If you’re currently hiring nurses for your healthcare organization, you likely understand the importance of conducting thorough background checks on each potential hire.
Did you know that a New York nurse was arrested for stealing 1,467 vials of fentanyl over a two-month period from the hospital where she worked?
Employment background checks allow you to verify the people you hire are qualified for their nursing positions and do not have any disqualifying criminal convictions.
Based on our experience, we’ve written this guide as a resource for healthcare organizations.
Key Takeaways
- A nursing background check is a detailed investigation of a nurse applicant’s education, employment history, professional license, criminal history, and any record of professional sanctions to verify they are qualified, safe, and hireable.
- These background checks are critical because of the employer’s substantial liability risks if they hire an unqualified or debarred nurse for patient care.
- Healthcare employers must comply with numerous federal and state laws and regulations when conducting nursing background checks to avoid potential penalties, fines, and civil liability.
What is a Nursing Background Check?
A nursing background check is confirms an applicant’s education, employment, and professional license.
This type of healthcare background check can also be used to reveal disqualifying criminal convictions such as fraud or abuse, disciplinary sanctions, and drug abuse.
It is used for multiple types of nursing professionals, including certified nurse assistants (CNAs), registered nurses (RNs), licensed practical nurses (LPNs), and family nurse practitioners (NPs).
Nurse background checks can help healthcare employers make informed hiring decisions when they have open positions to fill.
Why is it Important to Conduct Background Checks on Nurses?
Healthcare employers can face substantial risks of liability and harm to patients and other employees if they hire unlicensed or sanctioned nurses.
Your organization should understand that some nurses with records of misconduct might work across state lines.
While the Nurse Licensure Compact was instituted to address the shortage of nurses, it also has created a dangerous loophole through which some sanctioned nurses and those with problematic criminal convictions might work in a different state, placing patients and employees at risk.
A comprehensive nurse screening program helps to identify prospective nurses who should be disqualified from employment with your organization.
Nursing Background Check Requirements
Nursing background checks are important to protect potentially vulnerable patients from dangerous applicants.
As a result, nursing background checks might be much more extensive than regular background checks.
Some employers might require Office of Inspector General (OIG) checks on the List of Excluded Individuals/Entities (LEIE) database. Hiring an excluded individual might subject you to substantial sanctions.
Depending on the position, a SAM background check might also be necessary to check for suspensions or disbarments from federal contracts or subcontracts.
The Fraud Abuse Control Information System, or FACIS, is a collection of regularly updated databases comprising different levels of data to ensure that healthcare providers such as nurses and nursing home workers have no history of perpetrating fraud against the states and federal government or the abuse of those under their care in the performance of their duties.
There are different FACIS levels based on the position for which you are hiring:
- FACIS Level 1 – Includes OIG, Medicare Opt-Out, FDA, DEA, Tricare, and OFAC-SDN federal checks as well as Medicaid sanctions and state debarment sources
- FACIS Level 2 – Includes everything in level 1 plus additional relevant state information
- FACIS Level 3 – Includes everything in Levels 1 and 2 plus sanctioning board data from all 50 states and U.S. territories.
If you don’t properly perform a nursing background check, you could be exposed to stiff civil penalties and potential sanctions.
What Does a Nursing Background Check Include?
What shows up in a pre-employment background check for nursing depends on the requests you make when you order a background screen.
Most healthcare employers ask for the following searches:
- Identity verification
- Misdemeanor and felony convictions and pending criminal cases
- National criminal records search
- National sex offender registry search
- Domestic Terrorist Watch List
- Professional license verification
- Education verification
- Employment verification
- OIG excluded names list search
- SAM check
- FACIS check
- Drug test
Many state nursing boards require nurses to have current immunizations against common communicable diseases based on state law or facility policy.
The US Centers for Disease Control and Prevention (CDC) maintains a list of state vaccine requirements for nurses in various settings that vary based on the state and type of immunization.
Let’s take a look at what might appear on some of these checks.
Criminal Records Search
If a prospective nurse has a criminal record, a criminal background check will include the following conviction data:
- Date of the offense
- Type of the offense
- Level of the offense (felony or misdemeanor)
- Disposition of the offense
- Date of the disposition
- May include some sentence information
- Pending criminal matters
If your jurisdiction has an expungement law, any expunged convictions will not be reported.
Employment Verification
Employment verification enables you to confirm an applicant’s past employment history as reported on an application or resume.
You will see the following types of information about each of an applicant’s past jobs:
- Employer’s name and address
- Employment dates
- Positions/titles held
Employment verification helps you to weed out applicants who have been dishonest about their employment records.
