The Importance of Background Checks for Healthcare Workers

As healthcare facilities hire new nurses, doctors, and other medical personnel to care for their patients, they must ensure that everyone is fit for the job. That includes screening for criminal history and sex offenses.

Importance of Background Checks for Healthcare Workers

Another critical part of a background check is a drug test to see if the candidate has a substance abuse history. It is crucial in the medical industry because healthcare workers can access powerful prescription drugs.

Professional License

In the healthcare profession, there is an underlying edict: “first, not harm.” Healthcare firms must prioritize safeguarding their patients’ safety when employing new staff members. It is crucial to do a thorough background check for healthcare workers because they cannot afford to risk exposing their patients to an employee who is unfit for duty due to past criminal convictions or a history of negligence in the medical field.

Healthcare professionals can access powerful prescription and illicit drugs, so employers must verify applicants’ drug histories. In addition to a drug screening, an employer should also check for any criminal records, which is often a sign of a potential risk to their patients and employees.

As a result, a thorough background check can save you time and money in the long run by ensuring that all of your new hires have the proper credentials to carry out their duties. It includes a comprehensive credentialing search that reveals candidates’ educational and licensing history and references from professional supervisors and peers who can confirm their qualifications.

Licensing of health professionals is a significant regulatory and compliance issue in the United States. In many cases, health professionals who move from one state to another are subject to additional licensing requirements, fees, and paperwork, not to mention the potential for licensure suspension or revocation.

Obtaining professional licenses differs widely across jurisdictions and professions, with some occupations being licensed more frequently than others. For example, the percentage of dispensing opticians licensed in Denmark was higher than in most European countries.

Similarly, physicians were more likely to be licensed in the U.S. It is mainly because most doctors must possess postsecondary education or, at the very least, technical training and work experience.

It means that the professional licensing of a healthcare worker can vary significantly from jurisdiction to jurisdiction, and healthcare employers must conduct thorough background checks on their new hires. It can help them avoid many problems, including medical malpractice lawsuits that cost the healthcare industry $3.9 billion in 2017.

Excluded Individuals/Entities

Hiring healthcare workers with a clean background and a compliance history is essential for healthcare organizations. These positions account for 14% of the United States workforce, and a single negligent hiring decision can negatively impact an organization’s reputation, patients’ safety, and overall business operations.

Employers who want to avoid lawsuits, medical malpractice claims, and hefty settlements should take every precaution in their hiring practices. They should perform comprehensive due diligence on potential employees to ensure that they are licensed, have a transparent background with their licensing board, and do not have an exclusion from any state or federal programs.

The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) lists individuals and organizations not eligible to enroll in Medicare or Medicaid. These include those who have committed serious crimes against the government or people enrolled in government healthcare programs.

These exclusions make it difficult for providers to bill Medicare and Medicaid for their services and can result in significant monetary penalties. Suppose a provider hires an excluded individual to perform items or services paid for under a Medicare or Medicaid program. The provider must pay back 100 percent of the improperly received funds in that case.

However, it is essential to note that this is a rare situation, and only some people or companies included in a federal healthcare program will be on this list. Many people can be removed from the list through a process called reinstatement.

This process is challenging to go through and involves a complex appeals process. It can take months and even years to resolve, making it essential for healthcare employers to check exclusion lists as part of their screening processes regularly.

Healthcare facilities and businesses should conduct OIG exclusion screenings to determine if their current or prospective employees have been excluded from participating in federal healthcare programs, such as Medicare or Medicaid. It can help them minimize the risk of fines, revocation of billing rights, and other potential risks associated with these exclusions.

Exclusion and Sanction Lists

Performing a background check on a candidate for a healthcare position is more than just a good idea–it can protect patient safety and your organization’s financial integrity. Nevertheless, many businesses need help implementing a specific compliance solution encompassing all aspects of healthcare hiring.

One aspect of compliance that is especially important for healthcare organizations to manage is monitoring exclusions and sanctions. These can have severe financial and reputational consequences for healthcare providers, and they need to be monitored constantly if your organization wants to comply with federal and state laws.

For example, employers can conduct healthcare sanctions checks to avoid hiring candidates excluded from participating in federally funded programs. These individuals cannot receive Medicare or Medicaid payments for their services. A healthcare employer that hires or retains a banned party may face civil monetary penalties (CMPs) from the OIG or a state Medicaid division.

To make the most of these screenings, running them several times before deciding whether to hire a candidate is best. It is because some time can elapse between when a person has been sanctioned and when they appear on a sanctions list.

The Office of the Inspector General (OIG) recommends that healthcare organizations check the OIG exclusion list at least once monthly to verify that an individual has not been sanctioned. It is especially critical if your organization has recently employed a candidate.

Other than OIG, there are two other lists that healthcare organizations can use to screen their workforce for exclusions and sanctions: the Federal Excluded Entities List (LEIE) and the System for Award Management (SAM). LEIE is a federal database consolidating exclusion records from various government databases, including the EPLS and CCR/FedReg.

The OIG also has a federal SDN (Special Debarment Notice) list that can supplement the LEIE and SAM, but other government lists are more reliable. Since SDN records do not include identifiable data, they can be challenging to validate and resolve.

Sex Offender Registry

Healthcare organizations that hire healthcare workers often must rely on background checks to ensure they are hiring people with the right qualifications. These screenings can help prevent various problems, including liability issues, malpractice, lawsuits, and the loss of human life.

One of the essential parts of a healthcare worker’s background check is a national sex offender search. It pulls information from every state and territory to identify individuals with convictions or guilty pleas for a sex crime.

These checks are critical because healthcare professionals often come into regular contact with children and other vulnerable patients, which is where sex crimes can occur. They also work in an industry that needs a lot of new employees, and they cannot risk missing these vital steps to ensure they have the right people in their organization.

Many states have laws that make it harder for sex offenders to find housing and employment. It can harm their spouses and children, as well. In addition, they may be barred from working at schools or daycare centers that bring sex offenders into regular contact with children.

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