What is a FACIS Level 3 Search? A Guide for Healthcare Organizations

In healthcare today, thorough background screening isn’t just a good idea—it’s essential. Healthcare organizations need to properly screen their providers, employees, and vendors to protect patients and follow regulations. Among all screening options available, the FACIS Level 3 search is considered the gold standard for comprehensive searches in the healthcare field.

Healthcare fraud is a major problem in the US, with typical cases causing losses of over $1 million. Many cases even exceed $9.5 million in damages. These numbers show why thorough screening through systems like FACIS is so important for medical institutions and organizations participating in federal healthcare programs.

What is FACIS?

FACIS stands for Fraud and Abuse Control Information System. It’s a comprehensive database that identifies individuals and organizations in healthcare who have been sanctioned, excluded, or barred from practice. The control information system FACIS maintains includes restriction background search capabilities that far exceed standard employment background checks.

The system was created to combat healthcare fraud by bringing together information from thousands of federal and state sources. This solves a key challenge: dishonest individuals often hide their identities, making it necessary to check multiple sources for a complete picture. Not all regulatory agencies participate in the same databases, which is why a consolidated system is so valuable.

The Evolution of Healthcare Screening Requirements

Over the past decades, healthcare compliance requirements have become increasingly stringent. The need for comprehensive screening emerged from high-profile fraud cases that exposed weaknesses in traditional verification methods. The federal data compiled in FACIS represents a critical advancement in how the healthcare field approaches background screening.

Medical institutions must remain vigilant about who they employ, as regulations from the General Services Administration and numerous other federal and state agencies impose strict compliance requirements. A FACIS search helps meet these obligations efficiently.

FACIS Search Levels Explained

It offers different levels of searches to meet various screening needs:

FACIS Level 1

This basic search meets minimum federal requirements and includes:

• OIG List of Excluded Individuals/Entities
• System for Award Management (SAM)
• OFAC Specially Designated Nationals list
• Office of Research Integrity
• Some state Medicaid exclusions

Level 1 is sufficient for lower-risk positions but doesn’t provide enough coverage for roles involving patient care or financial responsibilities. For organizations participating in federal healthcare programs, this baseline screening is often inadequate to fully mitigate risk.

FACIS Level 2

Level 2 builds on Level 1 by adding a broader range of federal sources but does not include state-level exclusions or disciplinary actions. It offers more insight than Level 1 but still falls short of positions that require full regulatory compliance or involve direct patient care.

FACIS Level 3

This is the most comprehensive screening available, including:

• Everything in Level 1
• Over 5,000 additional data sources
• Both federal and state information
• Historical records back to 1992
• Continuous monitoring with monthly updates (76,000+ new records monthly)
• Specific medical registry searches not included in other screening levels
• Comprehensive search across all relevant databases

What Exactly Does a FACIS Level 3 Search Include?

A FACIS Level 3 search examines the entire FACIS database, which contains over 5,000 data sources and millions of records. The control information system FACIS maintains allows for incredibly thorough screening that covers both historical and current information.

Federal Sources:

• Office of Inspector General (OIG) exclusion list
• System for Award Management (SAM) maintained by the General Services Administration
• FDA Disbarment List
• Drug Enforcement Administration (DEA) sanctions
• TRICARE Exclusions
• FBI actions
• Department of Justice sanctions
• Treasury Department sanctions
• State Department listings
• Federal healthcare programs exclude databases
• Federal data repositories for healthcare sanctions

State Sources:

• State Medicaid Exclusions
• State Contractor Debarment Lists
• State Licensing Board Actions
• HEAT Task Force News
• State Attorney General Actions
• Federal District Attorney News
• Medicare/Medicaid Opt-Out Lists
• State-specific medical registry searches
• State Professional Licensing Board records
• State healthcare administration databases

What makes Level 3 searches so valuable is this combination of federal and state sources. The system also cross-checks information to find inconsistencies, giving you accurate and complete records. While not all regulatory agencies participate in centralized reporting, FACIS Level 3 makes every effort to include all relevant sources.

The Importance of Specific Medical Registry Searches

An important but often overlooked part of FACIS Level 3 searches is the inclusion of specialized medical registries. These databases provide critical information on healthcare professionals with disciplinary actions, malpractice judgments, substance abuse issues, patient abuse cases, or billing fraud—details that are typically missing from standard background checks. Including these registries ensures a more complete and reliable screening process.

Who Needs FACIS Level 3 Searches?

FACIS Level 3 searches are essential for:

• Healthcare organizations like hospitals, clinics, pharmacies, labs, home health agencies, and any group receiving Medicare/Medicaid funding or working with federal programs
• Healthcare professionals including doctors, nurses, therapists, pharmacists, coders, billers, administrators, and anyone with access to patient data

The Limitations of Standard Background Checks

Standard employment background checks aren’t enough for the healthcare industry. While they may cover criminal history, employment, and education, they often miss critical information like healthcare exclusion databases, licensing board actions, Medicare/Medicaid bans, and fraud investigations. That’s why medical organizations need specialized screening tools like FACIS Level 3 to ensure full compliance and patient safety.

