Texas Nurse Aide Background Checks: Registries, DPS, and Bars

Texas nurse aide background check requirements come from Chapter 250 of the Health and Safety Code, and they have three moving parts: a search of the Nurse Aide Registry, a search of the Employee Misconduct Registry, and a criminal history check through the Texas Department of Public Safety. An employer has to run all three before letting an aide or any other unlicensed worker have direct contact with residents, and certain convictions bar hiring either permanently or for five years from the date of conviction.¹

Who Has to Be Screened

The screening rule reaches anyone working as a nurse aide and anyone in an unlicensed position that involves direct contact with residents. Direct contact is the trigger: if the job puts the worker in physical proximity to residents in a way that creates an opportunity for harm, the check is mandatory.¹

Chapter 250 also covers a broader set of employers than most people expect. Nursing facilities, assisted living communities, intermediate care facilities for individuals with intellectual disabilities, home and community support services agencies, and adult day care centers all fall under it. So does a family that hires a home caregiver on its own — the individual employer carries the same screening obligation as a licensed facility.²

The Two Registry Checks

Before hiring, the employer must run the applicant’s name through two state registries. The Nurse Aide Registry tracks people who completed state-approved training and passed the competency evaluation, and it also records substantiated findings of abuse, neglect, or misappropriation of resident property. An aide with a disqualifying finding on the registry cannot be hired.¹

The Employee Misconduct Registry does the same job for unlicensed staff who are not nurse aides. It captures findings of abuse, neglect, and exploitation. A listing on either registry with a disqualifying finding is a hard bar, and skipping the search is a clear violation of state law.

Convictions That Permanently Bar Employment

Section 250.006 splits disqualifying convictions into two tiers. The first tier is permanent, and the statute currently lists 26 categories of offenses that trigger a lifetime ban. No amount of time, rehabilitation, or expungement effort changes the result.¹

The permanently barring offenses group into:

Criminal homicide, including murder and capital murder.
Sexual offenses: sexual assault, aggravated sexual assault, continuous sexual abuse of a child or disabled individual, indecency with a child, indecent exposure, invasive visual recording, improper relationship between educator and student, and online solicitation of a minor.
Violence against vulnerable people: injury to a child, elderly individual, or disabled person; abandoning or endangering a child, elderly individual, or disabled person; aggravated assault; deadly conduct; and terroristic threats.
Kidnapping and trafficking offenses under Chapter 20 of the Penal Code, plus agreement to abduct from custody and sale or purchase of a child.
Robbery, aggravated robbery, and arson.
Exploitation of a child, elderly individual, or disabled person; money laundering; and health care fraud.
Aiding suicide, obstruction or retaliation, false identification as a peace officer, and cruelty to animals.

Out-of-state history counts too. A conviction under another state’s laws, federal law, or the Uniform Code of Military Justice bars employment the same way if the offense has substantially similar elements to anything on the permanent list.¹ Moving to Texas does not reset the clock.

Convictions With a Five-Year Bar

The second tier disqualifies the applicant for five years measured from the date of conviction, not from the end of a sentence, probation, or parole. During that window the person cannot hold any position involving direct contact with residents.¹

The five-year bar covers:

Assault punishable as a Class A misdemeanor or felony.
Burglary.
Theft punishable as a felony.
Misapplication of fiduciary property punishable as a Class A misdemeanor or felony.
Fraudulent securing of document execution punishable as a Class A misdemeanor or felony.
False identification as a peace officer or misrepresentation of property.
Disorderly conduct involving the prohibited behaviors under Penal Code Section 42.01(a)(7), (8), or (9).

The tier distinction is worth reading carefully. A felony theft conviction opens a path to reapply after five years. A robbery conviction for the same dollar amount is permanent. The exact offense and punishment level, not the general category, decide which tier applies.

What DPS Needs, and When Fingerprints Come In

Section 250.004 lists the identifying information the employer sends to DPS to pull the criminal history record: the applicant’s complete name, race, sex, date of birth, and any known identifying numbers such as Social Security number, driver’s license number, or state identification number.³

When DPS returns a hit, the employer has to match the specific conviction to the barring list in Section 250.006. Not every conviction disqualifies. A minor traffic offense or a Class B misdemeanor theft, for example, is not on the list.³

Many Texas care facilities also require fingerprint-based checks that search state and federal databases. When a fingerprint check is required, the background check unit sends the applicant instructions to schedule an appointment with a DPS-approved fingerprint vendor.⁴

The fingerprint search covers four databases: the DPS database of Texas arrests, the FBI database of arrests nationwide, the DPS Texas sex offender registry, and the FBI National Sex Offender Registry. That is broader than a name-based check, which can miss records tied to aliases or prior legal names.⁴

Under the most recent fee schedule, a fingerprint-based check for a paid employee costs $39.75: $15 for DPS processing, $13.25 for the FBI check, and $11.50 for the vendor’s processing fee.⁵ Whether the applicant or the facility pays varies, so confirm before scheduling.

Working Before the Check Comes Back

State law lets a facility bring someone onto the payroll before the criminal history results arrive, with one hard restriction: no direct contact with residents until the results clear.⁶ A conditionally employed worker can do orientation, handle administrative tasks, or shadow other staff, but cannot provide hands-on care, help with daily living activities, or be left alone with a resident.

