied on.
Include the current CFPB Summary of Rights.
Pick a waiting period in your written policy and use it every time.
If state or city law sets a longer period, follow the longer one.

Step 3: Adverse action notice

After you take the adverse action, the FCRA requires a notice (15 U.S.C. 1681m(a)). It can be oral, written, or electronic. The FTC staff report says the pre-adverse and adverse action notices may not be in the same document.

The name, address, and phone number of the background check company that supplied the report.
A statement that the company did not make the decision and cannot give the specific reasons for it.
Notice of the person's right to dispute the accuracy or completeness of the report with that company.
Notice of the right to a free copy of the report from that company if requested within 60 days.
If a numerical credit score was used in the decision, the score and related details the law lists.

Fair-chance and ban-the-box laws

Some states and cities limit when and how employers can ask about criminal history. Two examples:

California: the Fair Chance Act (Government Code 12952) applies to employers with five or more employees. It bars asking about conviction history until after a conditional job offer. Before denying a job based on conviction history, the employer must make an individualized assessment and send a written preliminary decision with a copy of any conviction report. The applicant then has at least five business days to respond. The law does not apply to positions where a state, federal, or local law requires a criminal background check or restricts employment based on criminal history.

New York City: the Fair Chance Act bars most employers from asking about criminal history before a conditional offer. The city's guidance says that for temporary help firms, the conditional offer is the offer to place the applicant in the firm's labor pool. Before withdrawing an offer based on criminal history, the employer must follow the Fair Chance Process, including at least five business days to respond. The guidance also says a temporary help firm cannot refer only workers without criminal records because a client asks it to.

Check the laws in each state and city where you recruit.
Positions where a law requires a background check may be treated differently. Confirm which of your roles qualify.

State fingerprint checks, exclusion lists, and registries

Some states require fingerprint-based background checks for certain healthcare workers. Florida is an example. Its law (section 408.809) requires level 2 screening for several groups. Where a provider's licensing law requires it, these include people who will provide personal care or services directly to clients, and certain contractors. Level 2 screening (section 435.04) includes fingerprinting for state and FBI criminal history checks, plus a search of sex offender registries in any state the person lived in during the past 5 years. Florida also requires rescreening every 5 years.

Healthcare background packages may also include a search of the federal health care exclusion list. The HHS Office of Inspector General keeps this list, called the List of Excluded Individuals/Entities (LEIE).

A search of the Dru Sjodin National Sex Offender Public Website (NSOPW) can also be added. It is run by the U.S. Department of Justice with state, territorial, and tribal governments. It searches the registries of all 50 states, D.C., U.S. territories, and participating tribes by name. NSOPW says the data comes from each jurisdiction, so errors must be corrected with that jurisdiction.

Ask each state licensing agency or health department whether a fingerprint check is required for the roles you place.
A name search can match the wrong person. Confirm identity before acting on a registry hit.
If a background check company runs these searches for you, the FCRA steps above apply.

Keeping and disposing of reports

The FTC and EEOC say employers must keep personnel and employment records, including application forms and hiring records, for one year after the record was made or the personnel action was taken, whichever is later. If someone files a discrimination charge, keep the records until the case ends.

When you no longer need a report, the FTC says you must dispose of it securely. That means shredding, burning, or pulverizing paper, and erasing electronic files so they cannot be read or rebuilt.

Store reports separately and limit who can see them.
Keep copies of the disclosure, authorization, and every notice you send.

Common questions

Can the FCRA disclosure be part of our job application?

No. The FCRA requires the disclosure to be in a document that consists solely of the disclosure. The FTC says it cannot be in an employment application.

How long do we have to wait after the pre-adverse action notice?

The FCRA does not set a specific number of days. An FTC staff report says a reasonable period must pass, depending on the circumstances. Some state and city laws, such as California's and New York City's fair-chance laws, require at least five business days in certain cases.

What do we send with the pre-adverse action notice?

A copy of the background report you relied on and the CFPB's "A Summary of Your Rights Under the Fair Credit Reporting Act."

Can we re-run background checks on current workers?

Yes, if you have the person's authorization. The FTC says that if you want authorization for reports throughout the person's employment, the form should say so clearly and conspicuously.

When is the conditional offer for a staffing agency under New York City's Fair Chance Act?

The city's guidance says that for temporary help firms, the conditional offer is the offer to place the applicant in the firm's labor pool. Criminal history questions must wait until after that point, unless an exemption applies.

Do we need fingerprint checks?

Only where a state law or a facility contract requires them. Florida, for example, requires fingerprint-based level 2 screening for certain people who give direct care to clients of licensed providers, with rescreening every 5 years. Check with each state where you place workers.

Sources

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