Hospice Background Check Requirements
Short answer: a Medicare hospice must obtain a criminal background check on every employee who has direct patient contact or access to patient records, and its contracts must require the same of contracted staff. Checks follow state rules; where a state has none, they must be obtained within three months of hire and cover every state the person lived or worked in for the past 3 years (42 CFR 418.114(d)).
Updated October 24, 2026 · Checked against the official sources listed at the end
Who needs a check
Under 42 CFR 418.114(d)(1), the hospice must obtain a criminal background check on all hospice employees who have direct patient contact or access to patient records. That includes office staff who can open patient records, not only nurses and aides.
Hospice contracts must require that all contracted entities obtain criminal background checks on their contracted employees who have direct patient contact or access to patient records. Keep proof that the contractor did it.
When, and how far back
Checks must be obtained in accordance with state requirements (418.114(d)(2)). In the absence of state requirements, they must be obtained within three months of the date of employment, for all states the individual has lived or worked in during the past 3 years.
The exclusion check that goes with it
A background check isn't the same as an exclusion check. OIG's List of Excluded Individuals/Entities covers people barred from federal health care programs, and no federal program payment may be made for services furnished by an excluded person, including administrative and management services. Most hospices check every worker against the OIG list at hire and monthly, plus their state's Medicaid exclusion list.
How Pact handles it
Pact orders background checks online ($32 Standard, $70 Premium with a 7-year county search and FACIS Level 3), or tracks the ones you run on your own screening account, and keeps the dated report in each person's file. Every active staff member is checked against OIG's exclusion list monthly, plus the Medicaid exclusion lists of 25 states automatically (the rest by a monthly hand-check task in your portal, with the proof saved). Pact Compliance Review checks every credential document your staff upload, usually within minutes, 24/7. Background check reports are never sent to it; a person decides on those. Credential tracking is $10 per active staff member a month, $250 minimum.
Common questions
Do hospice volunteers need a background check?
418.114(d) names hospice employees and contracted employees with direct patient contact or access to patient records. Check your state's rules and your own policy for volunteers; many states and hospices require them too.
How long does a hospice have to get the background check?
Follow your state's timing. If your state has no requirement, within three months of the date of employment (418.114(d)(2)).
Does the check have to cover other states?
Where your state has no rule, yes: every state the person lived or worked in during the past 3 years (418.114(d)(2)).
Sources
- 42 CFR 418.114: Personnel qualifications (criminal background checks)
- OIG: Exclusions program and LEIE