Hiring Health-Care Workers: Background Checks Are No Place to Skimp

Employment in the health-care industry is growing so fast right now that, by 2024, the sector is projected to employ more Americans than any other industry. In just seven years, it’s expected to outstrip the combined total number of state and local government workers and eclipse the massive professional and business services market, which currently are the top two industries employing the most people in the United States.

Those forecasts likely come as no surprise to hiring managers, recruiters and others on the frontlines at hospitals, clinics and doctors’ offices across the country. In fact, the 10th annual HireRight Employment Screening Benchmark Survey found that 83 percent of respondents expected their workforce to grow in the next 12 months.

As industry leaders deal with this explosive growth, they also are grappling with other issues that make it challenging to find and retain employees.

• Across markets, the health-care sector has the second highest average total turnover rate at 19 percent—second only to the hospitality industry.
• With a low unemployment rate, the competition for qualified employees is growing, giving applicants more power in the hiring process.
• More state and federal laws require new and strict compliance, including ever-evolving requirements that health-care organizations check for any potential sanctions against employees on a monthly basis.
• And more state laws that now make medical or recreational marijuana legal are forcing new looks at drug policies and procedures.

Costs add up when hospitals or clinics aren’t fully staffed and must pay overtime or bring on contingent labor to fill in the gaps. To save money and speed up the hiring process, many in the health-care industry are rushing through background checks—or, in the case of contract hires or international job applicants, skipping them altogether.

But, when they bypass background checks, employers also are missing out on other benefits of background checks, including better quality hires, improved regulatory compliance, improved patient experience, more consistent safety and security, and a better reputation for the organization.

Nearly 80 percent of respondents said that a thorough screening of applicants’ backgrounds helped uncover issues that they may not have caught otherwise, according to HireRight’s survey. Those employers that forgo background checks are potentially exposing their organizations to increased risk and decreased compliance and potential fines by state and federal regulating bodies.

For these reasons, the health-care industry must recommit to conducting thorough background screening on all of its employees.

Screenings—Early and Often—for All

Patient safety comes first for health-care providers. Employee safety comes a close second. Anybody who works with patients or other employees should go through a careful background screening. Here’s who health-care providers need to screen:

Job applicants

A rigorous background check should always be standard before bringing new hires into the fold. According to HireRight’s Benchmark study, 88 percent of respondents conducted criminal records checks and other public record searches. About 84 percent checked a candidate’s employment history and references. About 75 percent verified that the applicant held the appropriate licenses and qualifications.

Health-care companies, however, are missing out on plenty of data if those are the only checks they conduct.

A robust screening generally includes verification of a candidate’s education, a motor vehicle records search, social media checks, credit history report and fingerprints. Health-care companies also should check for any additional names or aliases a candidate may have once used and ensure those candidates aren’t on the National Sex Offender or Adult Abuse registries.

Another important place to look: Federal, state and licensing board sanction databases. Right now, 40 percent of health-care organizations are checking only federal sanctions lists to determine whether a candidate or employee faces disciplinary action, according to HireRight’s Benchmark survey. Employers must look beyond those federal agencies and review all groups that may issue any number of exclusions, probations or letters of reprimand.

Contract hires

Nearly 45 percent of respondents in HireRight’s Benchmark survey reported contingent labor comprises 10 percent or more of their workforce, but only 25 percent of employers are screening them. Yet, many of these non-employees are walking hospital halls, treating patients, or handling sensitive information, just like full-time employees.

Hiring agencies and recruiters often conduct their own background checks on contractors, but they don’t always meet the same standards that employers require for full-time employees. Health-care organizations should require staffing firms to adopt the same screening package that is used for full-time employees and abide by similar hiring guidelines that are applied to employees. That package must abide by all state and federal regulations and could vary depending on the role that the temporary employee will fill.

Candidates with global experience or education

The health-care sector, of any industry, has the largest percentage of workers who are either born or trained in another country. About 25 percent of physicians and surgeons were born outside the United States, and about 20 percent of nurses, home health aides and psychiatric aides were born elsewhere.

Yet, according to HireRight’s survey, only 17 percent of respondents screen the international backgrounds of their U.S. employees and only 16 percent verify the backgrounds of employees who are based outside the United States.

Global background checks in countries where screenings aren’t a routine part of the hiring process can be more costly and time consuming. Often, employers must wade through more restrictive privacy laws and different cultural norms to secure the information needed.

The payoff, however, can be big when the effort allows employers to land on the most qualified candidate. After all, just like contingent employees, global candidates often have as much access to patients and sensitive records as anybody else.

All employees and non-employees post-hire

Compliance with federal or state regulations, accrediting agency requirements and general risk management mandate regular rescreening, but more than half of respondents in HireRight’s annual Benchmark survey said they don’t do them.

Any time an employer screens a job candidate, they’ve captured a single point in time. No matter how exhaustive that initial check was, only ongoing screenings will provide a full picture of an employee’s personal and professional life.

Regular checks will help ensure that employers aren’t missing out on a development in a person’s qualifications or status that could change their opinion about whether the employee should continue to be part of their organization or remain in the same role.

Employers should cast a wide net when rescreening existing workers and do it monthly.

Education and Caution Required

For health-care companies already contending with myriad challenges, more robust background checks may seem daunting. But there are ways to streamline the process.

Explain the process

Giving job candidates information about the screenings upfront is one of the best ways to cut down on confusion and inefficiencies, and increase the candidate’s overall satisfaction with the onboarding process.

Before the background check begins, candidates should understand the timeline, their rights and why employers are asking particular questions. They also should know what paperwork they’ll need and when to put their references on notice that they may be getting a call.

Finally, employers should outline ways for candidates to address any issues. For instance, if a candidate’s identity was stolen in the past, how can they address potential concerns that may crop up during a standard screening?

The more educated a candidate is about the process, the more empowered they will feel during a normally anxiety-ridden time as they wait for a job offer.

Make it flexible—and mobile

Education is one way to make the background check process a positive experience for job applicants. So is making it flexible—especially in the health-care industry. The sector is growing so quickly and employers are considering so many different types of candidates, the ability to adapt is critical.

In some cases and for some roles, for instance, the candidate may fill out all of the required information. In others, the recruiter may do the work. When a new facility or clinic is acquired, employers should develop a system so that all of the employees from the new organization are screened together.

Mobile-friendly screenings, especially when linked to an Applicant Tracking System, also can make a big difference. According to HireRight’s Benchmark survey, about 30 percent of respondents said they had incorporated mobile devices into the screening process to make it easier for job candidates. Another 20 percent said they were likely to add mobile-friendly applications in the next year.

Be cautious

Before employers set out on a comprehensive background screening program, they must ensure they truly understand the applicable regulations at the state and federal level and, for global candidates, foreign laws that may restrict what information is available.

Partnering with a professional background screening company that offers solutions to help you meet your compliance obligations is one way to approach the need to meet your regulatory screening requirements. An organization’s legal and compliance teams also must be involved in developing the screening program to guide those who will be running the checks. Best practice would be to include your security and Talent Acquisition as well as they may have other thoughts about the screening program and its guidelines.

With all of the challenges facing health-care organizations, background screenings may seem like an easy place to skimp. Many employers, after all, are doing only the most rudimentary of checks to save time and money. In reality, those challenges—from high turnover to new marijuana laws—just make complete screenings even more critical to ensuring the new employees coming on board are qualified to do the work.