Level 2 Background Screening: Healthcare Essentials

  • May 7, 2024
  • Joe DeSanzo
  • Approx. Read Time: 8 Minutes
PreCheck. 5 Disqualifiers Your Level 2 Background Check Can Uncover.

Today’s ongoing labor shortage, especially in the healthcare industry, is creating a highly competitive job market. This shortage, combined with rising hiring costs, makes selecting the candidates with the right qualifications more important than ever.

The last thing you want is to invest time and resources in onboarding a new hire who doesn’t meet your company’s stringent requirements or government regulations. 

This is where pre-employment background checks and screenings can help. A comprehensive healthcare background check ensures the applicant has the right skills and capabilities to handle the job and alerts you to any potential issues. 

When hiring healthcare workers, some background checks aren’t just a recommended practice but a requirement. For example, some states, such as Florida, require employers to complete a Level 2 background check for healthcare workers prior to hiring. 



Key Takeaways

        • Type 2 background checks provide a comprehensive look at a candidate’s criminal and professional background. 
        • Some employers, such as those in Florida, must conduct Level 2 background checks on all medical personnel providing patient care, whether directly or indirectly. 
        • Comprehensive pre-employment background screenings help ensure you make sound hiring decisions and remain in compliance with all federal and state regulations. 
        • Type 2 background screenings involve fingerprint-based criminal records checks at a federal and state level, as well as a search of the global terrorist list and sex offender registry. 
        • PreCheck’s employment screening process simplifies Level 2 healthcare background checks and provides accurate results. 


Table of Contents

  1. What Is a Level 2 Background Screening?
  2. How Does a Level 2 Background Screening Work?
  3. What Issues Could Disqualify Candidates from Employment?
  4. Why Is a Level 2 Background Screening Important?
  5. Limitations Of a Level 2 Background Check
  6. Streamline Your Hiring with Level 2 Background Screening Services From PreCheck


What Is a Level 2 Background Screening?

A Level 2 background screening is a comprehensive check of a person’s criminal record. Unlike a basic Level 1 background screening that only searches state databases using the applicant’s name, a Level 2 screening uses fingerprints to track both state and federal criminal records.

Some states require these high-level background screenings due to the responsibilities healthcare workers have regarding patient care. Even if your state doesn’t label this type of comprehensive screening as a Level 2 background check, a similar fingerprint-based screening is likely required for healthcare workers.

These high-level screenings can provide an array of information, such as:

    • Arrest Records
    • Conviction Records
    • Employment Verification
    • Education Verification
    • Professional License Verification
    • Federal and State Exclusion List Screening
    • Sex Offender Registry Check
    • Driving Records
    • Drug Screening

The purpose of Level 2 background screenings is to ensure new hires don’t have criminal records that could impede patient care, such as child pornography or assault. It’s the employer’s responsibility to conduct background checks on new hires to ensure patient safety.


Recommended Reading: How You Can Solve the Nursing Shortage


Screen smarter, hire safer. Get the right talent to drive your success. Speak to an expert.


How Does a Level 2 Background Screening Work?

The first step of any pre-employment background screening is to secure consent from the applicant. The Fair Credit Reporting Act requires this consent. 

Most employers provide information about background screenings and obtain consent during the application process. This step may prevent candidates from applying if they know they will fail a background check. 

Next, required applicants must go to a fingerprint facility in their area. They should bring proof of identification and have each fingerprint scanned into the FBI’s Integrated Automated Fingerprint Identification System (IAFIS). 

The applicant’s fingerprints are then run through the National Crime Information Center’s database, which includes records pertaining to arrests, convictions, and the global terror watch list.

State-wide criminal background checks are also required. For example, employers in Florida can have the Florida Department of Law Enforcement (FDLE) run this type of background check. 

These screenings include information pertaining to arrests, felony and misdemeanor convictions, and pending cases. These records do not always include information about active warrants. 

In addition to criminal history checks, Level 2 screenings include employment and education verifications, healthcare exclusions screening, sex offender registry search, and drug screening. Depending on the position, a licensing check may be included to reveal any disciplinary actions or other issues.


Level 2 1


What Issues Could Disqualify Candidates from Employment?

Once the screening is complete, employers receive a full report detailing any findings. 

There are several things that could disqualify a candidate from working in the healthcare industry or cause employers to take a closer look.

Below is a look at several findings on a healthcare background check that could disqualify a candidate.


Criminal Record

Healthcare workers often have direct access to patients and their care. Since you cannot watch your workers 24/7, it’s important to hire candidates you can trust to provide a high level of care.

To ensure a safe workplace, it may be necessary to disqualify candidates with certain criminal records from employment.

