Healthcare organizations are improving their ability to screen job applicants for criminal backgrounds and other disqualifying factors, but it is important to screen volunteers and others just as effectively.

At the same time, be careful not to make your screening process so onerous that it drives away good applicants.

Sharp HealthCare in San Diego uses a vendor to conduct background checks after a new hire has been offered and accepted a position, says Elmerissa Sheets, director of workforce development and recruitment strategy. Sharp HealthCare started performing background checks about 10 years ago.

“The background check includes criminal records, and that is very important to us as a healthcare provider,” Sheets says. “We do that with every single candidate and they are not fully hired — they can’t start working — until that comes back. If there are issues with the report, our vice president and human resources director check into it.”

More Thoroughness Needed

The health system has had to rescind offers after the background check revealed criminal convictions that the candidate did not divulge, Sheets says. Out of about 3,500 hires a year, about 40 offers are rescinded for background screening reports and similar issues.

In the past 15 years, she has seen more healthcare organizations perform background checks, prompted in part by hospitals that thought they were performing a sufficient check by looking for a criminal record in their own states.

“We feel like we’re at a high risk if we don’t do it, because we’re a healthcare company and have to trust people with our patients,” Sheets says. “One concern is people having convictions in other states, which is more difficult for us to determine on our own, so we use a vendor that can do a broader background check.”

Anonymous References Can Work

Sharp HealthCare changed its policy on references four years ago, after finding that the traditional method of calling former employers for a reference was yielding poor results. Concerns over liability have companies refusing to give references on past employees, so Sharp HealthCare switched to a vendor that collects information from past employers, some of it including detailed ratings of skills, and provides it anonymously to Sharp HealthCare.

Litigation concerning hiring decisions often can be traced back to earliest stages of the process, says Christopher M. Trebilcock, JD, principal with the law firm of Miller Canfield in Detroit.

“So many times when I get involved in litigation on the back end of a hiring decision, I look at the beginning of the application and onboarding process and see gaps, things that were not completely filled out,” he says. “Often, corporate risk management has provided forms for going through the due diligence to make wise hiring decisions, but then you go through those forms and too often see that they are incomplete. It’s more difficult to police when the applicant gives inaccurate information, but a lot of times it was just incomplete and nobody objected.”

Screen the Candystripers

Some companies are moving toward online application systems that prohibit moving on to the next question without answering the current one, he notes.

“It goes to the basics. You absolutely have to insist on complete information in the application process, and then you have to verify that information,” he says. “There are people who provide incomplete or inaccurate information and just hope that a busy human resources manager will gloss over it.”

It also is important to screen everyone who works in the healthcare organization in any capacity, says Mary O’Loughlin, managing director of healthcare at HireRight, a background screening company. HireRight recently found that background screening uncovered issues in 83% of junior-level candidates, 35% of mid-level candidates, and 14% of senior-level candidates in the healthcare industry.

“Everyone thinks of screening job applicants, but you also have to screen volunteers, contingency labor, anyone who is potentially going to be in your organization in some capacity,” she says. “You should be screening those people with the same level of rigor and caution as you do for your full-time employees. A lot of times volunteers or contingent labor will have similar access to patients, protected information, and drugs that your full-time employees have.”

O’Loughlin notes that the turnover experience in healthcare is higher than for other industries — about 19% — and the unemployment level in healthcare typically is about half of the overall rate. That puts pressure on the employer to have an effective and efficient screening program.

“Your process needs to be thorough with screening, but it also needs to promise that the candidate gets through the process quickly and without much hassle. A candidate who has a good experience with your application and screening process may stay longer and recommend your organization to others,” O’Loughlin says. “But if the experience is lengthy or overly complicated, that candidate may turn to other employment opportunities. You can’t let that discourage you from doing thorough background screening, but you also have to factor the applicant experience into how you design your processes.”


• Mary O’Loughlin, Managing Director of Healthcare, HireRight, Irvine, CA. Phone: (949) 428-5800.

• Elmerissa Sheets, Director of Workforce Development and Recruitment Strategy, Sharp HealthCare, San Diego. Phone: (858) 395-8616.

• Christopher M. Trebilcock, JD, Principal, Miller Canfield, Detroit. Phone: (313) 496-7647. Email: