What to Know About Healthcare Background Checks
Get in-depth information about healthcare background checks. Learn the ins and outs of healthcare background screening.
What is included in a healthcare background check?
Healthcare background checks typically include a more robust set of background checks including:
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Criminal history inquiries to identify potential unlawful offenses.
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National Sex Offender Public Registry (NSOPR) searches to screen for sex offender status.
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Exclusion list searches to verify eligibility to work for state and federal healthcare programs that receive funding.
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Drug testing to assess substance abuse.
Enhancing healthcare screening
Healthcare organizations often include additional provisions for advanced positions, like:
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Education and employment verifications to authenticate academic and work histories.
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Professional license verifications to authenticate credentials.
- Credit reports to summarize financial proficiency.
How are healthcare background checks different from standard employment screening?
Healthcare background checks are different from standard employment screening because they require additional searches for compliance. These added checks help maintain patient safety, ensure compliance with state and federal healthcare requirements, and support professional licensing.
How do healthcare background checks support patient safety and compliance?
Healthcare background checks support patient safety and compliance by helping identify risks to patient care, workplace safety, and compliance with state and federal regulations. Without them, medical care providers risk providing unqualified and potentially dangerous individuals access to patients and sensitive areas.
How can healthcare background checks help reduce negligent hiring risks?
Healthcare background checks help reduce negligent hiring risks by demonstrating reasonable due diligence during the hiring process. Negligent hiring claims can arise when employees cause harm on the job and have a history that may have disqualified them for the role. Red flags such as criminal infractions, lapsed licenses, and a presence on watch lists provide employers with background information to help determine whether an individual is fit to fulfill their duty of care.
What criminal background checks are commonly used in healthcare hiring?
Criminal background checks commonly used in healthcare hiring include:
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County Criminal Search – Provides criminal information from county courthouses.
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Statewide Criminal Search – A search of criminal history from counties within a specific state.
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National Criminal Database – Can locate potential records from sources outside of direct search areas.
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National Federal Criminal – Searches records from all 94 federal district courthouses.
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Global Watch List – Identifies those on watch status.
How do healthcare employers verify employment or education history?
Healthcare employers verify employment or education history by using professional verifications. These checks validate candidate-provided information from academic institutions and employers with certified contacts at the source.
How are medical professional licenses verified?
Medical professional licenses are verified using professional license verification services. These essential checks for medical personnel reveal information about the status of a professional license as well as any disciplinary actions and restrictions placed on them.
Why are healthcare sanctions and exclusion checks necessary?
Healthcare sanctions and exclusion checks are necessary to maintain participation in state and federal healthcare programs. There are three primary checks involved: OIG, GSA, and state Medicaid exclusion lists. Each provides slightly different results, detailed below:
Office of the Inspector General (OIG)
The OIG’s List of Excluded Individuals/Entities (LEIE) records exclusion actions taken only by the Office itself. OIG exclusions are split into Mandatory and Permissive categories and may be removed by the Office upon meeting reinstatement conditions. Learn more about each on the OIG’s website >
General Services Administration (GSA)
The General Services Administration’s System for Award Management (SAM) lists debarment actions taken by various Federal agencies. GSA exclusions are divided into four types: Prohibition/Restriction, Ineligible (Proceedings Pending), Voluntary Exclusion, and Ineligible (Proceedings Completed). Read about the cause and effect of each on the GSA website >
State Medicaid exclusions lists
44 states maintain individual Medicaid exclusion lists. While each list is upheld separately, the Affordable Care Act (ACA) stipulates that if a provider is excluded from one state Medicaid program, they should be removed from other state programs as well.
When are driving record checks required in healthcare?
Driving record checks may be required in healthcare for workers who operate company vehicles to transport patients, staff, or supplies. 49 CFR § 391.23 necessitates Motor Vehicle Record (MVR) checks for all motor carriers in accordance with FMCSA and DOT regulations.
Discover more about driving record checks in Your Guide to Driving Record Results >
Why do healthcare employers use drug testing programs?
Healthcare employers use drug testing programs to support workplace and patient safety and meet state regulations when applicable. These programs are especially important considering that an estimated 10% of healthcare workers abuse drugs, according to the U.S. Substance Abuse and Mental Health Services Administration and the American Nurses Association. Additional benefits of a drug-free workplace include lower absenteeism, increased productivity, and lower turnover.
