The Guide to HealthCare Background Checks

Healthcare is an immensely high-stakes, -skilled, -regulated, and fast-moving industry where workers are repeatedly tasked with making life-or-death decisions, performing well under pressure, and providing care in the most ethical manner possible. All these factors make healthcare one of the most critical industries and render healthcare jobs among the most well-compensated of any sector. At the same time, the high-stakes nature of healthcare makes it an industry fraught with potential for errors and abuse – and an industry where mistakes or ethical oversteps can devastate patients, their families, and society.

Healthcare background checks are a crucial safeguard that helps ensure the safe, competent, and ethical practice of medicine at every level. While employers in every sector utilize background screenings to vet prospective hires, background checks for healthcare professionals are particularly important, given the work that doctors, nurses, anesthesiologists, pharmacists, and healthcare professionals are trusted to perform. These individuals are responsible for saving and preserving life, caring for the most vulnerable members of our population, controlling how potentially lethal pharmaceutical products are distributed, and more. 

For instance, note how a simple error from a healthcare professional can have staggering consequences for the patient, ranging from lifelong complications to permanent disability to death. In addition, the medical field is rife with abuse and ethical oversteps. A doctor may have ample opportunity to sexually assault a patient, for instance, while a pharmacist can steal prescription drugs from their place of work to sell through back channels or feed their own addiction. Background checks for healthcare employees – by looking at education, licensing, work experience, criminal history, civil court history, drug screenings, and more – can minimize the likelihood of these errors or abuses manifesting. As such, healthcare background checks are a vital step for keeping any hospital, medical practice, or another healthcare-related work environment safe for patients.

Despite the massive importance of background checks for healthcare workers, there are numerous points in the healthcare ecosystem where due diligence in employee vetting can break down. For instance, a nationwide shortage of nurses – explored in our white paper, “The Nursing Shortage Explained & How Healthcare Can Fix It” – runs the risk of causing hospitals to reduce their hiring standards for nursing professionals. Still, were a hospital to reduce its background check requirements in hopes of attracting more potential nurses, it would be vulnerable to a poor hire – and to all the liabilities and negative press, it can bring. This topic was a common point of discussion during the peak of the Covid-19 pandemic when hospitals were desperate for healthcare workers and were considering waiving background screening requirements.

At backgroundchecks.com, we proudly offer products and services to help healthcare employers meet and exceed their healthcare background check requirements. From criminal history checks to education verification to drug testing, our background check services give healthcare employers the lens they need to examine their candidates critically and thoroughly. 

Types of Background Checks for Healthcare Workers

Because healthcare is a profession with such high levels of responsibility, necessarily professional qualifications, and overall stakes, it’s no surprise that most healthcare employers conduct exceedingly thorough background checks. Indeed, a typical healthcare background check will be half a dozen (or more) background checks, each examining a different part of a candidate and their past. Here are a few background check types most frequently seen in medicine.

Professional verification

Professional verifications, or work history checks, are background checks that consider a candidate’s professional history. For many jobs, employers want their candidates to have a specific amount of relevant or directly transferrable work experience. So, in the case of healthcare, a hiring manager at a hospital or medical practice will likely have considerable interest in where a candidate has worked in the past and in what capacity. Professional verifications provide a means to verify a candidate’s work history information on their resume. These background checks can also verify job titles, employment history, and sometimes details such as the reason for leaving and eligibility for rehire. All this information can be helpful for a hiring manager to have when filling a new position.

Education Verification

While many employers require their candidates to have certain types and levels of degrees, few industries have the rigorous academic requirements of medicine. Brain surgeons, for instance, need to have high school, college, and medical school credentials and additional educational backgrounds from residency and fellowship programs. Education verification checks are designed to verify that a candidate has all these required credentials. More than that, an education check can verify where the candidate achieved their education credentials, their dates of attendance, whether there were any special awards or honors attached to the degrees, and more.

Sanctions and Screening

One type of background check unique to the healthcare sector is the sanctions check. In the medical field, “sanctions” are exclusions attached to or levied against specific individuals who work in the industry. (Entities, such as hospitals, can also be sanctioned.) The Office of the Inspector General administers medical sanctions within the United States Department of Health & Human Services. Sanctions are intended to exclude individuals or entities from participating in federal healthcare programs – most notably, Medicare and Medicaid. A sanctioned hospital or healthcare provider cannot be reimbursed with federal dollars from Medicare or Medicaid. Additionally, a healthcare entity that receives Medicare and Medicaid reimbursement is barred from hiring any sanctioned individual as a matter of federal law.

