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Healthcare Background Checks: The Essential Guide

UPDATED 1/19/23

Conducting healthcare background checks is a necessity for all medical offices - whether dental,  optometry, veterinary, chiropractor, or other.

However, there are a few things employers should know before moving forward.

Trust is the foundation of the entire medical industry, and that's why dozens of states require medical employers to conduct background checks. Even if you're not in an area with such requirements, conducting these checks is still advisable. Patients need to know they can trust your team members, and in reality, you do as well. 

Maybe you think doing a background check for every employee is overkill. However, considering how many employees in a chiropractic or other practice may have access to patients' financial and medical information, the urgency of conducting healthcare background checks becomes apparent. 

Commit the following information to heart, and contact us at HR for Health today if you need more guidance. 


Table of Contents:

• Why You Need Healthcare Background Checks

• Are Background Checks Mandatory in the Medical Field?

• What Do Healthcare Background Checks Look for?

• National Criminal Background Check

• Identity Verification Check

• Drug Screening

• Verification of Past Education and Employment

• National Sex Offender Search

• Other Considerations

• Healthcare Background Check Pitfalls

• Timing and Notification Considerations

• EEOC Guidance

• How HR for Health Can Help


Why You Need to Conduct Healthcare Background Checks

Some employers view background checks as unnecessary. In specific industries, however, conducting them is more of a requirement. One of these industries is the healthcare field. This makes sense: After all, the relationships between medical professionals and their clients depend on a single word: trust. Unfortunately, trust in the medical field has gone down over the decades. 

There are various reasons behind this trend, but rebuilding this trust is important. If you're not conducting healthcare background checks on new employees, you're putting your trustworthiness at risk. For instance, if a pharmacy hires a dispatcher with recent drug convictions, clients will lose all confidence in the practice if something goes awry. 

These background checks do more than just protect your clients and reputation. You also protect other employees. By not hiring someone with a failed drug screening, you could prevent potential accidents in the office. You're also lessening the risk that something could happen that ends your practice, so you're indirectly protecting your team's jobs. 

Should you perform healthcare background checks on applicants? There's absolutely no reason not to.

Are Background Checks Mandatory in the Medical Field?

While it would benefit healthcare employers to perform background checks on applicants, some prefer to do the minimum allowed by law. When looking at statutes throughout the U.S., it's pretty clear that most states require some form of background investigation. However, even if you live in one of these states, you may not have to check out every team member. If you're hiring an HR coordinator in a dental office, for instance, you may be under no such requirement. 

Unfortunately, even the most in-depth guide to healthcare background checks cannot make this call for you. Whether these pre-employment investigations — or ongoing screenings while employed — are mandatory depends on a variety of factors. Everything from state laws to issues specific to your practice can affect this answer. 

What Do Healthcare Background Checks Look for?

Background checks in the medical field involve much more than just criminal history investigations. While this is an important part of the process, it's really only a small part of the necessary steps. Just because someone doesn't have a criminal history, for instance, doesn't mean they're right for the job. 

A physician assistant who seems overly qualified and has no criminal history could still cause significant issues if they have things in their background - like a criminal record - that could make it illegal for them to interact with patients or work at your practice. Because of this and similar problems, the most thorough healthcare background investigations include the following aspects: 

National Criminal Background Check 

Checking an applicant's criminal history can provide invaluable information. A pharmacy driver with a DUI, a bookkeeper with a fraud arrest, or a billing assistant with a history of theft can all create problems for you. 

Identity Verification Check 

Healthcare background checks are useless if the person you're investigating isn't the person who applied. Verify every potential employee's identity. 

Drug Screening

Failure to conduct drug screenings can create liability if an incident happens in the office. 

Verification of Past Education and Employment 

Anyone can lie on their resume. Don't assume people won't exaggerate or invent education and employment histories. That's what many are counting on you to believe. 


