Long-term Care (Nursing Homes): 10 Best Applicant Tracking Systems

Federal auditors are actively investigating whether nursing home workers were properly screened before their first shift, and the results so far are alarming. We ranked 10 applicant tracking systems on the one feature that matters most in long-term care hiring: how well the platform handles background screening, exclusion monitoring, license verification, and compliance documentation as a built-in workflow rather than a manual afterthought. The gap between the top-scoring and lowest-scoring platforms is significant, and understanding why could change how your facility approaches its next ATS decision.

Key Takeaways:

Recent OIG audits found that most nursing homes reviewed across multiple states failed to fully comply with federal background check requirements, with some facilities allowing staff to provide resident care before screening was completed.
Long-term care background screening goes far beyond a criminal check. A complete screening file requires nurse aide registry queries, OIG and SAM exclusion checks, state abuse registry searches, and primary-source license verification, all documented before a worker's first shift.
Not every ATS handles background screening the same way. The difference between native partner integrations that automate and document the process inside the platform versus manual export workflows that force recruiters into separate systems has real consequences for audit readiness.
CNA turnover in nursing homes still exceeds 42%, which means facilities are running the full screening cycle constantly. An ATS that cannot support that volume with automated, role-based, multi-state compliance workflows creates compounding risk with every new hire.
A screening completed on the hire date is not enough. OIG has specifically cited automated continuous monitoring, including monthly exclusion checks and license expiration tracking, as an effective compliance practice for long-term care facilities.

Long-term care employers need applicant tracking systems that do more than manage resumes. They need platforms where background screening, exclusion monitoring, license verification, and compliance documentation are built into the hiring workflow, not bolted on after the fact. The best ATS for a skilled nursing facility is the one that can prove every worker with resident access was screened, documented, and cleared before the first shift.

This ranking evaluates 10 ATS platforms on how well they support background screening integration, regulatory compliance, and the specific hiring challenges facing nursing homes and skilled nursing facilities in current context.

Why Background Screening Integration Is the Most Important ATS Feature in Long-Term Care

Nursing homes operate under intense regulatory scrutiny. The HHS Office of Inspector General has been conducting a multi-state audit series focused specifically on whether nursing home employees were properly screened before beginning work. In New Jersey, OIG found that 11 of 12 selected nursing homes failed to comply with federal background check requirements. In Alabama, 139 of 439 sampled employees had missing or incomplete screening documentation.

These are not isolated problems. Federal regulation 42 CFR 483.12(a)(3) prohibits facilities from employing individuals with specific disqualifying findings related to abuse, neglect, exploitation, or misappropriation. For other criminal history findings, EEOC guidance and the FCRA still require employers to conduct individualized, job-related assessments rather than applying blanket disqualification policies. Beyond criminal checks, facilities must verify nurse aide registry status, OIG LEIE exclusion lists, SAM databases, state Medicaid exclusion lists, and professional licenses at the primary source. CNA turnover in nursing homes still hovers above 42%, which means facilities are cycling through this screening process constantly, and each cycle requires proper candidate disclosure and written authorization under the FCRA.

An ATS that cannot handle these requirements through automated, documented workflows forces HR staff to manage compliance manually. In an industry where a single documentation gap can trigger survey citations and Medicaid reimbursement risk, the screening integration model is the most consequential technology decision an HR leader in long-term care can make.

The 10 ATS Platforms Compared

1. Paycom

Paycom is a major HCM platform serving over 36,000 clients with a single-database approach unifying payroll, HR, and talent acquisition. Its ATS includes built-in screening functionality with FCRA-compliant disclosure and consent capture.