Education Verification
Education verification helps you confirm your applicants have honestly reported their educational histories and the degrees and diplomas awarded.
An education verification will show the following data about your candidate’s educational history:
- Name, location, and address
- Attendance dates
- Diplomas, certificates, or degrees conferred
Professional License Verification
Professional license verification is critical for nursing job applicants.
A professional license verification report will reveal the following types of information:
- License type
- Issuance date
- Expiration date
- License status
- Any sanctions or suspensions
Verifying the professional nursing license of your applicants can help to ensure they are qualified for your positions and protect you from negligent hiring liability.
Drug Test
A drug screen will tell you if an applicant returned a positive result for any combination of the following substances:
- Marijuana
- Phencyclidine (PCP)
- Opiates
- Amphetamines
- Benzodiazepines
- Barbiturates
- Cocaine
- Propoxyphene
- Methaqualone
- Methadone
Know Before You Hire
How to Conduct a Background Check on a Nurse
1. Create a Thorough Background Check Policy
Before implementing nurse background checks, your organization must create a thorough policy that includes the specific searches you’ll perform and the steps HR staff should take during the process.
Include what your HR staff should do before conducting a background check, how to communicate the results, and how they should handle and evaluate the results.
2. Adhere to Notice and Consent Requirements
The FCRA requires you to notify applicants your organization conducts background checks.
Your notice should be in writing and provided in a standalone form devoid of extraneous information.
Before initiating a background check, you must also secure the applicant’s signed consent.
3. Choose a Reliable Provider
When choosing a third-party CRA to conduct nurse background checks, research them to find a reliable provider with significant experience handling healthcare background checks like iprospectcheck.
We have in-depth healthcare industry experience and can guide you about the appropriate searches to include for nurses.
Our vast resources and advanced technologies enable us to quickly return comprehensive, accurate, and legally compliant nurse background checks, allowing you to make faster, informed hiring decisions.
4. Choose Relevant Reports
Create a tailored nurse background check to meet your organization’s needs.
Your nurse background checks shouldn’t include the same reports you might order for a standard employment screen and should instead be comprised of searches relevant to the field.
With iprospectcheck, you can choose from several packages and numerous additional reports to create a tailored nurse background check.
5. Evaluate and Communicate the Results
Once you receive the results, evaluate them as called for in your organization’s policy.
If you decide to move forward and hire an applicant, contact them to schedule onboarding and their start date.
By contrast, if the results of a background check make you want to deny employment, follow the steps below.
6. Individually Assess Convictions
If an applicant has a conviction that doesn’t necessarily bar them from working as a nurse in your state, avoid automatically denying employment.
Instead, follow the EEOC’s guidance and individually assess the conviction as it relates to the duties of the job and workplace safety concerns before basing an adverse hiring decision on their criminal record.
7. Complete the Adverse Action Steps
When negative information makes you want to deny an applicant, complete these adverse action steps:
- Transmit a pre-adverse action letter – Send the applicant a pre-adverse action letter detailing the reasons why you want to deny employment based on the information contained in their background check. Enclose a copy of the report, and highlight the specific negative information that concerns you.
- Provide a reasonable response time – Give the applicant a reasonable response time (generally five business days). They can provide information to demonstrate the highlighted information is wrong or that they have rehabilitated.
- Send a final adverse action letter – If you ultimately decide to deny employment, send the applicant a final adverse action letter. Enclose a copy of their legal rights under the FCRA and relevant state laws.
Important Laws and Regulations
While there are no laws specific to nursing background checks, there are some federal and state laws that cover employment background checks in general.
Federal Laws
Fair Credit Reporting Act
The Fair Credit Reporting Act (FCRA) was passed to protect consumers’ privacy in the information that consumer reporting agencies (CRAs) gather and report to employers for background checks.
Under the FCRA, consumer reporting agencies cannot report the following types of information when it is seven or more years old for positions paying less than $75,000 per year:
- Arrests not resulting in convictions
- Bankruptcies
- Liens
- Civil judgments
- Lawsuits
- Collections
The FCRA doesn’t restrict the reporting of these types of information for jobs paying salaries of more than $75,000 per year.
An FCRA-compliant background check report can include information about convictions, education, licensure status, and employment irrespective of how old it might be.
Employers that receive reports containing negative information about applicants must go through the adverse action steps before they can make a final decision not to hire them.
The adverse action process involves the following steps:
- Send a pre-adverse action letter to the applicant. Include a copy of the report with the problematic information highlighted.
- Allow a reasonable response time (typically five business days). The applicant can provide evidence the information is wrong or that they have rehabilitated.
