Do Healthcare Companies Run Background Checks?

Companies in the healthcare industry routinely conduct background checks as a standard practice throughout the industry and often as a legal requirement. A study by the U.S. Department of Health and Human Services found that 19% of nurse’s aides with substantiated findings of employee theft, abuse, or neglect had previous criminal convictions, demonstrating why thorough screening is essential in healthcare. These checks protect patients, ensure regulatory compliance, verify professional qualifications, and help healthcare organizations avoid liability issues. From hospitals and clinics to home health agencies and long-term care facilities, background screening is a critical step in the healthcare hiring process that helps maintain the trust and safety that patients deserve. Let’s dive into the topic: Do Healthcare Companies Run Background Checks?

Why Healthcare Companies Run Background Checks

Healthcare background checks serve multiple critical purposes that directly impact patient care, organizational liability, and industry compliance:

Patient Safety as the Primary Concern

Healthcare companies conduct background checks primarily to protect patients, as healthcare workers have direct access to vulnerable populations, including children, the elderly, and individuals with disabilities. They administer medications, perform procedures, and often interact with patients at their most vulnerable. A thorough background check helps identify individuals who may pose a risk to patient safety, such as those with histories of patient abuse, violent behavior, or substance abuse issues, serving as the first line of defense in preventing potential harm.

Legal and Regulatory Requirements

Many states have enacted laws specifically requiring background checks for healthcare workers. These regulations may vary by state, but they generally mandate screening for certain positions, particularly those with direct patient contact.

Federal regulations also come into play, especially for organizations that receive Medicare and Medicaid funding. The Office of Inspector General (OIG) maintains a List of Excluded Individuals and Entities (LEIE), and employing someone on this list can result in significant penalties.

Minimizing Liability and Risk Exposure

Healthcare organizations face significant liability risks if they fail to properly screen employees, as the legal doctrine of “negligent hiring” holds employers responsible if they hire someone who causes harm when a reasonable background check would have revealed concerning information. A comprehensive screening process helps healthcare companies demonstrate due diligence in their hiring practices, potentially reducing liability if an incident occurs.

Protection of Organizational Reputation and Trust

A single incident involving an improperly vetted healthcare employee—such as patient abuse, medication theft, or fraud—can severely damage an organization’s reputation, eroding public trust and taking years to repair. Conducting thorough background checks helps safeguard a healthcare organization’s credibility by ensuring that employees meet high standards of integrity and professionalism.

Types of Background Checks in Healthcare Settings

Healthcare background checks are more comprehensive than those in many other industries. They typically include multiple components designed to provide a complete picture of an applicant’s history and qualifications:

National Criminal Background Checks

A national criminal records check searches databases from all 50 states, U.S. territories, and the District of Columbia to identify convictions that may make an applicant unsuitable for healthcare employment. However, because national databases may be incomplete or outdated, many healthcare employers also conduct county-level criminal background checks in areas where the applicant has lived or worked to ensure a more thorough screening process.

Identity Verification

Identity verification confirms that applicants are who they claim to be. This prevents identity fraud and ensures that all subsequent background check information pertains to the correct individual. This verification typically involves confirming Social Security numbers, addresses, and other identifying information. It’s a foundational element of the background check process that helps maintain the integrity of all other screenings.

Drug Screening

Drug screening is crucial in healthcare, where employees have access to controlled substances, with studies estimating that 10-12% of U.S. physicians have substance abuse disorders. Pre-employment testing helps identify current substance abuse issues, while ongoing random testing acts as both a deterrent and detection method, commonly screening for opiates, marijuana, cocaine, amphetamines, benzodiazepines, barbiturates, methadone, and PCP.

Education and Credential Verification

Healthcare positions often require specific degrees, certifications, or licenses. Education verification confirms that applicants have the qualifications they claim, ensuring they have the necessary training to perform their roles safely and effectively. This verification process typically involves contacting educational institutions directly or using verification services to confirm graduation dates, degrees earned, and sometimes even academic performance.

Employment History Verification

Employment verification checks confirm previous work experience, positions held, dates of employment, and sometimes reasons for leaving. This helps identify any discrepancies in an applicant’s work history and can reveal potential red flags, such as unexplained gaps in employment or inconsistencies in reported job titles or responsibilities.

Professional License Verification

For licensed healthcare professionals like physicians, nurses, and therapists, license verification is essential. This process confirms that:

1. The applicant holds the license they claim
2. The license is current and in good standing
3. There are no restrictions on the license
4. No disciplinary actions have been taken against the licensee

License verification is particularly important because licensing boards may take disciplinary action for issues that might not appear in criminal background checks, such as patient care complaints or practice violations.

Federal Exclusion Lists

The federal government maintains several lists of individuals and entities excluded from participating in federal healthcare programs. Being on one of these lists effectively prevents employment in many healthcare settings, particularly those that receive Medicare or Medicaid funding.

The OIG’s LEIE and the SAM database are the primary resources checked. Individuals may be on these lists due to healthcare fraud, patient abuse, licensing board actions, or controlled substance violations.

Sex Offender Registry Checks

The National Sex Offender Registry search is critical for healthcare positions, especially those involving vulnerable populations. This check identifies registered sex offenders across all states and territories. Given the inherent vulnerability of many patients, this check helps prevent potentially dangerous individuals from gaining access to patients in healthcare settings.

Level 2 Background Checks in Healthcare

Some states, like Florida, require Level 2 background checks for roles involving vulnerable populations. These fingerprint-based screenings search state and FBI criminal databases, sexual offender registries, domestic violence records, and abuse registries. They are commonly required for physicians, nurses, home health aides, pediatric healthcare workers, and staff in long-term care facilities.