If a conditionally employed person has direct resident contact before clearing the check, the facility has violated the statute regardless of whether the results ultimately come back clean.

Rechecks After Hire

The screening obligation continues past the hire date. Texas administrative rules require facilities to search both the Nurse Aide Registry and the Employee Misconduct Registry annually for every unlicensed employee, looking for any new findings of abuse, neglect, mistreatment, or misappropriation of resident property entered since the last review.⁷

Facilities have to run ongoing criminal history checks as well, document each search in the personnel file, and give unlicensed employees written information about the Employee Misconduct Registry, including that a listing makes them ineligible for continued employment.⁷ An employee clean at hire can become disqualified later.

Out-of-State Aides Coming to Texas

A nurse aide certified in another state can join the Texas Nurse Aide Registry through reciprocity, but a fresh background check is part of it. The applicant runs a name-based DPS criminal history check for each last name they have used, then submits a reciprocity application through the TULIP online portal.⁸

The application asks for the criminal history results, an active nurse aide certificate from the other state, a valid government-issued photo ID, and a Social Security card. If the originating state does not assign an expiration date to the certification, Form 5506-NAR is required too. HHSC reviews the application, checks the Employee Misconduct Registry, and issues the Texas certificate if everything clears.⁸

Approval in another state does not exempt an aide from Texas screening. Each state has its own registry and its own list of barring offenses, so an aide who could work elsewhere may still be disqualified under Section 250.006.

Disputing a Finding on the Nurse Aide Registry

A nurse aide who receives notice that a finding of abuse, neglect, or misappropriation will be entered on the Nurse Aide Registry can dispute it before it becomes final. The process starts with an informal review, and the aide has to request it within 10 days of receiving the written notice. At the informal review, the aide can give testimony in person or by phone to impartial HHSC staff.⁹

If HHSC upholds the finding, the aide can escalate to a formal hearing under the Administrative Procedure Act. That request has to be made within 30 days of receiving the informal review results. Missing either deadline lets HHSC treat the finding as final and enter it on the registry.⁹

Missing the 10-day informal review window does not automatically end the process; the aide can still request a formal hearing. Missing the 30-day hearing deadline waives the right entirely. Treat both dates as hard cutoffs.

Federal Layers That Sit on Top of Chapter 250

Chapter 250 is not the whole picture for facilities that take Medicare or Medicaid dollars. Facilities also have to screen employees and contractors against the Office of Inspector General’s List of Excluded Individuals and Entities. Anyone on the LEIE is barred from any federal healthcare program, and a facility that hires an excluded individual faces civil monetary penalties. OIG updates the list by the 10th of each month, state Medicaid agencies are expected to check it monthly, and a name match alone is not enough — verification with a Social Security number or employer identification number is required.¹⁰

Federal exclusion criteria overlap with the Texas bars without matching them. Mandatory exclusion applies to anyone convicted of a crime related to healthcare delivery under Medicare or a state health program, patient abuse or neglect, a healthcare fraud felony, or a felony related to unlawful manufacture or distribution of a controlled substance.¹¹ Full Chapter 250 compliance and a missed LEIE check can coexist.

When a facility uses an outside company for the background report rather than pulling directly from DPS, the Fair Credit Reporting Act adds its own rules. The employer has to give the applicant a standalone written disclosure that a background report will be obtained for employment purposes and get written authorization before pulling it.¹² The disclosure has to be just that; liability waivers, application-accuracy certifications, and overly broad authorizations belong in a separate document.¹³ If the report turns up disqualifying information and the facility denies the hire, the FCRA still requires an adverse action notice with the screening company’s contact information, a statement that the company did not make the decision, and notice of the applicant’s right to a free copy of the report and to dispute inaccuracies. A Chapter 250 disqualification does not remove that notice obligation.

1
State of Texas. Texas Code Health and Safety Code 250.006 – Convictions Barring Employment
2
State of Texas. Texas Code Health and Safety Code 250.001 – Definitions
3
State of Texas. Texas Code Health and Safety Code 250.004 – Criminal History Record Information
4
Texas Health and Human Services. Texas Administrative Code Chapter 745 Subchapter F – Background Checks
5
Texas Department of Family and Protective Services. DFPS Background Checks Fees
6
State of Texas. Texas Code Health and Safety Code 250.003 – Criminal History Check Required
7
Cornell Law Institute. 26 Texas Administrative Code 506.36 – Criminal History and Nurse Aide Registry Verification
8
Texas Health and Human Services. CNA Initial Reciprocity Process
9
Cornell Law Institute. 26 Texas Administrative Code 556.13 – Findings and Inquiries
10
Office of Inspector General. LEIE Quick Tips and Instructions
11
Office of the Law Revision Counsel. 42 USC 1320a-7 – Exclusion of Certain Individuals and Entities From Participation in Federal Health Care Programs
12
Office of the Law Revision Counsel. 15 USC 1681b – Permissible Purposes of Consumer Reports
13
Federal Trade Commission. Background Checks on Prospective Employees – Keep Required Disclosures Simple