- Send a final adverse action notice if you decide not to hire the applicant after the previous two steps. Include a copy of their rights under the FCRA and state laws.
Title VII of the 1964 Civil Rights Act
Title VII of the Civil Rights Act of 1964 (Title VII) prohibits employers from discriminating against applicants or employees based on their protected characteristics, including race, color, disability, pregnancy, sex, national origin, religion, and others.
This law is enforced by the Equal Employment Opportunity Commission (EEOC), which has issued guidance for what employers should do when they receive criminal history information on background checks.
Under Title VII, employers that receive background check reports containing criminal records must assess convictions individually concerning the open position’s required duties before making a decision not to hire the applicants based on their criminal records.
Fair Chance to Compete for Jobs Act
The Fair Chance to Compete for Jobs Act was signed into law by former President Trump in Dec. 2019.
It is a federal fair chance hiring law that governs federal agencies and private employers with federal contracts.
A federal agency can’t contract with a private company if it requests criminal history information before making a conditional job offer.
State Laws
State employment background check laws differ from state to state.
Some states have ban-the-box laws that affect when you can ask about criminal history information or conduct background checks during the hiring process.
However, most ban-the-box laws include exemptions for jobs requiring these types of checks under different laws, which include laws governing nursing positions in many states.
A few examples of state laws affecting nurse background checks include:
- California – All nurses must submit fingerprints to the California Department of Justice at the time they apply for a license, registration, or permit. The CDOJ completes state and federal fingerprint-based background checks and continuously updates when a nurse receives a conviction or is arrested.
- Delaware – Nurses must consent to criminal background checks through the Delaware Bureau of Identification and the FBI.
- Missouri – The Missouri Board of Nursing requires nurses to submit fingerprints for background checks.
These are only a few examples. Most states have laws requiring fingerprint-based background checks for nurses.
Make sure to review your state’s laws to understand your requirements.
Partner With iprospectcheck for Reliable Background Checks
Background checks help to screen out potentially dangerous and unqualified applicants who could harm your patients, staff, and organization.
Because of their importance, you must take care to thoroughly screen prospective nurses and conduct ongoing checks of your existing nursing staff.
Call iprospectcheck to learn more about our background check services and receive a free quote: 888-509-1979
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.
FAQs
How long does a nursing background check take?
How long a nursing background check will take will depend on the screening method you choose.
If you try to do it yourself by submitting requests to numerous county, state and federal agencies, past employers, licensing boards, and educational institutions, the process could take weeks to complete.
The best method for completing nursing background checks is to work with a reliable and experienced provider like iprospectcheck.
Our vast resources and research methodologies often allow us to return background check reports in as little as a couple of hours.
How far back do nursing background checks go?
How far back a nursing background check might go depends on your state, the salary offered, and any fair chance hiring laws that might apply.
If the position pays less than $75,000 per year, the FCRA limits the following information to no more than seven years old:
- Arrests not leading to convictions
- Collections
- Civil lawsuits and judgments
- Chapter 13 bankruptcies (10 years for Chapter 7)
These restrictions don’t apply to jobs paying more than $75,000 per year.
The FCRA doesn’t restrict the reporting of convictions. However, some states do restrict the reporting of convictions after a certain period.
What can prevent you from being hired as a nurse?
Several red flags can prevent applicants from being hired for nursing jobs.
For example, some states bar any nursing applicants with felony convictions, However, in California, a felony is not an automatic bar, and the state nursing board reviews applicants with convictions on a case-by-case basis.
Here are a few common reasons why nursing applicants might be denied employment.
1. Disqualifying Criminal Convictions
Because of the access nurses have to patients, certain types of criminal convictions will disqualify them from employment.
Some examples of criminal convictions that might result in a denial of employment include any convictions dealing with theft, drug abuse, patient or elder abuse, or sexual offenses.
2. Exclusions or Sanctions
Nurses who appear on the list of excluded individuals and those who appear on the sanctions list can’t be hired for jobs with agencies that contract with Medicare or Medicaid.
Appearing on the exclusions or sanctions list will likely prevent someone from being hired as a nurse.
3. Failed Drug Screen
Since nurses have access to prescription medications, employers typically request pre-employment drug screens to screen out applicants who illegally use drugs.
Failing a pre-employment drug screen will likely result in a conditional offer of employment being withdrawn.
4. Lies About Employment or Education
Some prospective nurses lie about their past employment or education to hide issues, employment gaps, or an inadequate educational background.
Healthcare employers that request employment and education verification can easily spot these lies or omissions and will likely deny employment to dishonest applicants.
5. Licensure Issues
If a nurse applicant’s license has expired or been suspended, they will likely be denied a job.