For all these reasons, healthcare employers check all prospective hires for medical sanctions. Even beyond legal and monetary factors, the fact is that a sanctioned practitioner will typically be guilty of a severe offense – and is not someone healthcare employers would want to hire in the first place. Common reasons a doctor might be sanctioned include patient abuse or neglect, fraud, and the illegal sale of controlled substances.

Drug Screening

Drugs impede reaction times and impair mental and bodily performance. These issues are usually near the top of the list of reasons many employers try to maintain a drug-free workplace. Drug use on the job can hurt productivity, make workplace accidents and injuries more likely, and cause other problems that negatively affect everything from company culture to workplace safety. 

All these factors exist in healthcare environments, usually amplified by a factor of 10. Healthcare professionals must be fully alert and mentally present to deliver the finest care possible to their patients. Doctors or nurses who are impaired, whether by drugs, alcohol, or even fatigue – are much more likely to commit medical malpractice. Drug screening for healthcare professionals is one method healthcare providers can use to ensure the best possible performance of their staff.

Another reason for drug testing in medical workplaces is that prescription pharmaceuticals and other controlled substances are used daily in healthcare workplaces. The potential for healthcare professionals to be addicted to drugs – and to steal drugs to satiate their own addictions – is higher than for many other fields, simply because of proximity. Statistics indicate that 10-15% of doctors will develop drug or alcohol abuse problems at some point in their careers – higher than the 8-10% rate of addiction for the general population. Healthcare providers can sometimes spot these addiction patterns through drug screening background checks.

Criminal Background Checks

Criminal history checks are the most common background checks for most employers. They are also a piece of the puzzle for healthcare organizations. Candidates with a history of violent crimes, theft, fraud, elder or patient abuse, drug-related offenses, or sexual offenses can pose significant risks to a healthcare provider. A prospective hire with convictions for assault, rape, murder, or other violent crimes may be a direct threat to their would-be colleagues or patients. Drug offenses can predict potential problems with drug theft or misuse. It is vital to check for fraud, given the opportunities healthcare professionals often have to take advantage of vulnerable patients. 

Criminal background checks can help healthcare organizations spot any criminal activity that might serve as a red flag in a candidate’s past. At backgroundchecks.com, we offer a range of different criminal history checks, ranging from the county level to the state level, all the way to federal courts. We also have a proprietary multi-jurisdictional search database, which spans hundreds of millions of criminal records across the country. Additional checks, including alias checks and address history checks, can help us find a candidate’s criminal history, even if they’ve relocated to a different state or changed their name since being convicted of a crime.

Apart from the healthcare process, another important consideration is the amount of sensitive information that hospitals, doctor’s offices, and other medical enterprises hold. Patient information is mainly confidential and must be kept private to comply with HIPAA requirements. A growing trend of data breaches at hospitals has more healthcare providers thinking about this type of risk. While the perpetrators of data breaches are often external hackers and not internal personnel, checking candidates for histories of embezzlement, fraud, theft, identity theft, or cybercrime is still a worthwhile part of the hiring decisions for healthcare providers. 

Sex Offender Checks

In most states – but not all – registered sex offenders cannot legally be licensed as medical doctors. In these states, sex offender background checks should be a crucial part of vetting when someone applies for a medical license. However, that’s not to say that healthcare employers should be complacent regarding vetting for sex offender status. Redundancy is the best safeguard for background checks, and employers are always safest running their own sex offender checks to ensure they missed nothing at the state level.

Even in states where sex offenders may be licensed as doctors, healthcare providers should run sex offender checks as an additional protection for their employees and patients. Sexual abuse can run rampant in healthcare environments, given the power imbalance in many doctor-patient relationships. Sex offender status is one red flag that can predict this type of abuse, meaning that sex offender registry checks are vital to protect patients from potential misuse.

What to Keep in mind

There are many things to remember when hiring healthcare workers. Here are a few valuable insights to remember when designing a background check policy for your hospital or healthcare entity.

