Background Screening
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Sherry Ledbetter Central Systems Management Background Screening Section 2727 Mahan Drive, Mail Stop #40 Tallahassee, FL 32308 (850) 410-3400 / SC 210-3400 (850) 487-0470 / SC 277-0470 Fax |
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Provides screening services for health care providers in Florida currently
licensed by
the Agency for Health Care Administration
Regulations
Secure Background Screening Website
- Background Screening Website -- a secure website for requesting and viewing criminal history screening results processed by the Agency.
Site requires a user code and password.
FEES |
The Agency for Health Care Administration's (Agency), Background Screening provides screening services for health care providers currently licensed by the Agency. There are two types of screening requests that are presently performed:
Level I Criminal History - consists of a query of the Florida Department of Law Enforcement (FDLE) database for the criminal arrest history of an individual. The cost of this search is $24.00.
Level II Criminal History - consists of a search of the FDLE and the Federal Bureau of Investigations (FBI) databases for any criminal arrest information both state and nationally. The cost of this search is $43.25. The Agency can only process Level II screening requests as required by law. If you have questions regarding screening requirements please refer to "Who is required to be screened?" to determine if a Level II screening is authorized.
Requesting a Level 1
1. Complete the "LEVEL I CRIMINAL HISTORY CHECK" form with the name and address of the provider requesting the screening.
DOWNLOAD LEVEL I REQUEST FORM [101 KB PDF]
To be processed, the form must have the NAME, ADDRESS, DATE OF BIRTH, SOCIAL SECURITY NUMBER, RACE and SEX of the individual. Also include the EMPLOYER (Provider) NAME and ADDRESS. Please print legibly.2. Include the screening fee of $24.00. If paying by check or money order please make payable to the Agency for Health Care Administration. Background screening fees are nonrefundable.
Obtaining the Results
Upon receipt of the request, the information is sent directly to FDLE via modem and the results are subsequently downloaded to the Agency.
Once the results are received, they are reviewed and analyzed by background screening personnel for any disqualifying offenses
as listed in Chapter 435, Florida Statutes. The results of that analysis are entered into our database and a copy is mailed to
the requesting provider. The results can also be immediately accessed on the Background Screening website. To access
this secure website, you must have an active provider license with the Agency as well as an assigned user code and password.
Requesting a Level II
| The Agency can only process Level II screening requests as required by law. If you have questions regarding screening requirements please refer to "Who is required to be screened?" to determine if a Level II screening is authorized. |
1. Obtain an "Applicant" fingerprint card as provided by Background Screening.
2. Fill out the top portion of the card completely.
- The fingerprint card must include NAME, ADDRESS, DATE OF BIRTH, SOCIAL SECURITY NUMBER, RACE, SEX, HEIGHT, WEIGHT, PLACE of BIRTH, EYE COLOR, HAIR COLOR and SIGNATURE of the applicant. Also include the EMPLOYER (Provider) NAME and ADDRESS.
- Please print legibly in black ink only
- DO NOT use a highlighter in the entry blocks
- DO NOT write text outside the boundary of the entry blocks
- DO NOT place labels or write in "Leave Blank" areas
- Submission on a nonstandard fingerprint card will be automatically rejected
A card cannot be processed if any of these items are missing. Fingerprint cards that are not completed appropriately will be returned to the requesting health care provider. Background Screening fees are nonrefundable.
DOWNLOAD FINGERPRINT CARD EXAMPLE [102 KB PDF]
3. Include the screening fee of $43.25. If paying by check or money order please make payable to the Agency for Health Care Administration. Background screening fees are nonrefundable .
4. Complete and attach AHCA Recommended Form Background Screening Verification - Level 2. If Background Screening receives a fingerprint card and is unable to determine if the individual requires a Level 2 screening by law, the card will be returned to the requesting provider.
Obtaining the Results
Upon receipt of the request, fingerprint cards are submitted electronically to the Florida Department of Law Enforcement (FDLE). Electronic processing of the fingerprint card means screening results (both state and national) are available to the Agency within 72 hours of submission. Once the results are received, they are reviewed and analyzed by background screening personnel for any disqualifying offenses as listed in Chapter 435, Florida Statutes. The results of that analysis are entered into our database and a copy is mailed to the requesting facility. The results can also be immediately accessed on the Background Screening website. To access this secure website, you must have an active provider license with the Agency as well as an assigned user code and password.
Fingerprint Card Rejection/Resubmission
Often the FBI rejects a card because of illegible fingerprints. A letter from the Agency will be sent to the provider requesting the individual to be fingerprinted again. The new card must then be returned to the Agency with a copy of the reject letter attached. The card must be received by the Agency within 21 days of receipt of the letter in order to be resubmitted. There is no charge for a resubmission. If the card is not received within 21 days a new screening must be submitted and appropriate fees must be paid.
Send completed forms and appropriate fees to:
Background Screening
Agency for Health Care Administration
2727 Mahan Dr.
Building 3, M.S. #40
Tallahassee, FL 32308
For more information or to request fingerprint cards email us and include the name of the provider, the address, phone number and a contact person along with the number of cards needed.
For more information regarding the background screening process contact our office at (850) 410-3400.
If you have specific questions regarding screening requirements pertaining to a provider license, contact the appropriate licensing unit:
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Long Term Care Unit Nursing Homes, ICF/DDs, Prescribed Pediatric Extended Care Centers, Transitional Living Facilities, Homes for Special Services |
(850) 488-5861 |
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Hospitals & Outpatient Services Unit Abortion Clinics, Ambulatory Surgery Centers, Birth Centers, Crisis Stabilization Units, Hospitals, Organ Procurement Organizations, Tissue Banks, Eye Banks, Residential Treatment Facilities, Utilization Review |
(850) 487-2717 |
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Health Care Clinic Unit |
(850) 488-1365 |
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Home Care Unit Home Health Agencies, Homemaker, Sitter, Companion Agencies, Home Medical Equipment Providers, Hospice, Nurse Registries, Health Care Services Pools |
(850) 414-6010 |
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Assisted Living Unit Adult Day Care Centers, Adult Family Care Homes, Assisted Living Facilities |
(850) 487-2515 |
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Laboratory Unit Drug Free Workplace, Multiphasic Health Testing Centers |
(850) 487-3109 |
What the screening results mean:
Each screening request will culminate into a result. This result will determine if an individual is eligible or ineligible/disqualified from employment. The following is a list of the possible screening results and what they mean:
| The following definitions are provided as standards in determining employment eligibility for health care providers licensed by the Agency. If the Level 1 or Level 2 data fields are blank either a screening has not been requested through the Agency for this individual or the result has not yet been received. |
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