National Sex Offender Search 

Imagine what would happen if someone discovered that a pediatrician’s office hired a receptionist on the national sex offender registry. The reputational damage alone could put the practice out of business.

Other Considerations

You may think conducting a healthcare background check that includes all these possibilities is overkill. Fortunately for those hoping to save resources, it is overkill in certain situations. A background check on an anesthesiologist assistant, for instance, should be much more thorough than one conducted on a dental receptionist.

You'll need to consider the specifics of the job you're offering and the federal and state mandates you're under. It's vital to seek HR advice to make sure you're compliant with the law. 

Healthcare Background Check Pitfalls

Even if your medical practice has all the money in the world to perform background investigations, you could still run into pitfalls that damage your practice. In fact, making certain mistakes when conducting these checks could create significant legal liability. This is why it's essential to abide by the following rules of healthcare background checks at all times:

• Make your screening policy as consistent as possible. This means you should embed it into your process for all new hires moving forward. This ensures consistency and that you never miss a check when you need one.

• Get permission before conducting an investigation.

• Allow applicants to correct potential mistakes.

• Only check records relevant to the position. You wouldn’t run a credit check unless an employee’s credit was somehow relevant to the position for which you were hiring them, for example, if they were handling money or making financial decisions.

• Avoid conducting social media screenings.

• Consider conducting ongoing screenings.

• Double-check state and federal guidelines for restrictions.

It's imperative to remember these important tips for healthcare background checks. 

Performing a screening on a kennel assistant without their permission or looking into the driving record of a virtual assistant are just a few mistakes that could legally damage your practice. Background investigations are invaluable tools, but make sure you're using them correctly!


Timing and Notification Considerations

When performing background checks, timing matters. Some states require waiting until you're extending an offer of conditional employment, so you should ensure you're current with your state's requirements. These requirements are generally put in place to limit how and when employers can access criminal history. Other states allow you to conduct a background check before extending a job offer. 

HR for Health can help you track related laws and make certain you're conducting background checks in accordance with relevant laws.

Furthermore, notice requirements exist per the Fair Credit Reporting Act (FCRA) if your practice executes a background check via a third party. You need to be prepared to follow the relevant law.  You'll also have to get authorization before conducting the background check, and be prepared to provide the required notices if you deny employment due to the findings.

Healthcare Background Checks: The Essential Guide

If you decide not to hire someone due to background check results, there are several steps to take in addition to the pre-adverse action notice. First, you must provide a copy of the background check and a copy of "A Summary of Your Rights Under the Fair Credit Reporting Act." You should also allow the candidate to respond to the findings if they dispute anything and/or claim the info is incorrect. Finally, allow the candidate five business days to respond.

Some states have additional requirements, and you'll want to adhere to these laws. Again, HR for Health can help keep you compliant with these requirements by advising you on the correct background checks to make, and helping you determine the best way to approach the background check process. 

EEOC Guidance

The United States Equal Employment Opportunity Commission (EEOC) recommends taking a holistic approach to candidate hiring decisions. In other words, please don't turn a potential hire away based on one issue in their background check. Specifically, they recommend you take a full view of the infraction:

• What role are they applying for?

• How long ago was the legal issue?

• What was the nature of the issue?

• Is there evidence that the applicant has been rehabilitated from whatever this problem was?

Keep in mind that when a decision is made not to hire, you must provide the candidate with a final notice of adverse action, including required details per the Fair Credit Reporting Act (FRCA). 

How HR for Health Can Help

Running a medical office can be an arduous task for even the most experienced and committed professional. This partially explains why so many employers in the healthcare field dread the idea of performing background checks on every employee. As we’ve discussed here, though, the rewards far outweigh the costs. Protect your clients, your employees, and yourself. 

Rules and regulations regarding healthcare background checks vary by state and can change at a moment's notice. Schedule an HR Consultation with HR for Health today, and we’ll help you better understand your rights and responsibilities.

Schedule an HR Consultation