Healthcare Background Checks: A Complete Guide [2022]

healthcare background check

Healthcare is a fast-moving industry that requires employers to take special considerations.

Subject to federal and state-mandated changes, healthcare is more fluid and variable than many other sectors. Because of this, the professionals who work within the healthcare industry need to be exceptionally well-trained and capable of providing high-quality care to patients.

For employers, ensuring these things can be easier said than done. Fortunately, that’s where healthcare background checks come in.

Essential for all healthcare facilities, medical background checks allow employers to evaluate an applicant’s background, work history, and credentials and determine whether the candidate in question is right for the job.

To help you navigate healthcare background checks for your company, we’ve created this comprehensive guide. In it, we’ll discuss the importance of background checks, their essential elements, and how to make yours more effective.

Let’s get started.

Why are Healthcare Background Checks Important?

For some employers, running a comprehensive background check on every candidate seems like overkill. It is, however, the only way to ensure you’re hiring the right candidate for the job, and that you won’t encounter unexpected or dangerous problems with an applicant at a later date.

A study conducted by the U.S. Department of Health and Human Services Office of the Inspector General (DHHS OIG) found that 19% of nurse’s aides with substantiated findings of employee theft, abuse, or neglect had one or more convictions on their records.

Out of those, 53% had prior convictions for theft offenses, and those with substantiated abuse or neglect were a little more than three times likelier to have prior convictions for crimes against persons.

Healthcare background checks are crucial for all of the following reasons:

  • Verifying applicants are qualified for their jobs
  • Protecting patients and other employees from potential harm
  • Minimizing exposure to potential negligent hiring liability
  • Encouraging honesty during the hiring process
  • Ensuring current employees haven’t committed disqualifying offenses since their initial hiring
  • Making certain that licensed professionals continue to hold valid licenses

Healthcare background checks are tailored to the healthcare industry. They are more thorough than many other kinds of background checks and evaluate metrics explicitly designed to help employers find the right care providers.

Of course, these background checks vary in complexity based on the position a company is hiring for. A physician, for example, will require a much more comprehensive check than a nurse, medical assistant, or home health aide.

Healthcare Background Check Requirements

Healthcare background check requirements vary depending on which organization conducts them, what the open position is, and how thorough the employer wants to be in the background check.

Still, most healthcare-specific background checks include the following:

1. National Criminal Search

National criminal searches tap comprehensive databases to locate criminal records on a national level. These searches draw from millions of records across thousands of jurisdictions and databases. The search also examines offender registries from all 50 states, as well as Guam, Puerto Rico, and Washington DC.

2. National Sex Offender Search

This is a simple yet critical component of a healthcare background check. These searches pull data from all 50 states, as well as U.S. territories, and the District of Columbia. The goal is to identify people who have been criminally charged and convicted of, or who have pleaded “guilty” to a sex crime.

Today, more than 500,000 registered sex offenders live in the United States. Since healthcare professionals come into regular contact with children and vulnerable adults, running a national sex offender search on each applicant is essential.

3. Identity Verification Check

Identity verification checks ensure the applicant is not misrepresenting who they are. They also ensure that all subsequent background check inquiries are evaluating the correct individual.

4. Drug Screening

Drug screening is especially important in the healthcare industry. Healthcare workers have access to powerful prescription drugs, which means employers must know whether the applicants they’re interviewing have a history with substance abuse.

This is especially critical since drug use is common among physicians and other highly-trained healthcare providers. In fact, a landmark study published in the Journal Psychiatric Clinics of North America estimated that 10%-12% of physicians working in the U.S. have a substance abuse disorder.

Fortunately, drug screenings can reveal drug habits that may disqualify an applicant from a position in healthcare.

5. Past Employment and Education Verification

Most jobs in the healthcare field require a postsecondary degree or at least some technical training and on-the-job experience. Education and employment verification allows you to ensure the applicant has the correct degree of preparation for the job. Employment verification will also allow you to determine if the applicant was fired from a previous job because of negligence or another severe mistake.

6. Federal Exclusion Search

A federal exclusion search enables employers to access a U.S. Government list of healthcare workers who are prohibited from receiving federal funds. This search identifies candidates who may be working in healthcare with a criminal record and who would prevent your organization from participating in federally funded programs like Medicare.

7. Additional Considerations

In addition to the requirements listed above, all positions, including background checks for nursing home employees, will require that healthcare sanctions (and potential exclusions) be checked at the state and federal level.

Finally, all positions should utilize continuous monitoring. This will alert the employer if an active caregiver gets arrested or becomes disbarred during employment.

Level 2 Background Check for Healthcare Workers

Level 2 background checks for healthcare workers are required in some states because of the responsibilities healthcare professionals have.

They are fingerprint-based searches of state and national registries that are designed to yield more information than what you might receive from a name-based search.