Benefits of FACIS Level 3 Searches

Better Patient Safety

These searches identify people with histories of patient abuse or neglect, protecting vulnerable patients. For medical institutions, nothing is more important than ensuring that caregivers and staff have clean records.

Fraud Prevention

By spotting individuals with histories of fraud, you can avoid costly schemes that could harm your organization. The comprehensive search capabilities of FACIS Level 3 are especially valuable for identifying potential fraudsters who have operated across multiple states.

Regulatory Compliance

Organizations working with Medicare and Medicaid cannot employ excluded individuals. FACIS Level 3 searches help you meet these requirements imposed by federal healthcare programs. The federal data included in these searches is continuously updated to ensure compliance with the latest regulations from the General Services Administration and other oversight bodies.

Reputation Protection

One incident with an excluded provider can seriously damage your organization’s reputation. Thorough screening protects your brand and maintains patient trust. For medical institutions, reputation is a critical asset that must be safeguarded through proper screening.

Ongoing Monitoring

Instead of just checking once, FACIS Level 3 can continuously monitor and alert you when new actions are reported against your employees. This ensures that organizations remain compliant even when new information emerges after initial hiring.

Reduction in False Positives

The control information system FACIS uses sophisticated matching algorithms to reduce false positives, saving your organization time and resources that would otherwise be spent investigating incorrect matches.

Best Practices for Implementation

1. Create a clear screening policy that outlines which roles require Level 3 searches, when and how often to screen, who oversees the process, how results are documented, and steps to handle any potential matches.
2. Follow FCRA requirements by giving written disclosure, obtaining written consent, properly handling any negative findings, and keeping thorough documentation throughout the screening process.
3. Combine FACIS Level 3 with other screening methods such as criminal background checks, license verification, education and employment verification, drug testing, reference checks, and credit history where legally permitted and relevant for a more complete and reliable hiring process.
4. Establish an evaluation process for findings by forming a review committee to assess potential matches, documenting how decisions are made, applying standards consistently, and considering the severity, relevance, and recency of any issues uncovered.
5. Partner with experienced screening providers instead of handling searches in-house. Make sure they have access to all required databases, understand healthcare compliance standards, and have a proven track record with similar medical organizations.

Implementing FACIS Level 3 in Different Healthcare Settings

Different types of medical institutions have unique considerations when implementing FACIS Level 3 searches:

Hospitals

Hospitals typically need to screen a large volume of employees across diverse departments. Creating a streamlined process for managing these screenings is essential, often requiring integration with HR systems.

Small Medical Practices

Smaller practices may have limited administrative resources but still face the same compliance requirements. For these organizations, working with a screening provider that offers user-friendly interfaces and clear reporting is particularly important.

Home Health Agencies

With staff working remotely in patients’ homes, thorough screening is especially critical for home health agencies. These organizations should prioritize continuous monitoring due to the autonomous nature of their caregivers’ work.

Long-Term Care Facilities

Given the vulnerable nature of their resident population, long-term care facilities should implement comprehensive screening protocols that include ongoing monitoring and regular rescreening.

The Cost-Benefit Analysis of FACIS Level 3

Although FACIS Level 3 searches may cost more upfront than basic screenings, they offer significant long-term value by helping avoid costly penalties, prevent fraud, reduce legal risks, protect your reputation, and enhance patient safety. For organizations in federal healthcare programs, the cost of non-compliance far outweighs the investment in thorough screening.

The Future of Healthcare Screening

As the healthcare industry evolves, screening requirements are expected to become increasingly stringent. Trends such as AI-driven matching, improved integration across compliance databases, more frequent updates to exclusion lists, stricter penalties for non-compliance, and a broader range of individuals requiring screening are on the rise. Organizations that establish strong screening protocols now will be better prepared to adapt to these future changes.

Conclusion

In today’s complex healthcare environment, compliance is not optional; it is essential. FACIS Level 3 searches offer the most thorough screening available, helping healthcare organizations protect patients, reduce risk, and meet strict regulatory requirements. By going beyond standard background checks, your organization can hire with confidence while safeguarding its reputation and ensuring long-term success.

Sapphire Check provides healthcare-specific background screening services, including comprehensive FACIS Level 3 searches. Our experienced team understands the demands of healthcare compliance and delivers accurate, timely results tailored to your needs. Contact us today to strengthen your screening process and maintain full regulatory compliance.

FAQs

What’s the difference between Level 1 and Level 3?

Level 1 covers only minimum federal requirements, while Level 3 includes federal sources plus thousands of state sources and historical data back to 1992. Level 3 provides a far more comprehensive view of a candidate’s background, making it ideal for high-risk roles.

How often should we conduct these searches?

The best practice is to check before hiring, before the start date, and then monthly thereafter. With 75,000+ new records added monthly, regular screening is essential to stay compliant and catch new sanctions promptly.

How long do these searches take?

Searches with no findings are typically completed immediately. Those that identify potential matches may take 1–3 days to review. Timelines can vary slightly based on the volume of records and the responsiveness of the agencies involved.

What penalties exist for not screening properly?

Organizations employing excluded individuals may face fines up to $10,000 per item claimed plus three times the amount for each service provided by the excluded person. They may also face program exclusion and reputation damage.