5 Tips to Improve Post-Hire Screening in Healthcare

Karen Axelton
September 28, 2023
5 min read

Background checks go beyond an onboarding checklist for healthcare organizations. Ongoing screenings are an integral part of a risk management strategy to ensure patient safety and mitigate risk, and even continue eligibility for federal funding. Keep reading to learn how to improve your post-hire screening process leading to better patient outcomes.

Healthcare employers typically conduct multiple employee background screenings on an ongoing basis, including criminal records monitoring, motor vehicle records (MVR) checks, professional license verification, and drug testing.

Further, healthcare organizations receiving funding from Medicare or Medicaid must comply with the Centers for Medicare & Medicaid Services (CMS) guidelines, which include searching applicable State Medicaid exclusions sources monthly. It is also recommended to search the Department of Health and Human Services’ Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE) and The System for Award Management (SAM) database monthly.

Post-hire background screenings for healthcare are essential, but conducting these checks poses challenges for busy HR teams—especially those relying on manual processes. Initiating background screenings, checking licenses and lists, and following up to remind employees of necessary actions is time-consuming and prone to errors.

How can you improve your post-hire background check process? Here are five tips.

1. Educate employees on the process

Employees may not understand the need for post-hire background checks or may see them as implicit criticism. Moreover, background checks may cause anxiety for some employees, particularly if they don’t understand how they work or why they’re necessary.

It’s important to have a written background check policy as part of your employee handbook, and ensure every employee reads and understands it. Be transparent about what types of screenings each position requires, how often screenings will take place, and how background checks impact decisions about hiring, promotions, and employment.

Keep employees in the loop about how the background screening process works so they know what to expect, and provide a way for them to get quick answers to any questions they may have.

When employees know why background checks are important and how they impact your business, you build trust which can quell anxiety about the process. Additionally, knowing that your organization prioritizes employee and patient safety can also instill confidence which leads to improved employee retention.

Mitigate risk with comprehensive, compliant screenings

2. Stay up-to-date with federal, state, and industry requirements

HR professionals must be familiar with applicable state laws regulating healthcare background checks. For example, 15 states require employees of home health agencies to undergo background checks after their initial pre-employment screenings at frequencies ranging from annually to every six years. Additionally, state agencies in California, Delaware, and New York receive automatic notifications of subsequent arrests, which must then be adjudicated. Your state department of health or social services is a good source of information about state requirements, such as additional post-hire background checks.

On the federal level, healthcare organizations receiving federal funding must follow CMS guidelines for national background checks. Checking the OIG Exclusion List screening is an industry standard procedure.

In addition, any employer performing background screenings through a consumer reporting agency (CRA) must comply with the federal Fair Credit Reporting Act (FCRA). The FCRA requires that employees provide written consent for a background check prior to it being conducted, which includes ongoing screenings. If possible, you may wish to gather “evergreen consent” from the candidate, which enables you to run subsequent background checks throughout their employment.

3. Prioritize workplace safety and patient care

Post-hire background checks help you enhance workplace safety and provide better patient care by providing the most up-to-date information about employees. Adding aliases to your background check package helps to mitigate risk by providing the most complete data. For example, conducting a sanctions search without including an employee’s maiden name may not return comprehensive results. Confirming that an employee has a current license and no new sanctions against them helps to ensure your healthcare workers are trained and qualified, which can lead to better patient outcomes.

Ongoing screenings can also act as deterrents to risky behavior, creating a safer workplace for patients and employees alike. An employee who knows they’ll be screened for drugs on a regular basis may be less likely to partake, helping to mitigate the risk of accidents or errors on the job. A home health aide who chauffeurs seniors as part of her job may be encouraged to drive more safely if she knows her MVR is continuously monitored for new violations.

Increase visibility with continuous screenings

4. Act quickly when screenings show alerts

Patient care and safety is paramount. When a post-hire screening returns with an alert, start by reviewing the information to determine if it is relevant to the employee’s role and what actions, if any, need to be taken. Depending on your company policies and federal, state, and industry regulations, you may be legally required to take certain steps.

For instance, if you conducted the screening through a CRA and are considering terminating employment or denying a promotion or transfer based on information from a background check, you must follow the adverse action process. It is also a best practice to conduct an individualized assessment prior to making your final decision.

Using a background check provider that notifies you in real-time when an employee’s record has a reportable change can mitigate risk, helping to protect your patients, employees, and organizational reputation. Take advantage of real-time data by acting on alerts quickly when you receive one.

5. Use technology to automate manual processes

Managing multiple types of post-hire background checks for employees in a wide range of healthcare roles can quickly become complicated for busy HR professionals. Tracking industry screening requirements, monitoring background check progress, and reviewing results can mean lots of manual work, increasing the chance of errors while using valuable staff time.

Look for ways to implement technology to streamline both pre-employment and ongoing background check workflows. For example, setting up searches to run on a periodic basis—like professional license verification, continuous criminal monitoring, and the OIG and SAM database checks—not only frees up valuable time for your HR team but also helps you support compliance by being proactive about any potential alerts .

Working with a background screening partner that uses advanced technology, like Checkr, can reduce manual processes, expedite background checks, and save your HR team time while providing peace of mind that you’re making employment decisions based on the most up-to-date and accurate data.

Expedite hiring to convert candidates quickly

Checkr simplifies post-hire background checks for healthcare

Ongoing background screenings are an essential tool to help healthcare organizations protect patients, reduce legal risk, and enhance patient care.

Streamline the post-hire background check process with Checkr. Our machine learning technology automates data retrieval to deliver fast, accurate results in an easy-to-read format. Checkr’s built-in compliance tools help your background screenings follow relevant regulations and requirements, including adverse action, so you can make employment decisions with confidence. Employees stay up-to-date with timely communications and can easily share comments and context around their background check results.

Whether you are screening clinicians, administrators, or support staff, Checkr offers a full suite of background screening options to fit your healthcare organization’s needs.

Get faster, smoother healthcare background checks with Checkr


The resources provided here are for educational purposes only and do not constitute legal advice. We advise you to consult your own counsel if you have legal questions related to your specific practices and compliance with applicable laws.

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About the author

Karen Axelton writes about business topics and best practices. She has written hundreds of articles on business subjects, including background screening, hiring and employment trends, human resource management, and the use of technology in the workplace. Her work includes educational articles, e-books, white papers, and case studies.

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