Some of the types of searches performed in a level 2 background check include the following:

  • Conviction records
  • Professional license verification
  • Employment verification
  • Education verification
  • Disciplinary actions from the licensing body
  • Federal exclusions/sanctions
  • Sex offender registry search
  • Identity verification
  • Driving records
  • Certifications

Many different types of criminal offenses will raise red flags on Level 2 background checks since they are meant to help to protect vulnerable patients.

Some examples of offenses that might be disqualifying on a Level 2 background check include the following:

  • Aggravated assault/battery
  • Arson
  • Battery of a vulnerable adult or minor
  • Child pornography
  • Crimes of domestic violence
  • Enticing/luring a child
  • Aggravated child abuse
  • Incest
  • Kidnapping
  • Murder

This isn’t an exhaustive list. Other offenses that appear on a Level 2 background check for healthcare workers might also be disqualifying.

Recommended Hospital Pre-Employment Background Check Packages

We understand hospital background checks. In fact, we specialize in the healthcare industry. With that in mind, here are the healthcare background check packages we typically recommend:

Physicians

  • Identity Verification
  • County Criminal Records Check
  • National Criminal Records Check
  • National Sex Offender Records Check
  • Past Employment Verification
  • Education Verification
  • Healthcare Sanctions Checks and Ongoing Monitoring
  • Motor Vehicle Records
  • Lab-Based Drug Screening
  • Electronic I9
  • License Verification

Nurses

  • Identity Verification
  • County Criminal Records Check
  • National Criminal Records Check
  • National Sex Offender Records Check
  • Healthcare Sanctions Check and Ongoing Monitoring
  • Motor Vehicle Records
  • Lab-Based Drug Screening
  • Electronic I9
  • License Verification

Certified Nursing Assistants

  • Identity Verification
  • County Criminal Records Check
  • National Criminal Records Check
  • National Sex Offender Records Check
  • Healthcare Sanctions Check and Ongoing Monitoring
  • Motor Vehicle Records
  • Lab-Based Drug Screening
  • Electronic I9
  • License Verification

Home Health Aides

  • Identity Verification
  • County Criminal Records Check
  • National Criminal Records Check
  • National Sex Offender Records Check
  • Motor Vehicle Records
  • Drug Screening
  • Electronic I9

What Disqualifies You From Working in Healthcare?

Several things can disqualify applicants for healthcare jobs (e.g. physician, nurse, CNAs, EMTs, pharmacy technicians, and more)

Some of the common red flags on healthcare background checks are described below.

1. Certain Criminal Convictions

People who work in healthcare often have direct access to patients. This means that certain criminal convictions will be disqualifying.

Some of the common types of convictions that could result in a denial for a position include convictions for drug abuse, theft, elder or patient abuse, sexual offenses, and others.

2. Lying About Past Employment

Some applicants lie about their past jobs on their resumes or applications to try to hide employment gaps or other problems.

Healthcare organizations that ask for employment verification can quickly identify omissions or lies about past employment, and lies will likely result in being denied a position.

3. Lying About Education

Applicants also sometimes lie about their educational attainment or the schools they’ve attended.

Employers that request education verification can see all institutions the applicant has attended, their attendance dates, and whether they received diplomas, certificates, or degrees.

Applicants who lie about their education will likely be turned down for employment.

4. Sanctions or Exclusions

Applicants for positions with healthcare organizations that contract with Medicare or Medicaid will likely be turned down for employment if they appear on the Office of the Inspector General’s list of excluded individuals/entities.

5. Failing the Drug Screen

Healthcare employees frequently have access to various types of prescription drugs.

Because of potential issues with drug thefts, employers typically condition employment on passing pre-employment drug screens.

An applicant who fails a drug test will likely be denied employment.

6. License Problems

Applicants for healthcare jobs that require licensure must have valid, current licenses.

If an applicant’s license has been suspended or has expired, they might be turned down for the position.

What Are Health Care Sanctions and Why Do They Belong on a Healthcare Background Check?

Nurses and doctors are licensed professionals and are governed by state licensing boards in the states where they practice. They are expected to adhere to the standards expected of similarly situated medical professionals in their communities and their professions. When a physician or nurse fails to meet the standards of his or her field, he or she may be sanctioned by the licensing board.

Healthcare sanctions might include public censures, suspensions, fines, or other actions. If you are planning to hire a medical field professional, understanding whether a candidate has been sanctioned can help you to avoid hiring staff members who may not have the skills that you need or that might have engaged in ethically questionable behavior.

Receiving information about healthcare sanctions on a healthcare background check can allow you to make better hiring decisions and to protect patient safety and confidentiality.

How Far Back Will a Typical Background Check for Healthcare Workers Go?

The Fair Credit Reporting Act applies to employers in every state for employment background checks. This law is enforced by the Federal Trade Commission and includes rules for consumer reporting agencies on the types of information that can be provided and the length of time for which the information is reportable.

