The importance of adequate health care background screening was made evident by the case of health-care nurse Charles Cullen who confessed to murdering up to 40 patients in hospitals in Pennsylvania and New Jersey in spite of being fired at least five times from previous facilities.

Proper health care background screening is therefore critical in ensuring that such occurrences do not happen again.  In many cases personnel fired for unethical behavior or incompetence are re-employed quickly afterward because the previous employers have felt that they had insufficient proof of wrongdoing to warrant including this information in a reference.  Although the next employers could not reasonably be able to be accused of negligent hiring, since they had take all reasonable steps in their background check, they could be employing an employee totally unsuited for the job.

Very frequently an employer will accept the minimum of information, such as verifying previous employment dates provided and relatively neutral references, without carrying out more searching investigation. Minimum experience and qualifications are frequently accepted due to a shortage of nurses and other medical and clinical personnel, and it is possible for the wrong people to slip through.  Not all potential killers have a previous criminal conviction.

The Joint Commission of Accreditation of Healthcare Organizations did respond by insisting on criminal background screening of all employees in the health care industry, but this does not identify those who are unsuitable on grounds which are, as yet, less than criminal. Poor or inadequate performance and negligence are rarely criminal offences, but are reasons for dismissal that an employer may be unwilling to pass on to subsequent employers.

Adequate health care background screening requires the use of several potential information sources.  Since the health care industry has been shown to employ a large number of people with criminal convictions, it seems that this has not been adequately done in the past.  The first problem is to establish identity, and this is a task best carried out by professionals rather than employers themselves.

Once the identity of the applicant has been established the most accurate criminal records kept are those in county courthouses. Professional background researchers will use people to personally visit courthouses and physically search the records.  This needs to be done in every county the applicant has resided in. It is easy to claim no criminal convictions by having a clean record in the current county of residence. Some will even change state, when the screening becomes even more difficult, especially if a full residential record is not available.

In such cases it is frequently easier and more secure just to refuse the application.  If the applicant cannot provide and prove a complete residential record, then you must assume that they are trying to hide something. Credit checks can often come up with residential status, as can address changes registered with post offices. The most important objective of health care background screening is to determine previous criminal convictions and despite what many people still believe, there is no national record of criminal convictions in the USA that is open to the public.

The FBI maintains the National Crime Information Center, but this is open only to law enforcement officers.  State records are notoriously incomplete.  It is not an easy job, therefore, to establish the criminal status of a job applicant, but health care background screening has become so important that every step possible must be taken.  Professional researchers should be employed for this since the penalty for negligent hiring is now high enough to warrant the cost.

The health care profession has a bad reputation in this respect and steps that can be taken, other than the criminal background checks, are employment application reviews.  In these, the applicant is interviewed after providing an application form which is compared to the original resume which should be requested prior to the interview. When people lie they frequently forget the details of the lie, and this can be found out by skilled interviewers.

References provided should be pursued as vigorously as possible, and employers that do not initially provide any more information than employment dates should be pressed for more information as to why the employment was terminated. Vehicle license checks should be carried out, as should checks on any professional licenses required.  These can often reveal information not recorded elsewhere.

Those carrying out the screening or background checks should themselves be checked out to make sure they are professionally capable of doing to the job properly.  An incompetent researcher is not going to be able to thoroughly check a candidate who is determined to hide something in his or her past.

Health care background screening is of extreme importance to the health care industry, and every effort should be made to ensure that employee background checks are completed with a high degree of both accuracy and competence.