How to Close the Background Check Loopholes for Nurses and Physicians

  • July 5, 2016
  • Bryan Barajas
  • Approx. Read Time: 3 Minutes

Most healthcare employers rely on a rigorous background check program in order to safeguard their patients and staff. Background screening is an important part of the hiring and employment qualification process, especially in a safety-sensitive industry such as healthcare. Unfortunately, there are a few background check loopholes in healthcare, particularly for nurses and physicians, which makes having a strong background screening program much more important. As you review your healthcare organization’s background screening policy, here are a few loopholes to consider regarding nurses and physicians.

Six States Don’t Require Background Checks for Nurses

The states of Colorado, Hawaii, Maine, New Hampshire, New York, and Wisconsin do not require any type of criminal record checks for nurses to be licensed. Colorado recently made news headlines for its lack of protections for the public when dealing with nurse licensing. “Nurses with convictions for sexual offenses, drug thefts and crimes of violence have escaped detection under Colorado’s porous system for licensing [healthcare] workers,” Christopher N. Osher comments in his article for The Denver Post. Like the other five states without background check requirements, Colorado’s nurse licensing system mostly relies on self-disclosure and complaints to identify dangerous applicants or licensees with criminal histories. The Denver Post found dozens of Colorado cases in which nurses or applicants failed to reveal convictions and continued working in the state, according to the article. This investigation is one example of the impact of this loophole and why many hospitals and employers choose to run their own background checks.

Fifteen States Don’t Require Background Checks for Physicians

Only 45 state medical boards conduct criminal background checks as a condition of initial licensure, according to the Federation of State Medical Boards. There are 15 states and two territories that do not conduct background checks upon licensure:

    • Alaska
    • Colorado
    • Connecticut
    • Hawaii
    • Maine
    • Maryland
    • Missouri
    • Montana
    • New York
    • Pennsylvania
    • Puerto Rico
    • Rhode Island
    • Utah
    • Vermont
    • Virgin Islands
    • West Virginia
    • Wisconsin

The background check loopholes are more significant for physicians than they are for nurses. Pennsylvania’s General Assembly considered an amendment to close the state’s background check loophole, as we discussed earlier this year. While states are working to close the loophole, there are a few more considerations for healthcare employers. First, how accurate are the background checks state boards are conducting? Second, what’s the longevity of a background check? In other words, will records from a background check be accurate and up-to-date two, five, or ten years later?

Background Screening Best Practices for Healthcare Employers

According to the Federation of State Medical Boards, 39 state medical boards require fingerprints as a condition of licensure and 43 state medical boards have access to the Federal Bureau of Investigation (FBI) database. Human resources and employment screening experts, however, have scrutinized the quality and accuracy of FBI fingerprint background checks. “Results from these databases are incomplete, the databases include arrest records employers shouldn’t be considering and the system doesn’t allow applicants to challenge the results,” Roy Maurer discusses in a May 2016 article for the Society for Human Resource Management (SHRM).

Since state legislators increasingly propose FBI and state fingerprint background checks, healthcare employers should not rely on the licensing boards’ background screening processes. Conducting pre-employment criminal background checks is important for mitigating risk. For medical staff services departments, conducting physician background checks before appointment is much important, considering the many medical boards that do not conduct checks as a condition of licensure.

Healthcare employers should consider that criminal background checks represent a snapshot and are a “moment-in-time” look at an individual’s criminal history. As a best practice, therefore, healthcare organizations should perform continual, routine background checks on their medical staff and employees. There are far too many stories of healthcare providers with criminal activity and finding your organization in tomorrow’s newspaper with a similar story can damage your reputation. That’s why healthcare organizations are increasingly adopting ongoing background screening policies that close the background check loopholes for current and new employees.

Does your healthcare organization have a strong criminal background check program? Contact us to learn how PreCheck can help you implement an effective healthcare specific background screening program tailored for your organization.

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