• There is no such thing as an all-inclusive background check: As you’ll see when browsing the products we offer at backgroundchecks.com, there is no one background check service that covers everything. Instead, the best background checks involve layering multiple checks, for instance, multiple levels of criminal history checks, background checks to verify credentials, and sex offender registry searches. Using all these checks (and others) will allow you to build a healthcare background check that covers a much broader array of information than one type of check ever could.
• You should consider role-specific checks: Some checks won’t make sense for all (or even most) types of healthcare professionals but still have value for specific roles. For instance, driving history checks are of utmost importance when hiring ambulance drivers. A motor vehicle record check is irrelevant to the average doctor or nurse but is as crucial as any other check for ambulance drivers. Similarly, a hospital administrator working in a role that gives them access to financial records or resources should perhaps face credit history checks, which can shed some light on financial responsibility. Again, that check wouldn’t be relevant for the average clinical job but might make sense for more niche roles.
• Everyone needs a background check: Background checks in healthcare aren’t reserved for doctors and nurses. Everyone who works in a hospital or healthcare office, from administrative workers to custodians, should be vetted thoroughly. While not every person has the same high level of responsibility for direct patient care that a doctor has, there are still opportunities for error or abuse that can harm a healthcare provider’s reputation. Background checks can help keep patients safe by ensuring that every person on staff places the same value on patient safety, privacy, confidentiality, and dignity.
• Hiring foreign healthcare workers can complicate matters: During the pandemic, there was much talk about hiring foreign healthcare workers to reinforce the strained hospital system in the United States. Indeed, foreign doctors and other medical professionals can be a credit to hospitals here in the U.S. However, it’s essential to remember that most background check companies are primarily set up to vet domestic citizens. Foreign background checks require a different process, which should be understood when hiring a healthcare professional from another country.

Where healthcare workers are employed

Most healthcare workers are employed in hospitals, clinics or in-home care. While employers in either category should be vigilant about background checks, minor work environment and employee responsibility variations may affect how to prioritize checks. Read on to learn more.

Hospitals & Clinics

Typically, when people think of healthcare professionals, they envision them working in a more clinical setting. This environment might include hospitals, specialty clinics, private practice medical offices, or other places patients visit when they “go to the doctor.” In most cases, employers in these categories will use a full array of background checks to vet their employees, ranging from criminal history to verifications that examine education, employment history, and professional license status. To learn more, read our article about how hospitals use background checks.

Home care

Home care is an increasingly important part of the healthcare ecosystem due mostly to the aging of the baby boomer population. By 2030, every member of the baby boomer generation will be 65 or older. As more boomers reach retirement age – and beyond – more will require regular nursing care. Some will seek that care in nursing homes or assisted living communities – healthcare environments that combine hospitals/clinics and home care agencies. Many others will hire in-home caregivers to assist with various daily tasks. Depending on a patient’s needs, home care providers can help with cooking, cleaning, paying bills, medication management, checking blood pressure or taking other vitals, grocery shopping and other errands, dressing, grooming, and more.

Background checks for in-home care providers differ slightly from the screening protocols for more clinical healthcare professionals. Most notably, home caregivers are not required to be doctors or even nurses. Instead, home care jobs usually carry lower and less specialized education requirements. That’s not to say that some in-home care agencies won’t seek more highly qualified providers, such as registered nurses, to be caregivers. In most cases, though, education and licensing aren’t nearly as prioritized in background checks for home care providers.

Instead, employers in this sector of the healthcare world might pay more attention to work history and professional references. Finding someone who has previously worked in similar positions and comes highly recommended by previous employers or patients is valuable to home care agencies and can be checked through employment verifications and reference checks.

In-home care agencies also tend to look closely at candidates for histories of fraud, theft, embezzlement, identity theft, and elder abuse or neglect. Some or all these checks are important in a clinical environment but are essential for home care. A patient usually interacts with multiple healthcare professionals in a hospital or doctor’s office. In-home care is different; a patient usually only interacts with one caregiver one-on-one. This setup leaves substantial opportunity for a caregiver to take advantage of their charge, whether by theft or abuse. Thorough criminal background checks, sex offender registry checks, abuse/neglect history checks, and even credit history checks can all make the difference in preventing this type of harmful behavior.

Learn more by reading our blog post, “What You Need to Know About Background Checks for Caregivers.”