Though important, gaps in the background check process for home healthcare providers can compromise the quality of care provided. The reasons for these gaps include a limited scope, inadequate screening, bad information, loopholes, privacy laws, and a lack of immediate action. Some states are working to take steps to address the problems, but at the agency level, employers should consider including drug screenings, reference verifications, and professional license validation, as well as updating screening policies to align with best practices and legal regulations.