Exclusion Screening

Importance of Ongoing Healthcare Background Checks


Emptech's founder, Jeff Aleixo


Jeffrey Aleixo

Ongoing background healthcare checks, exclusion screening compliance

Subject to federal and state-mandated changes, the healthcare industry is constantly evolving, requiring professionals who work within this industry to provide high-quality care to patients and maintain effective healthcare compliance. Healthcare background checks allow employers to evaluate applicants’ background, work history, and credentials in order to determine if the candidate in question is right for the job, which is essential for all healthcare organizations.

While most hospitals and healthcare organizations conduct pre-employment background checks, this may not be enough. Ensuring patient safety, creating a safe work environment for employees, and mitigating risk are essential reasons for conducting ongoing healthcare background checks. Without this, healthcare employers can be missing out on critical information about their staff and expose themselves to potential compliance issues.

Why Are Healthcare Background Checks Important

For some employers, running comprehensive healthcare background checks on every candidate can seem too complicated and time-consuming. However, this is the most reliable way for employers to ensure they are hiring the right candidate for the job, and to prevent any unexpected or dangerous problems with an applicant in the future.

While healthcare is one of the most highly regulated industries, there is no legal requirement for hospitals to conduct background checks on their staff. Most healthcare employers, however, choose to conduct background checks after the time of hire because it can help mitigate risk and protect their reputation.

Healthcare background checks are tailored to the healthcare industry and may vary in complexity based on different positions within a company. For example, a physician will require a much more detailed background check compared to a nurse or a medical assistant.

Exclusion Screening and Background Checks in Healthcare

For healthcare employers, continuous exclusion screening is already an industry standard. Hiring an employee excluded by the HHS OIG for posing risks to patient safety or financial integrity not only extends those risks to the provider’s business but also exposes them to overpayments when receiving reimbursements from federal health care programs. However, while exclusion screening serves an important purpose in an effective healthcare compliance program, it may not be enough to uncover other compliance issues that a background check can reveal.

Exclusion screening helps healthcare organizations remain compliant and avoid civil monetary penalties. According to the OIG issued a Special Advisory Bulletin in 2013, it is advisable to conduct monthly exclusion screening. At the same time, healthcare employers should perform healthcare background checks on an annual or biannual basis to safeguard their patients and staff.

Use this comprehensive guide on exclusion screening to remain compliant with constantly evolving healthcare regulations, prevent compliance risks, and avoid any potential costs.

Healthcare Background Checks Requirements

Healthcare background checks differ from a standard investigation in several ways. They vary depending on a position within a company, which organization conducts them, and how thorough the employer wants to be during a background check.

Healthcare background checks frequently include the following:

National Criminal Search

This search locates potential criminal records on a national level. It encompasses millions of records across thousands of jurisdictions and databases and also examines offender registries.

National Sex Offender Search

As a critical component of healthcare background checks, this search identifies any registered sex offenders. Since healthcare professionals come into regular contact with children and vulnerable adults, running a national sex offender search on each applicant is essential.

Identity Verification Check

This type of healthcare background checks ensures that applicants are not misrepresenting who they are. This also ensures that all subsequent healthcare background checks are evaluating the correct individual.

Drug Screening

Because healthcare workers have easy access to drugs, it is imperative that employers know if they have a history of substance abuse. Drug screening can reveal drug habits that may disqualify an applicant from a position in healthcare.

Employment and Education Verification

These are both crucial steps within healthcare background checks as they ensure that only qualified employees are working with patients. Employment verification can also allow employers to determine if applicants were fired from a previous job because of negligence or another severe mistake.

Excluded Entities and Individuals

The Office of the Inspector General (OIG) maintains an up-to-date database of excluded individuals and entities. This search identifies candidates who may be working in healthcare with a criminal record and who would, therefore, prevent an organization from participating in federally funded programs.

Ongoing Background Checks as a Proactive Approach in Healthcare

Each state has clear requirements for employees in the healthcare industry. To run healthcare background checks, employers need to gain access to applicants’ criminal records, contact law enforcement offices, and more. Therefore, implementing a thorough, efficient background screening program that is also effective can be challenging for healthcare employers.

On the other hand, outsourcing both exclusion screening and background checks is a simple way to ensure accuracy, coverage, and compliance. Ensuring patient and staff safety and maintaining information security is a top priority for every healthcare organization. Accordingly, automating healthcare background checks provides the most accurate and complete information in the most efficient and cost-effective manner possible.

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