Employee Misconduct Registry Texas: How to Check a Caregiver's Record

What the Employee Misconduct Registry Is

The Texas Employee Misconduct Registry (EMR) is a state database maintained by the Health and Human Services Commission (HHSC) that lists individuals who have been found to have committed abuse, neglect, or exploitation of residents or clients in state-regulated facilities and programs. A finding on the EMR permanently bars that person from working in any HHSC-regulated facility or program — nursing homes, assisted living, home health agencies, and personal care programs.

Licensed home care agencies in Texas are required to check the EMR before hiring any employee who will have direct contact with clients. But families hiring a private caregiver (through Craigslist, word of mouth, or a CDS arrangement) have to run this check themselves. The state doesn't do it for you when you're the employer.

How to Search the EMR

HHSC provides a free online search at the EMR portal on the HHS website. You need the person's full legal name and date of birth. The search returns one of two results:

• No record found: The person has no EMR findings (though this doesn't mean they have no criminal history — the EMR only tracks formal HHSC findings)
• Record found: The listing shows the type of finding (abuse, neglect, or exploitation), the date, and the facility or program involved

An EMR finding is different from a criminal conviction. The EMR uses an administrative process — HHSC investigates a complaint, makes a finding, and the individual can appeal. Someone can appear on the EMR without ever being criminally charged, and someone with a criminal record might not appear on the EMR if the incident wasn't investigated through the HHSC process.

The Nurse Aide Registry: A Second Check

The Nurse Aide Registry (NAR) is a separate database that lists certified nurse aides (CNAs) in Texas. It tracks both active certifications and any findings of abuse, neglect, or misappropriation of property. A finding on the NAR prohibits the person from working as a CNA in any Texas facility.

Check the NAR at the HHSC NAR search portal. You need the aide's name; the search shows certification status and any findings. A CNA whose certification has expired or been revoked is a red flag — even if they're applying for a non-CNA personal care position.

Verifying a Home Care Agency's License

Every home care agency in Texas that provides personal care, skilled nursing, or home health services must hold a Home and Community Support Services Agencies (HCSSA) license from HHSC. Unlicensed agencies operate illegally, and their clients have no recourse through the state complaint system if something goes wrong.

To verify an agency's license:

1. Search the HHSC Long-Term Care Provider Search at the HHS website
2. Enter the agency name or city
3. The search returns the license type, license number, status (active, expired, suspended), and any enforcement actions

Look for the license type that matches the services your parent needs. A "Personal Assistance Services" license covers non-medical personal care (bathing, dressing, meal preparation). A "Home Health Services" license covers skilled nursing and therapy. Some agencies hold both.

Check the enforcement history. If the agency has multiple complaints or sanctions, consider that a warning sign — especially complaints involving medication errors, inadequate supervision, or failure to conduct background checks on their own employees.

What Licensed Agencies Are Required to Screen

Texas law mandates that HCSSA-licensed agencies conduct the following checks on every employee who provides direct client care:

• Texas DPS criminal history check (name-based and fingerprint-based)
• Employee Misconduct Registry search
• Nurse Aide Registry search (for employees working in a CNA role)

The standard Texas DPS criminal history check covers the most recent seven years under the Fair Credit Reporting Act, unless the caregiver's annual salary exceeds $75,000 (in which case it covers the full record). This means a conviction from eight years ago may not appear on a standard agency background check.

When You're Hiring a Private Caregiver

If your family is hiring a caregiver directly — whether through Medicaid's Consumer Directed Services option or private pay — you're the employer, and the screening burden falls on you. At minimum:

1. Search the EMR (free, online)
2. Search the NAR (free, online)
3. Run a Texas DPS criminal history check (available through the DPS website for a small fee)
4. Check references — call previous employers, not just the references the applicant provides

For caregivers who previously worked in another state, Texas background checks won't catch out-of-state convictions unless they resulted in a federal record. Consider running a multi-state background check through a licensed consumer reporting agency for comprehensive coverage.

What to Do If You Find a Problem

If your search reveals an EMR or NAR finding on someone already working for your parent through a licensed agency, contact the agency immediately. They're legally prohibited from employing that person in a direct-care role and may face enforcement action for failing to screen properly.

If you discover issues with a private caregiver, terminate the arrangement. You can report suspected abuse, neglect, or exploitation to the HHSC Complaint and Incident Intake Line at 1-800-458-9858.

The Aging in Place in Texas guide includes a caregiver vetting checklist covering all required screenings, interview questions that reveal care philosophy, and a crisis backup plan for when a caregiver relationship breaks down.

See more Texas guides →