What federal laws affect healthcare background checks?
Federal laws that affect healthcare background checks include Title VII of the Civil Rights Act, the Fair Credit Reporting Act (FCRA), the Social Security Act (§ 1128 and 1156), and the Patient Protection and Affordable Care Act (PPACA). Here’s a quick guide to the regulations enforced by each:
FCRA
Applicants must be made aware of and consent to background checks performed by a Consumer Reporting Agency (CRA). Employers must also follow the adverse action process closely and dispose of unneeded reports “so that it can't be read or reconstructed.”
For more information on FCRA employer requirements, see our FCRA Checklist >
SSA § 1128 & 1156
Healthcare providers must run individuals through OIG, GSA, and state Medicaid exclusion lists monthly. Employers may be liable for harsh monetary penalties and removal from healthcare programs if found to be employing excluded individuals.
PPACA
Public Law 111–148 requires long-term care (LTC) facilities in participating states to screen candidates using the Centers for Medicare & Medicaid Services’ (CMS) National Background Check Program.
Title VII
Employers need to make employment decisions solely on background information that pertains to the applied role. Discriminating based on race, color, national origin, sex, religion, disability, genetic information, or age is strictly prohibited. Applicants also have the right to obtain a copy of their report and dispute information.
How do state healthcare screening laws differ?
State healthcare screening laws differ because each state’s medical board creates its own criteria for licensure and disqualification. Most stipulate specific screening methods, rescreening frequencies, specialized checks, and more.
For a more in-depth explanation, read Healthcare Background Check Requirements by State >
How are physicians and medical staff screened?
Physicians and medical staff are screened first for licensure and second for employment. Licensure by a state’s Board of Health, Medical Practice, or equivalent institution often requires fingerprint criminal history screenings through the FBI or state record systems. Employment screenings then require exclusion list checks for participation in federal programs and additional background checks according to organizational risk management policy.
What background checks are required for nurses?
Background checks that are often required for nurses include license verifications, criminal history inquiries, abuse registry checks, and more.
For a full breakdown, check out Background Checks for Nurses >
What screening requirements apply to allied health professionals?
Screening requirements that apply to allied health professionals often overlap with those of other regulated healthcare positions. Common checks on allied health professionals include:
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License, certification, and credential verifications
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Validation of education and work experience
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Criminal history checks
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TB and role-related health screenings
How are healthcare contractors and vendors screened?
Healthcare contractors and vendors are screened similarly to other traveling and allied medical professionals. The major difference with contracted healthcare professionals is the addition of access requirements.
For a more in-depth explanation, read Contractor Background Checks in Healthcare Facilities >
What background checks are required for healthcare volunteers and students?
Background checks that are required for healthcare volunteers and students generally coincide with other healthcare professional screening requirements. In most cases, neither group requires license verifications, but additional checks may be necessary depending on a volunteer’s role. For a more detailed explanation, review our articles on each:
How long do healthcare background checks typically take?
Healthcare background checks typically take between 24 and 48 hours to complete. Internal data shows that 81% are finished in 24 hours or less, while almost 92% are finished in 48 hours or less.
How often should healthcare organizations rescreen employees?
It’s recommended that healthcare organizations rescreen employees through OIG and GSA on a recurring basis, determined by state healthcare compliance regulations. Every state has its own renewal requirements, so employers may want to work with their legal counsel to determine a compliant schedule.
What challenges do healthcare employers face with multi-state screening?
Some challenges that healthcare employers face with multi-state screening include:
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Difficulty managing state-specific healthcare labor laws
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Trouble with verifying multi-state licenses and credentials
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Not knowing when ongoing monitoring is necessary
What should healthcare employers do if a background check contains inaccurate information?
If a background check contains inaccurate information, healthcare employers should direct applicants to submit a dispute to the screening provider. Once received, the Consumer Reporting Agency (CRA) performs a reinvestigation, corrects any inaccuracies found, and provides both the employer and applicant with an updated report. To increase the chances of correction, applicants should supply supporting documentation if available.
How do healthcare organizations manage high-volume screening?
Healthcare organizations manage high-volume screening by performing background checks en masse. Seasonal hiring periods or staffing shortages necessitate quick background checks, and bulk screening can save an average of ten minutes per order.