Maintaining Compliance During Healthcare Staffing Shortages

Healthcare compliance leaders are operating under unprecedented pressure. Staffing shortages continue to strain organizations across the country, creating a tug-of-war between filling critical roles quickly and maintaining the rigorous screening standards that protect patients and preserve accreditation.

The risk isn’t that compliance teams try to cut corners. Stretched resources, compressed timelines, and manual processes create conditions where compliance degrades gradually through deferred checks, incomplete documentation, and assumptions that "someone else verified it."

This article examines where compliance breaks down during staffing shortages, why partial compliance is more dangerous than obvious gaps, and how healthcare organizations can stabilize their credentialing processes without slowing hiring to a halt.

Table of Contents

1. How Staffing Pressure Creates Compliance Blind Spots
2. 4 Critical Areas Where Compliance Fails
3. Why Partial Compliance Is Your Biggest Risk
4. Building Compliance Systems That Scale Under Pressure
5. How to Maintain Rigorous Standards During Ongoing Volatility

How Staffing Pressure Creates Compliance Blind Spots

Human resources and credentialing teams are stretched thin. They are hiring for revenue-generating roles, managing background checks, verifying credentials, and juggling competing priorities—all under pressure to fill roles "yesterday." Most rely on institutional knowledge rather than documented processes. This is not an isolated problem: 81% of healthcare executives believe talent shortages will significantly impact their strategies, making staffing pressure a systemic challenge across the healthcare industry.

Hiring Urgency Compresses Decision Windows

When a background check returns unclear results or a license verification reveals an alias name, teams under pressure have less time to investigate. They face increased temptation to move forward regardless.

Turnover Erases Institutional Knowledge

When experienced team members leave, undocumented steps disappear. New hires may not know to check for board actions on a license or verify all alias names in a criminal search.

Workforce Complexity Multiplies Verification Requirements

Many organizations rely on travel nurses in multiple states, locum tenens providers, and telehealth clinicians licensed in multiple jurisdictions—each requiring verification across different state systems.

Manual Tracking Breaks Down at Scale

Spreadsheets don’t send alerts. Calendars don’t detect board actions. Email reminders don’t create audit trails. As volume increases, manual systems fail. Organizations that scale headcount without scaling compliance infrastructure face the greatest risk.

These conditions create environments where compliance violations become inevitable.

4 Critical Areas Where Compliance Fails

The following breakdowns are common, preventable, and often discovered only during audits.

1. Background Screening Narrows Under Pressure

Criminals change names, use aliases, and relocate to make records harder to find. Yet many organizations still search only the name on the application or limit searches to the candidate's county of residence.

What fails:

• • Alias searches are skipped. Organizations search only the provided name, so they miss records filed under maiden names, nicknames, or alternate spellings.
  • The geographic scope is too narrow. Searching only in the candidate's home county misses crimes committed elsewhere. A provider who committed a misdemeanor in another state won’t appear in a county-only search.
  • Screening becomes inconsistent. Under hiring pressure, teams make ad hoc decisions to skip checks without documenting the rationale, creating defensibility problems during audits.

Best practice: Check all names and aliases at the county level, including both misdemeanors and felonies. Organizations can strengthen their approach by reviewing  what state boards of nursing look for in background checks.

2. License Verification and Ongoing Monitoring Fall Through the Cracks

Many organizations verify a license at hire and assume the work is done. Teams struggling with slow credentialing processes often have no bandwidth left for post-hire monitoring.

What fails:

• • Verification stops at hire. Organizations treat licensure as a one-time checkbox, creating a dangerous gap between initial verification and ongoing reality.
  • Expiration tracking misses disciplinary actions. Board actions, such as probation or practice restrictions, might not affect expiration dates but should disqualify providers from certain roles.
  • Multi-state licensing creates blind spots. Providers under the Nurse Licensure Compact hold a single license, but board actions in one state may affect privileges in others.
  • Manual systems can’t scale. Monitoring thousands of licenses on spreadsheets creates single points of failure. When the person responsible leaves or falls behind, expirations and board actions go unnoticed.

Best practice: Automate ongoing license monitoring to track status in real time. For organizations evaluating verification solutions,  following license verification best practices for nurse practitioners and other providers is crucial.

3. Sanctions and Exclusions Are Checked Once, Then Forgotten

Sanctions and exclusions lists are updated monthly. The absence of post-hire screening means an organization could employ an excluded individual for months before discovering an issue.

What fails:

• • Screening happens only at hire. Most organizations check Office of Inspector General and System for Award Management databases once and never revisit, exposing themselves to potential federal penalties.
  • Monthly list updates change the risk profile. If a provider is added to a list after hire, the organization remains responsible for removing them from patient care and federal billing.
  • "We'll hear about it" is not defensible. Regulators expect documented proof of continuous monitoring, not reactive responses.
  • Employers remain responsible even when unaware. Organizations are liable for employing excluded individuals, even if the exclusion occurred post-hire.

Best practice: Implement monthly sanctions monitoring using automated tools. Organizations building comprehensive compliance programs should consider how sanctions screening fits within broader  risk management strategies in healthcare.

4. Documentation Gaps Create Audit Vulnerability

If a compliance step is completed but not documented, auditors assume it didn’t happen.