Employers may be able to overlook lesser crimes, such as a misdemeanor drug conviction from 10 years ago. However, more serious offenses, such as child or elder abuse, patient abuse, sexual misconduct, or murder, can jeopardize patient care.


Exclusions or Sanctions

Any candidate on the OIG or state exclusion list is prohibited from working with any healthcare facility that serves Medicare or Medicaid patients.

It’s the employer’s responsibility to screen these databases and refrain from employing anyone on the lists.


Licensing Issues

Naturally, you cannot hire any physician, surgeon, nurse, or other medical professional who doesn’t have an active license or certification required for the position.  


Falsifying Information on Application

According to a recent study, 70% of candidates lie on their job applications. As an employer, any lie can make you reconsider hiring an applicant. It’s important to consider the magnitude of the lie.

For example, there’s a big difference between a candidate embellishing some of their soft skills, such as time management and problem-solving abilities. It’s another thing altogether to lie about their previous job duties, experience, or capabilities.

False information that could impact the applicant’s ability to provide the necessary services is certainly a reason for disqualification. Other instances should be considered on a case-by-case basis.


Failing a Drug Test

Candidates applying for a job in the healthcare industry should know that drug screening is part of the hiring process. If an applicant fails a drug test with this knowledge, it may indicate a drug problem and result in disqualification.


Recommended Reading: Your Must-Have Guide to Healthcare Background Check Compliance


Level 2 2


Why Is a Level 2 Background Check Important?

Here are the key reasons why Level 2 background screening is so important in the healthcare hiring process.


In-Depth Criminal History

A Level 2 background screening involves a more comprehensive search of state and federal court records. This higher-level screening prevents bad hires in several ways.

First, a comprehensive healthcare background check can alert you to candidates with a history of criminal acts, such as domestic violence or child abuse, which could impact their ability to work with patients.

Secondly, fingerprint screenings ensure candidates' identity and prove they haven't been arrested or convicted under other names.

For example, a fingerprint screening can reveal crimes committed under the applicant's maiden name. Conducting a name-based search requires you to only check the information provided by the applicant.

Finally, a nationwide criminal record search prevents applicants with criminal records from crossing state lines to avoid detection.


Sealed Court Records

According to the specifics of the case, a judge may choose to seal the court records. This is common practice with juvenile convictions.

If the records are sealed, they will not be available with a Level 1 background check. This is true even if these records include details about arrests or convictions.

Conversely, Level 2 background checks include sealed court records. You’ll have full access to the applicant’s complete criminal background so you can make informed hiring decisions.


Detailed Employment History

A Level 2 background check for healthcare workers provides details about the applicant’s employment history, including their specific job title and dates of employment. This can help in several ways.

First, it can help you determine if their prior job titles provide the level of experience you’re looking for in a new hire. Secondly, it can alert you to potential patterns in their job history.

For example, does the applicant switch jobs often? If so, this could be a red flag and indicate that the employee may not stay with your company for long.


Level 2 3


Limitations Of a Level 2 Background Check

While Level 2 background checks provide a wealth of details about prospective candidates, even those screenings have their limitations.


No Medical Records

Level 2 background checks don’t include information about the applicant’s medical records and for good reason. HIPPA rules and regulations forbid it.

Employers, even potential employers, cannot gather information about a candidate’s medical history. If this information is obtained incidentally, it cannot be used to make hiring decisions.


No Warrant Information

Criminal background checks do not always provide warrant information. In many cases, this information is not available until the actual arrest takes place.


Limited to Lookback Period

Not all arrests are included in a background check. In some instances, arrests older than seven years may be omitted if these arrests never led to a conviction.

Additionally, civil lawsuits and judgments, as well as bankruptcies, will not appear on a background screening after seven years or 10 years in the case of some bankruptcies.



Depending on the crime, applicants may be able to request an exemption to ensure their criminal charges are not held against them during the hiring process. An exemption can be made for those with misdemeanor charges or felonies if at least three years have passed.

Some juvenile changes may also be exempt. Exemptions are often determined on a case-by-case basis and based on the severity of the crime.

Level 2 background checks can give employers the insights they need to make sound hiring decisions. It’s important for employers to understand how these background checks work and the type of information they provide.


Recommended Reading: 5 Ways to Increase Healthcare Student Engagement


Optimize Your Hiring with Screening Services From PreCheck

Level 2 background screening can be complex and yet still leave room for further diligence in ensuring depth of decision-ready information at time of hire, as well as post-employment.  PreCheck offers a vast suite of services that complement Level 2 requirements while also providing more in depth protection for your program. 

Our comprehensive services include background checks, drug screening, employment verification, and licensing checks to help you make informed hiring decisions about your healthcare employees.

Speak to one of our experts today to learn more about our PreCheck services.


Screen smarter, hire safer. Get the right talent to drive your success. Speak to an expert.


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