The Legal Aspects of Conducting Healthcare Background Checks

    Hospitals must conduct thorough healthcare background checks to ensure patients are safe from dangerous or incompetent practitioners. These healthcare checks often include national criminal searches, sex offender registry checks (with alias detection), identity verification checks, and drug screenings.

    Since healthcare employees frequently have access to prescription drugs, a federal exclusion search is also essential. This search identifies candidates with records preventing them from being eligible for Medicare or other government healthcare programs.

    Criminal Background Checks

    As healthcare workers frequently contact patients, running thorough healthcare background checks is essential. It contains a nationwide search that searches through large databases to locate conviction records from every one of the fifty states.

    Healthcare employers should also run a national sex offender search to ensure the applicant is not registered as a sex offender. It is crucial since healthcare professionals often have direct contact with vulnerable individuals such as children and older adults.

    Another thing that healthcare organizations should be sure to do is running education and employment verification searches. It helps to identify candidates who have lied about their education or work history to conceal issues that could impact patient safety or their ability to perform their job well.

    Finally, healthcare employers should be sure to run a federal exclusion search that helps them to avoid hiring candidates who are not eligible for healthcare positions because of previous criminal convictions that would prevent them from receiving Medicare or Medicaid payments. It is a crucial step because failing to conduct a federal exclusion search can put your organization at risk of fines or even loss of accreditation.

    Another issue that healthcare employers need to be aware of is the limit on how far back a criminal record check can go in some states. The laws controlling this differ from state to state, so it is crucial to be informed of any changes.

    Professional Licensing

    In the healthcare industry, many positions require a license to operate. A professional license verification search confirms an applicant’s certifications and identifies any restrictions on their licensing that might pose a risk to patients.

    As in any industry, mistakes and abuses happen in healthcare workplaces. A doctor may knowingly prescribe the wrong medication; a nurse might steal drugs from the hospital supply room to sell or feed an addiction; or a home health aide could mistreat vulnerable elderly patients. Conducting background checks that examine criminal records, education, licensing, drug screenings, employment history, and civil court histories can help mitigate these risks.

    In addition, healthcare employers should consider incorporating additional checks specific to their industry. For example, a motor vehicle record check might be irrelevant to the average doctor or nurse but might make sense for an ambulance driver. Other specialized reviews include education and employment verifications, which confirm an applicant’s degree and work experience and help to identify whether they were fired from a previous job for negligence or another severe mistake. A federal exclusion search, which looks through a list of those prohibited from taking part in government healthcare programs like Medicare and Medicaid, is another unusual check. Using this search can prevent organizations from hiring sanctioned individuals and alert employers to potential violations of HIPAA regulations.

    Drug Screening

    When it comes to healthcare, the security of patients and other staff members depends on the presence of fully licensed professionals abstaining from drugs that can impair their ability to execute their jobs or threaten those around them. For this reason, comprehensive drug screening is an integral part of any healthcare hiring process.

    Healthcare candidates can be subject to different drug tests depending on the industry and job type. For instance, pre-employment urine testing is standard for medical professionals like doctors and nurses, who must be able to operate without being impaired. Benzodiazepines and synthetic marijuana (sometimes called “K2/Spice”).

    Some businesses use periodic or post-accident drug testing for workers in the healthcare industry in addition to pre-employment drug tests. In these cases, the drug screening policy must clearly outline how employees will be selected for testing and the specific substances for which they’ll be tested.

    Blood tests are less common in healthcare because they’re more invasive and can only reveal the presence of toxins within minutes. However, they’re sometimes used for regulated positions like federal workers and workplaces where safety and security are paramount. A blood test can screen for the following substances: ethyl alcohol, amphetamines, barbiturates, phencyclidine, heroin, methadone, oxycodone, cocaine and metabolite, fentanyl, and opiates.

    Exclusion Lists

    The health, well-being, and even lives of individuals who seek treatment from healthcare providers are at stake. Regulatory bodies must ensure the healthcare workforce members they hire and retain have no blemishes in their backgrounds that call into question their ability to treat patients. It goes beyond criminal records to include healthcare-related misconduct like fraud, malpractice, and the misuse of controlled substances. There are monetary considerations, specifically concerning reimbursement from government-funded healthcare programs.

    Conducting a federal exclusion search (LEIE) is required for all healthcare organizations contracting with government-funded programs. If this search is not executed and an excluded person is hired or retained, the Office of Inspector General (OIG) may levy hefty fines.

    A national criminal search taps into multiple jurisdictional databases, offender registries, and other data sources to locate any felony, misdemeanor, or juvenile severe record relevant to a healthcare job role. This search also includes education and employment verification, as it’s vital for healthcare employers to know if applicants need to fill in their employment history, which may conceal licensing and integrity issues.


    Since state exclusions are submitted to OIG monthly, there is often a lag time of several months before these data are added to the LEIE. By using a screening solution that automatically checks for these state-based exclusions alongside the LEIE, you can minimize liability by only hiring and retaining candidates who are not already excluded. Including searches of state Medicaid agencies and fraud unit exclusion lists is also a good idea.