What Disqualifies a Candidate from Healthcare Employment

Not all negative findings on a background check automatically disqualify a candidate from employment in healthcare. Organizations typically have policies that outline:

1. Automatic disqualifiers – findings that always prevent employment
2. Discretionary factors – findings that require case-by-case evaluation

Some common disqualifying factors include:

• Criminal Convictions: Violent crimes, sexual offenses, crimes against vulnerable individuals, theft, financial crimes, and drug-related offenses may disqualify candidates, especially if relevant to the role. Timeframe, rehabilitation, and context may be considered.
• False Information on Applications: Lying about education, credentials, employment history, or criminal records, as well as providing false identification, often results in disqualification due to trust concerns.
• Sanctions and Exclusions: Candidates appearing on federal exclusion lists or with active professional sanctions are typically disqualified, as employing them can lead to legal penalties.
• Failed Drug Screenings: Positive drug tests are often disqualifying, especially for roles with medication access, though some organizations allow rehabilitation programs.
• License Issues: Revoked, suspended, or restricted licenses usually prevent employment in licensed roles. Serious disciplinary actions may also be disqualifying.

The Healthcare Background Check Process

Understanding the typical process for healthcare background checks can help both employers and applicants navigate the screening effectively:

Step 1: Disclosure and Authorization

Under the Fair Credit Reporting Act (FCRA), employers must provide a clear disclosure that a background check will be conducted and obtain written authorization from the applicant.

Step 2: Information Collection

The applicant provides necessary information for the background check, including:

• Personal identifying information
• Educational history
• Employment history
• Professional licenses and certifications
• Disclosure of criminal history (where legally permissible to ask)

Step 3: Background Investigation

The actual investigation begins, which may be conducted by the employer’s HR department, a third-party background check company, or a combination of both. This investigation includes all the relevant checks described earlier.

Step 4: Review of Findings

When the background check is complete, the employer reviews the findings according to their established policies. They consider factors such as:

• The nature and gravity of any negative findings
• The time that has passed since the offense or conduct
• The nature of the job sought

Step 5: Pre-Adverse Action Process

If negative information may lead to an adverse employment decision, the FCRA requires the employer to:

• Provide a pre-adverse action notice
• Include a copy of the background check report
• Provide a copy of “A Summary of Your Rights Under the FCRA”
• Allow the applicant time to dispute inaccurate information

Step 6: Final Decision

After allowing time for the applicant to respond, the employer makes a final decision and, if adverse action is taken, provides an adverse action notice as required by the FCRA.

Best Practices for Healthcare Background Checks

Healthcare organizations can optimize their background screening processes by following these best practices:

• Develop a Comprehensive Written Policy: A clear background check policy ensures consistency and compliance by outlining required positions, types of checks, disqualifying criteria, evaluation processes, and implementation responsibilities.
• Ensure Legal Compliance: Background check processes must adhere to regulations like the Fair Credit Reporting Act (FCRA), Equal Employment Opportunity Commission (EEOC) guidance, state-specific laws, healthcare regulations, and ban-the-box laws where applicable. Regular legal reviews help maintain compliance.
• Apply Consistent Standards: All candidates for the same position should undergo the same level of scrutiny to ensure fairness and legal compliance.
• Implement Continuous Monitoring: Background checks offer a snapshot in time, but ongoing monitoring systems help detect new criminal charges, license actions, or exclusions affecting current employees.
• Partner with Reliable Screening Providers: Many healthcare organizations work with specialized background screening companies to ensure compliance with industry-specific requirements and access up-to-date databases of sanctions and exclusions.

Conclusion: Do Healthcare Companies Run Background Checks

Thorough background checks are a critical safeguard in healthcare, ensuring that employees are qualified, trustworthy, and safe to work with vulnerable populations. These screenings protect patients from harm, shield organizations from liability, and uphold the trust essential to the healthcare system. As the industry evolves, background checks will continue to advance, incorporating technologies like continuous monitoring and artificial intelligence to enhance patient safety and organizational security.

Sapphire Background Check provides comprehensive, industry-specific background screening solutions tailored to the unique needs of healthcare organizations. Our advanced screening technology, compliance expertise, and commitment to accuracy help you hire with confidence while protecting your patients and reputation. Contact us today to learn how we can support your hiring process with reliable and thorough background checks.

FAQs

Do all healthcare companies run background checks?

Yes, virtually all healthcare companies conduct some form of background checks on employees. The extent and depth of these checks may vary based on the organization’s size, the roles being filled, and state requirements, but background screening is standard practice throughout the industry.

How far back do healthcare background checks typically go?

Most healthcare background checks look back 7 years for criminal history, in line with FCRA guidelines. However, certain positions may have longer lookback periods, and some information (like professional license sanctions or federal exclusions) may be reported regardless of when they occurred.

Can I work in healthcare with a criminal record?

It depends on the nature of the offense, when it occurred, the specific healthcare role, and state regulations. Minor offenses unrelated to healthcare duties might not be disqualifying, especially if they occurred many years ago. However, violent crimes, sexual offenses, and crimes against vulnerable individuals typically prevent healthcare employment.

How long does a healthcare background check usually take?

Standard healthcare background checks typically take 3-5 business days, though this can vary based on the complexity of the check and the responsiveness of verification sources. Some components, like education verification, international checks, or comprehensive national sex offender searches, may take longer.

What are healthcare sanctions and why do they matter?

Healthcare sanctions are disciplinary actions taken against healthcare providers by licensing boards, government agencies, or healthcare organizations. They matter because they may indicate professional misconduct, patient care issues, or fraud that wouldn’t appear in a standard criminal background check.