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Guide to Nursing Background Checks

Jennifer Brozic
September 11, 2023
5 min read

Nurses play an integral role in protecting public health throughout the healthcare system in the US. Choosing the right candidates is essential to maintaining patient safety and minimizing organizational risk. Nurse background checks help ensure you hire qualified candidates with the necessary education, skills, and licenses for your open nursing positions.

Let’s take a closer look at the types of information a nursing background check may include, how long it takes to complete, and ways to help ensure compliant background check processes.

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What is a nursing background check?

Nursing background checks can verify information about and provide insight into the history of candidates for nursing positions, such as an RN, CRNA, or LPN. Additionally, some states require both an initial and/or yearly criminal background check for nursing school.

Employers and educational institutions can choose what searches to complete. Depending on the comprehensiveness of the screening, it may include:

  • A criminal background check to identify reportable misdemeanor and felony convictions.
  • A sex offender registry search to identify whether a candidate is a registered sex offender, including registration date and current status.
  • Employment verification to confirm previous positions held, employment dates, and employment status.
  • Education verification to review the candidate’s enrollment history, dates of attendance, degree(s) earned, and graduation date.
  • Professional license verification to determine whether the candidate’s licenses are active and in good standing.
  • Healthcare sanctions check to identify disciplinary action against a candidate, as well as exclusions and debarments. These checks include different screening options (such as Level 1 or Level 2) to meet your healthcare organization’s nursing background check requirements.
  • Drug testing to screen for certain controlled substances or alcohol.

What shows up on a nursing background check?

What shows up on a nursing background check varies depending on what screenings you include in your search. It may consist of a candidate’s criminal history, and exclusions, debarments, suspensions, or other disciplinary action. A nursing background check may also show whether a candidate holds the active, professional license(s) necessary to be eligible for the role.

In some states, the candidate's fingerprints may be run through the Federal Bureau of Investigation’s (FBI) Integrated Automated Fingerprint Identification System (IAFIS). Depending on where the candidate lives, the record may only include a candidate’s criminal history for the last seven years. In others, there may be no reporting time limit. How far back a background check goes depends on the state.

Since a criminal background check is common during the hiring process, you may wonder if hospitals hire nurses with misdemeanors, or if it is possible to be a nurse with a felony? The answer to these questions depends on the state where the nursing job is located.

In some states, certain convictions that appear on a criminal background check can make a candidate ineligible for the nursing workforce.

For example, the state of Texas won’t issue a nursing license to individuals who have been convicted of certain crimes, including violent offenses, such as kidnapping and murder; crimes involving children and the elderly; sex offenses.  Crimes related to drug and alcohol use, fraud, theft, and lying may also result in the disqualification of an individual’s nursing license in Texas.

However, in California, no convictions on a criminal background check automatically disqualify an individual from receiving a nursing license. If the applicant has a criminal conviction, the Enforcement Division of the California Board of Registered Nursing will review their application to determine whether to issue or renew the license. Convictions for offenses related to a nursing license, such as assault, failing to adhere to reporting requirements, sex offenses, theft, and fraud may be disqualifying in California.

You can check with your state to find out what charges can stop someone from being a nurse.

What are the differences between Level 1 and Level 2 healthcare sanctions checks?

Level 1 and Level 2 healthcare sanctions checks are common screenings used in nursing background checks, with both levels searching primary sources, such as the Federal Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE) and System for Award Management (SAM) database, for exclusions, debarments, sanctions, and disciplinary actions against healthcare professionals.

One type of healthcare sanctions checks is a FACIS® (Fraud and Abuse Control Information System) search. There are four levels of FACIS® searches that employers may choose to use depending on the requirements of the position and risk involved. A Level 2 healthcare sanctions check for healthcare workers is one of the least utilized search options, as a Level 3 search is the most popular, including the most comprehensive information.

Checkr offers three standalone healthcare sanctions checks to help your organization meet state and federal requirements for healthcare-related screenings.

Checkr healthcare sanctions checkIncluded sources
FACIS Level 1 / 1M• Excluded Parties List System (EPLS)
• OIG Exclusion List (LEIE)
• SAM Database
• State-level Medicare and Medicaid search (where available)
FACIS Level 3Level 1M, plus:
• Sanctioning boards from all 56 US jurisdictions across all provider types 2,500 state-specific sources
Global Watchlist• OIG Exclusion List (LEIE)
• SAM Database
• OFAC Sanctions List
• FBI Most Wanted Lists
• Interpol’s Most Wanted Lists

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How long does a nursing background check take?

A nursing background check may take as little as an hour, or multiple business days. Turnaround times vary based on multiple factors, including when you submit the request, the scope of your search and whether you conduct the background check yourself or work with a consumer reporting agency (CRA).

For example, a professional license verification or healthcare sanctions check may be completed quickly because the searches involve digital databases. Other screenings, such as education verification or county criminal records searches, may take several days.
Checkr eliminates the guesswork by enabling employers and candidates to track the status of screenings. By using machine learning and data from millions of background checks per year, we can predict turnaround times at the county level and provide an estimated completion time for individual reports.

How employers can maintain compliance

A nursing background check is a valuable tool that can help your organization make informed hiring decisions. However, maintaining compliance with local, state, and federal laws throughout the process is challenging. It’s important to understand what information you may or may not consider when making hiring decisions and at what point during the application process you can compliantly conduct a background check. Having a screening policy in place (drafted in consultation with your legal counsel) and adhering to that policy for each new candidate can help ensure your background checks are legally-compliant.

When you work with a CRA, like Checkr, you must follow the rules established in the federal Fair Credit Reporting Act (FCRA), including:

  • Letting the candidate know you will be conducting a background check
  • Obtaining the candidate's consent to conduct a pre-employment screening
  • Following the adverse action process if the results of the background check may negatively impact your hiring decision

The Equal Employment Opportunity Commission (EEOC) also provides guidelines for using criminal records in employment decisions to help employers prevent unintentional discrimination. The EEOC encourages employers to consider the nature of the offense, its relevance to the position, and when it occurred before making a hiring decision.

How to order nursing background checks

There are two options to conduct the nursing background checks you need — do it yourself or work with a third-party provider, like Checkr.

If you opt for the DIY approach, you must verify each piece of information separately. For example, you can check the National Student Clearinghouse or contact colleges and universities to verify education information. You can also request criminal records from state courts or check the OIG's sanctions database or SAM exclusion list to find out if a candidate has any exclusions.

Managing compliance on your own can be both time-consuming and complex. Hiring laws and regulations vary by location, and they can change frequently, making it difficult for employers to ensure compliant background checks.
Working with a CRA can save your human resources team time and support compliance in hiring decisions. For example, Checkr’s compliance tools help to ensure you only receive reportable records, saving you time and reducing your organization’s risk.

Get a nursing background check from Checkr

Background checks are often part of a comprehensive pre-employment screening for nursing and other healthcare positions. Checkr helps you find qualified candidates with fast, accurate screenings. We offer a full suite of background checks, including nursing-specific checks like healthcare sanctions checks and professional license verification. Working with Checkr saves time and minimizes risk by supporting compliance with local, state, and federal guidelines governing background checks in the healthcare industry. Get started with Checkr for nursing background checks.

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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

Jennifer writes about a variety of topics, including background checks, employee benefits, small business insurance, risk management, workplace culture, and more. Her work includes educational articles, blogs, e-books, white papers, and case studies.

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