Top 10 Background Check and Compliance Issues in Healthcare and How to Navigate Them
Healthcare background checks allow you to maintain quality patient care by protecting the workplace from high-risk hires. However, to achieve effective background screening, you’ll need a robust screening program and a trusted partner to help you understand and manage the associated compliance risks.
With reliable and accurate background screening, you can navigate healthcare compliance issues and protect your organization’s patients, bottom line, and reputation. Here are the ten background check and healthcare compliance issues you need to avoid.
1. Non-compliance with current FCRA background check requirements
Employers conducting background checks must comply with the Fair Credit Reporting Act (FCRA) rules for collecting and reporting background data. The FCRA requires organizations conducting background checks to comply with the following requirements:
- Make proper disclosures and obtain authorization from candidates before conducting background checks
- Use up-to-date and accurate sources of background data
- Follow legal adverse action procedures
Not following FCRA requirements can result in penalties and lawsuits. In fact, lawsuits related to FCRA violations have increased by 150 percent in the last ten years, and can lead to hefty fines and settlements.
2. Improper background check disclosures
Before conducting a background check for employment purposes, you must provide each candidate with a disclosure notice of your intent. Under FCRA guidelines, background check disclosures must be stand-alone documents, separate from applications and other recruiting documents.
To avoid the risks of using improper disclosures, including fines and lawsuits, you will also need to prevent disclosure form mistakes, which can include the following:
- Not communicating disclosures in writing
- Not explaining the disclosure and adverse action process
- Combining disclosures with liability waivers and other documents
3. Not following rules for healthcare background checks
Federal regulations require background checks in healthcare hiring. Centers for Medicare and Medicaid Services (CMS) rules require healthcare employers to conduct background checks before hiring individuals with patient access. Also, the Joint Commission has background check requirements for accredited healthcare organizations. Not following these rules can expose your organization to penalties such as fines, possible loss of accreditation, or even clawback of CMS funding.
Background screening doesn’t stop when the healthcare hiring process concludes. You should also conduct continuous checks for employment sanctions and exclusions among your workforce. Specifically, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) requires healthcare employers to check exclusion and sanction lists routinely for employee names. The following lists are commonly included in continuous sanction monitoring:
- HHS OIG List of Excluded Individuals and Entities (LEIE)
- U.S. General Services Administration (GSA) System for Award Management (SAM)
- U.S. Treasury Office of Foreign Asset Control (OFAC) database
4. An outdated policy or poorly defined processes
Your background check policy should have clear details explaining why and how your organization conducts background checks. Without this information, your policy can quickly fall out of step with actual practice.
If your policy lacks sufficient detail or you don’t update it regularly, you can encounter problems related to consistency and adherence to compliance requirements. Therefore, in partnership with your background screening provider, it’s critical to review and audit your background screening policy and processes regularly.
5. Outdated technology
The best background screening technology goes far beyond sending a background check request through an online portal and getting the results in a few days. Modern background screening technology can automate workflows and help you run a more efficient screening program. On the flip side, if you’re using outdated screening technology, you can miss opportunities to use data for better decision-making. A lack of automation can also cause you to waste time on double-entry and manual processes.
If you’re using less-than-stellar technology, you could be missing out on the following benefits:
- The ability to make batch background check requests
- Reports and analysis to help you see trends in your background check program
- Integrations with your applicant tracking system (ATS)
- Dashboard views to help you see where candidates are in the screening process and where you need to take action
6. No mechanism for identity verification
Compliant and accurate background checks go hand in hand, but without a background check process focused on verifying identity, you can end up conducting a background check on the wrong person.
Not all background check providers have a process in place for verifying identity, so you’ll need to work with a background screening provider who does. When your screening provider uses a social security number (SSN) trace along with a combination of other best practices, you can collect more accurate candidate data at the outset of the background check process.
7. Including prohibited items in background checks
A background check is not a catch-all for everything in a person’s background. If background check results include prohibited items, you can violate candidate privacy and fall out of compliance with FCRA rules. Your organization can also face regulatory fines and lawsuits if you make adverse action decisions based on inaccurate or prohibited background data.
To avoid the penalties of non-compliance, your screening provider must make sure the following items do not appear in background check reports:
- Convictions older than seven years in jurisdictions where they are prohibited, for example, California, Massachusetts, and New York
- Bankruptcies older than ten years
- Expunged criminal records
8. Incomplete education and employment verifications
Education and employment verifications provide you with valuable information about a candidate’s credentials and work history. However, if your provider doesn’t put in the required effort to obtain verification information, you won’t get it. Many background screening companies conduct a maximum of three attempts for education and employment verifications. If they don’t get a response, you see little more than “No data available” on the background check report. You end up paying for a complete background check but get incomplete results.
When you work with a background check provider who goes beyond three verification attempts, you get valuable information and the best value for your background check investment. With a provider committed to accuracy and quality, you can also identify diploma mills and other fake credentials.
9. Conducting background checks only on employees
Full-time healthcare employees aren’t the only individuals with access to patients, so it’s unwise to limit background checks to full-time hires. You should conduct background checks on anyone who could potentially pose a risk to patients or others in the workplace, including part-time and hourly employees, volunteers, fellows, and interns.
Visiting nurses and temporary hires are also part of your workforce. Whether you hire them directly or through an agency, make sure background screening is performed consistently with your policies.
10. Falling out of alignment with changing laws
Many laws impact the hiring process, including “ban the box,” salary history bans, and marijuana legislation. Most of these laws are set at the state and local level, and they differ from location to location. In some cases, laws vary from city to city within the same state.
By failing to keep current with changing laws, your background check practices can lead to uneven compliance. Due to variations in local laws, you can comply with rules in one hiring location, but face background check and healthcare compliance issues in another.
How to Avoid Background Check and Healthcare Compliance Issues
Healthcare background check compliance requires a full understanding of your workplace and industry requirements, as well as a partner who can guide you and help you manage compliance risks along the way. Take the following steps to avoid healthcare compliance issues when conducting background checks:
Review your background check program and policies regularly
As hiring laws evolve and your internal processes change, it’s essential to make sure your policies reflect actual practice. Your background screening process from last year may not allow you to remain in compliance with this year’s expanded hiring laws. Also, as you add new background screening products, you will need to update your policies accordingly. For example, if you decide to introduce workforce monitoring activities, you will need to update your employee handbook.
Since policies don’t live in a vacuum and should guide your organization’s daily background screening activities, be sure to include key stakeholders when considering changes. HR, compliance, legal, and your background check provider can all work together to keep your screening policies in good shape.
Work with a qualified background screening provider
A great partner offers guidance, education, and best practices to help you stay in compliance and on track with your goals. When you work with a screening provider committed to quality and compliance, you can achieve the following benefits:
- Up-to-date knowledge of all FCRA and industry-specific background screening requirements
- Expertise and resources to help you review and approve your background screening program for compliance and best practices
- Technology to automate key background screening processes and help you stay informed about your overall program
- Commitment to accuracy and high-quality background checks
- Guidance on new and updated legislation affecting your hiring process
Healthcare background screening involves many layers of complexity, and there is no shortage of compliance hurdles. Once you understand your compliance obligations and have the necessary processes to support an efficient and compliant screening program, you can overcome common pitfalls and hire with confidence. To help you understand the compliance health of your background screening program, use our Healthcare Background Screening Compliance Checklist.