Under this act, most information can only be reported for seven years. However, the limits do not apply for jobs that pay salaries of at least $75,000.

Many states also have laws that restrict the reporting period for certain types of information. However, other information is not covered by these restrictions, including education verification, credentials verifications, and sanctions information.

Working with a qualified background screening provider like iprospectcheck can help you to get all of the information that you need to make good hiring decisions for health care positions in your practice or facility.

How to Develop a Hospital Background Check Policy

Having a strong background check policy can help you remain compliant with all relevant state and federal laws.

Here are some steps to take to ensure the effectiveness of your hospital’s background check policy.

1. Identify the Positions That Will Be Subject to Background Checks

You might have different types of background checks for different jobs within your organization.

You should clearly identify the types of jobs that will be subject to different types of background checks.

All of the applicants for the same type of position should undergo the same types of background checks to maintain fairness and consistency.

2. List the Specific Types of Searches That Will Be Performed

Include a list of the specific types of background searches that will be performed on applicants for each type of position within your organization.

Make sure to define the different types of searches and what they will entail.

3. Have A Defined Policy About Disclosure and Authorization Requirements

Include a written policy outlining the disclosure and written authorization requirements under the FCRA with clear steps to ensure your HR staff understands them.

4. List the Steps of the Adverse Action Process

Clearly list the steps of the adverse action process so that your HR staff members know what to do when problematic information appears on background checks.

5. Include a Strong Drug Testing Policy

Make sure your drug testing policy complies with all relevant state and federal laws.

If your organization will have ongoing random screenings, define how employees will be selected, how long they have to report to the testing facility, and how positive results will be handled.

How is COVID-19 Impacting the Healthcare Background Check Process?

The COVID-19 pandemic has brought new challenges to the healthcare hiring and background checking process.

As healthcare facilities face staff shortages because of the pandemic, they need to continue hiring nurses, doctors, respiratory therapists, physical therapists, and other healthcare workers to care for the many patients who are seeking care.

At the same time, however, court closures around the country have caused some delays in background checks. As a human resources professional in the healthcare field, there are several things that you should know about the hiring process and pre-employment background checks during the pandemic.

Healthcare background checks may take longer

Courts around the U.S. have undergone closures. When this occurs, it causes a delay in the ability of background screening providers like iprospectcheck to access the information needed for background checks.

Even when courts are open, some are accepting fewer requests per day because of staff shortages. This also results in a delay in getting the information back.

While court records may take some time to come back, other types of information are accessible and may be provided faster. For example, motor vehicle records, education records, and credential records can still be accessed.

There are a few options that you have if you cannot get all the information that you need from a pre-employment background check during this time.

What to do if you cannot get results quickly

One option that healthcare facilities might consider is conditional hiring.

With this process, you can extend a conditional offer to an otherwise qualified candidate while you wait for the pre-employment medical background check to come back. Since the position is conditioned on the background check, this allows you to rescind it if unfavorable information is revealed.

However, you will need to make sure that you comply with the FCRA when taking an adverse job action based on a pre-employment background check received after an employee has started working.

While you are waiting for a background check to come back, you should be careful about asking a prospect about his or her criminal history information.

Some states have “ban-the-box” laws that control when and if employers can ask about prior convictions. Make sure that you know your state’s law before asking for this type of information.

If you will be rehiring former employees or want to have someone start who was previously screened but prevented from working because of the pandemic, it is a good idea to complete a new pre-employment background screen.

Even if the candidate had a screen before, the information can be outdated. In general, if the background check was completed more than 30 days ago, it is a good idea to complete a new screen.

What Background Check Company Do Hospitals Use?

Hospitals use many different background check companies, but iprospectcheck stands out as one of the most trusted.

A leader in background checks for the healthcare industry, we specialize in comprehensive, compliant, accurate background checks with rapid turnaround times.

Ready to learn more about our background checks for healthcare employees? Contact us today to request a free consultation.

DISCLAIMER: The resources provided here are for educational purposes only and do not constitute legal advice. Consult your counsel if you have legal questions related to your specific practices and compliance with applicable laws.

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About the Author
Matthew J. Rodgers

Matthew J. Rodgers

Matthew J. Rodgers is a highly accomplished business executive with over 30 years of experience providing strategic vision and leadership to companies ranging from the fortune 500 to iprospectcheck, a company which he co-founded over a decade ago. Matthew is a valued consultant who is dedicated to helping companies create and implement efficient, cost effective and compliant employment screening programs. Matt has been a member of the Professional Background Screeners Association since 2009 . When not focused on iprospectcheck, he can be found spending time with his family, fly fishing, or occasionally running the wild rivers of the American west. A lifetime member of American Whitewater, Matt is passionate about protecting and restoring America’s whitewater rivers.