What fails:

• • Records are incomplete or missing. Organizations can’t produce time-stamped verification records, sources, or proof of follow-up actions.
  • Processes are not repeatable. Without documentation, new team members cannot replicate workflows, creating vulnerability when experienced staff leave.
  • Regulators audit evidence, not intent. The Joint Commission, National Committee for Quality Assurance (NCQA), and state medical boards require proof that every hire was screened consistently, completely, and on time.

Best practice: Document every step, and store records centrally. Organizations looking to meet 2026 compliance requirements can use the 12 Days of Compliance framework as a roadmap for strengthening documentation practices.

These four areas represent the most common compliance failures during staffing shortages. Addressing them systematically reduces organizational risk and creates audit-ready processes that withstand scrutiny.

Why Partial Compliance Is Your Biggest Risk

When nothing is checked, the problem is visible. An inconsistently followed process, however, creates a cover that gives organizations a false sense of confidence.

Leadership believes the organization is compliant because "we do background checks" or "we verify licenses." But incomplete processes create gaps that regulators will find. An absence of checks is an obvious problem. But when checks are performed inconsistently, the pattern can go undetected until an audit forces a review.

Regulators expect consistency. An organization that screens some hires thoroughly and others superficially can’t explain the difference without admitting to inadequate processes.

Most organizations don’t choose partial compliance; rather, it emerges unintentionally as teams make ad hoc decisions under pressure. For example, a hiring manager says, "We need this person on the floor Monday," so HR skips a verification step or accepts incomplete results.

Over time, these shortcuts become informal practice. No one sets out to create partial compliance. It emerges from a lack of standardization, documentation, and oversight.

The solution is consistency, not perfection. Organizations that define clear standards and apply them uniformly to new hires will create defensible compliance programs that withstand regulatory scrutiny.

Building Compliance Systems That Scale Under Pressure

Healthcare organizations that maintain compliance during staffing volatility share a common characteristic: They don’t rely on individual effort. They rely on systems that function regardless of who is in the role or how urgent the hiring need becomes.

Two elements are essential to building these systems: repeatable processes that anyone can follow, and technology that handles the work humans cannot scale.

Build Repeatable, Documented Processes

Effective compliance depends on clear standards that any team member can follow. The following elements create consistency without requiring heroic effort:

• • Define screening scope by role. Not all roles require the same screening level, but every role should have a clear, documented standard. Patient-facing roles, for example, require criminal checks, license verification, and sanctions screening.
  • Set monitoring frequency and escalation paths. Establish how often to monitor licenses and when to perform sanctions screening. Document what happens when a license expires or a sanctions match is found.
  • Prioritize consistency over perfection. Define a sustainable standard, and apply it uniformly. Eliminate unnecessary duplication, such as verifying high school diplomas when an advanced degree presupposes earlier credentials.
  • Document everything centrally. Auditors expect time-stamped records of every verification, clear sources, and proof of follow-up actions. Without documentation, even diligent compliance work becomes invisible.

These practices allow organizations to move quickly without sacrificing defensibility.

Use Technology to Handle Tracking, Alerting, and Consolidation

Technology should handle:

• • Tracking: Centralized records of all verifications, expirations, and monitoring intervals
  • Alerting: Real-time notifications when a license expires, a board action is issued, or a sanctions match is found
  • Consolidation: Integration with HR systems to eliminate duplicate data entry

Humans still own judgment and decisions:

• • Interpreting findings: Not all criminal records or board actions disqualify a candidate. In those instances, someone must review the context.
  • Employment decisions: Technology surfaces information. Humans decide what to do with it.
  • Policy exceptions: Every organization will encounter edge cases requiring judgment and documentation.

Automation reduces manual work, but compliance leaders must still review alerts, investigate discrepancies, and ensure workflows function as intended.

With documented processes and technology that handles routine tracking, compliance scales without adding headcount. Organizations can absorb hiring surges, staff turnover, and operational disruptions without creating gaps that auditors will find.

How to Maintain Rigorous Standards During Ongoing Volatility

Staffing shortages aren’t anomalies. They are a structural feature of the healthcare labor market, and compliance strategies must assume continued volatility.

Organizations that invest in clear processes, ongoing monitoring, and documentation discipline are better positioned to protect patients, preserve accreditation, and defend their hiring practices during audits. Compliance isn’t an obstacle to hiring. When done well, it reduces risk, creates consistency, and allows organizations to move quickly without cutting corners.

Why Cisive PreCheck Partners With Healthcare Organizations During Staffing Crises

Healthcare compliance is categorically different from general employment screening. The regulations are stricter, the consequences are higher, and the healthcare workforce is more complex. PreCheck brings healthcare-specific expertise that directly addresses the challenges outlined in this article.

Regulatory expertise:

• • Deep knowledge of Joint Commission standards, NCQA requirements, and state-specific licensing rules
  • Workflows designed to satisfy accreditation expectations and audit requirements

Purpose-built technology:

• • Tools for ongoing license monitoring across multiple jurisdictions
  • Automated sanctions tracking, with real-time alerts
  • Multi-state credentialing systems that scale with hiring volume

Operational continuity:

• • Documentation and institutional knowledge that persists when internal staff turn over
  • Support that absorbs verification volume during hiring surges without compromising quality

When compliance knowledge lives with one person, your organization is vulnerable. PreCheck provides the systems and expertise to maintain rigorous standards even during periods of extreme staffing pressure.

Ready to strengthen your healthcare compliance program during workforce shortages?

Talk to a PreCheck expert to learn how automated credentialing and ongoing monitoring can help your organization maintain rigorous standards for your healthcare professionals without slowing hiring.