Improve patient care with healthcare background checks

A healthcare background check is a type of screening used by healthcare organizations to determine a candidate's qualifications for a job. Generally they screen for healthcare sanctions, criminal records, and other potential red flags. Healthcare background checks can help employers thoroughly vet a healthcare worker’s background to ensure that a candidate is trustworthy and has the proper professional licensing, education, experience, and qualifications for a role.

The healthcare industry is heavily regulated due to the sensitive nature of patient care and public safety. Healthcare background checks are typically used by hospitals, urgent care facilities, medical practices, medical staffing agencies, and other types of employers that provide healthcare services or support the healthcare industry. 

Healthcare background check requirements vary based on the individual organization and position, but often include criminal history, professional license verification, healthcare sanctions, and drug testing. Background check requirements in the healthcare industry are complex, so employers should consult their legal counsel, but generally physicians and nurses may be subject to more rigorous screenings than medical assistants or caregivers. Healthcare background checks may also be required by law, depending on the nature of the role. Each state has its own licensing requirements for home health agencies (HHAs) and other caregiver organizations. 

Organizations that are contracted within the TRICARE network, the US military’s healthcare program, must comply with certain healthcare background check requirements for certain physician and non-physician candidates. Additionally, organizations that receive federal grants or other federal funding are required to conduct healthcare sanctions checks as part of the background screening process.

Healthcare employers may also be required to run post-hire screenings, such as healthcare sanctions and professional license verification rechecks, at regular intervals during the employee's tenure. 

Employers that work with a consumer reporting agency (CRA) to conduct background checks for healthcare employees must adhere to the guidelines of the Fair Credit Reporting Act (FCRA), which requires providing written notice to the candidate of your intent to conduct a background check and receiving written consent from the candidate before proceeding. Should an employer choose not to hire a candidate based on information from the results of a background screening, they must also follow the adverse action process.  

A Level 2 background check for healthcare workers is a type of FACIS® (Fraud and Abuse Control Information System) search to show any exclusions, debarments, sanctions, or disciplinary actions against healthcare professionals. 

There are four FACIS screening levels–1, 1M, 2, and 3–that search various primary sources and lists, including the Federal Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE); System for Award Management (SAM) database; and state-specific Medicare and Medicaid data (where available). 

More comprehensive search results are returned with each level, so employers may choose different search levels depending on the type of position being filled, the type of risk, and federal or state requirements for the screening. Checkr offers level 1M and level 3 screenings to help your organization meet state and federal requirements for healthcare background checks. 

A background check for healthcare workers can show many types of information about a candidate, depending on the type of screening being conducted and the nature of the role. 

Here are common healthcare background screenings and what may show up:

Health Insurance Portability and Accountability Act (HIPAA) violations may show up on a healthcare background check, depending on the nature of the offense and if there is resulting disciplinary action, such as civil or criminal penalties. 

For example, if a healthcare worker commits a HIPAA violation that is also a violation of the Social Security Act, the violation must be reported by the employer to law enforcement and the US Department of Health and Human Services (HHS), the organization that oversees HIPAA enforcement. The case is then tried by the Department of Justice, which may result in a criminal conviction and therefore would appear on a criminal background check for healthcare workers. 

Common HIPAA violations that may result in disciplinary action include prohibited disclosures of protected health information, failure to perform an organization-wide risk analysis, and denying patients access to their records. 

Other violations may not result in legal or financial penalties, such as charging an unreasonable amount to provide a patient with a copy of their PHI, and therefore would not show up on a healthcare background check. 

Certain results of a healthcare background check may disqualify a candidate for employment based on your hiring criteria. Reasons for disqualification may include felony or misdemeanor criminal convictions, such as fraud or patient abuse; healthcare sanctions, such as HIPAA violations, Medicare or Medicaid violations, or disciplinary actions against a license; an inactive professional license; or positive results on a drug screening. 

These disqualifications may be based on requirements mandated by state law, such as professional licenses for physicians, nurses, and aides. Other types of checks may be required as part of a healthcare organization’s hiring policy, such as a drug-free workplace. 

Roles that require operating a vehicle, such as EMTs, paramedics, and other transport workers may require a clean driving record. If an MVR shows a history of accidents or vehicle-related crimes, the candidate may be disqualified. Other types of medical roles, especially those that have access to sensitive populations, like children and the elderly, may disqualify candidates with relevant criminal records.

Lookback periods for hospital background checks, along with other types of healthcar e pre-employment screenings, vary depending on the type of checks being performed and who is conducting the background check. For example, healthcare sanctions have differing lookback periods depending on the type of exclusion. Permissive exclusions typically remain on the OIG list for three years or less and mandatory exclusions remain for five years or 10 years if the individual has received two mandatory exclusions. If an individual has received three or more mandatory exclusions, the record will remain permanently.

Employers conducting background checks for healthcare employees that choose to partner with a CRA, like Checkr, to conduct healthcare background checks are subject to limits set by the FCRA for certain types of reports. For example, criminal convictions can be reported indefinitely for most searches, but there is a seven-year limit for non-conviction criminal information (such as arrest records, paid tax liens, and civil judgments). A candidate’s civil history, including credit information, judgements, and tax liens, is also limited to seven years. Bankruptcies, however, can be reported up to ten years. Lookback limits may not apply if the expected salary for the role is $75,000 or higher. 

A background check for hospital employment can take a few minutes to several weeks to complete. Turnaround times typically depend on who is performing the background check, the type of screenings being conducted, and the role.

Hospital human resources professionals that conduct background checks directly may be able to access some records online, such as OIG/SAM database checks and professional license verifications. Other types of healthcare background screenings for hospitals may require placing phone calls, mailing forms, or visiting the courthouse. 

Healthcare organizations that decide to partner with a CRA, like Checkr, can benefit from quicker, more accurate results. Checkr’s advanced technology gathers and sorts data from thousands of databases and record sources. In addition, Checkr’s candidate portal provides both employers and candidates a transparent view of screening statuses during every stage of the background check process. 

Healthcare background checks are often part of comprehensive pre-employment screenings in the healthcare industry to help protect patient safety, prevent costly violations, and improve patient outcomes. Healthcare employers that partner with a professional background check provider, like Checkr, can benefit from faster turnaround times and more accurate results. Plus, Checkr’s multiple background check options, including healthcare-specific screenings like healthcare sanctions and professional license verification, help employers save time and support compliance with federal, state, and local guidelines. Get started.

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