How to keep criminals out of your facilities

It won’t be easy to keep people with criminal records from being hired at your facilities, but there are steps to take that can sharply decrease the chance of putting your patients in the hands of criminals. Here are some suggestions from Sandy Mahon, vice president for risk management and quality assessment with Program Beta in Alamo, CA, the risk pool for California hospital districts:

o Conduct criminal background checks if you can afford them.

The cost of the checks will vary depending on what service you use and the volume of inquiries, but $15 each is typical. That can be cost-prohibitive if you have a large network of facilities and a lot of applicants because of the high turnover rate common in some health care fields, such as long-term care. You may want to do background checks on just the new hires, not all applicants.

o Do the background checks only in long-term care if your budget is tight.

"Risk managers should be devoting more attention to long-term care because that’s where the problem is," Mahon says. When it comes to staff with criminal backgrounds, not all of your departments are created equal. Your long-term care facilities are much more at risk for this problem than other departments, so it’s a good idea to devote scarce resources to those problem areas.

o Improve your interview techniques.

The interview process should involve questions intended to ferret out those with criminal backgrounds. For starters, ask if the person has ever been convicted of a crime. If your organization has a policy prohibiting people with certain criminal backgrounds from working there, explain that policy and the fact that lying about one’s background can cause dismissal. Such questions won’t bring forth everyone’s criminal record, but they may eliminate some that would have slipped by.

o Closely monitor the employee’s probationary period.

Take advantage of the usual probationary period to scrutinize new hires closely. Step up your efforts in long-term care and don’t tolerate any sign of criminal or unethical conduct.

"You’re subject to any of their individual faults being played out in your arena," Mahon says. "If he’s a thief, you’re going to have lost patient valuables. If he’s convicted of any kind of abuse or molestation, you run the risk of patients being physically abused or raped."

o Watch night-shift employees more closely.

Mahon says she expects those with criminal records to seek night-shift work because it usually allows them to work with less direct supervision and with fewer people alert in the facility. There is no evidence that those with criminal backgrounds seek the night shift, but Mahon says it’s well-known that drug-abusing nurses and doctors seek night-shift work for the same reasons.