The Importance of Background Checks in Healthcare: Ensuring Patient Safety and Reducing Organizational Risk

The Importance of Background Checks in Healthcare: Ensuring Patient Safety and Reducing Organizational Risk

Jun 27, 2023
  • Author:
    Noelle Abarelli

In the healthcare industry, conducting thorough background checks is crucial to ensure patient safety and minimize organizational risk. While criminal background checks in healthcare have been a standard practice for many organizations, there is still considerable variation in the information collected, the time period covered, and the frequency of checks. This blog post explores the significance of background checks, the elements included in them, and the considerations organizations should keep in mind when developing their background check policies.

The Case for Background Checks in Healthcare

The case of Dr. Michael Swango, a serial killer who was able to practice medicine in different locations despite a criminal history, highlights the importance of comprehensive background checks. Dr. Swango's case could have been prevented had a criminal background check been conducted, potentially saving numerous lives. This example serves as a compelling reminder of the need for standardized and stringent background checks in the healthcare industry.

Elements of Background Checks

Background checks for healthcare providers encompass various components. For independent providers, criminal history checks are typically performed, while employee checks may include employment history, credit history, and education verification. Other elements include a national sex offender search, Social Security Number verification, identity verification, license verification, drug screens, and more. Each organization should determine the specific elements based on their requirements and the services they offer.

Regulatory Requirements and Industry Standards

Accreditors, state regulatory agencies, and industry bodies have varying guidelines and requirements regarding background checks. Some state regulations mandate background checks for facilities and employees, while others may only require them for independent contractors. Organizations should ensure compliance with state and federal regulations, as failure to do so may lead to legal and reputational consequences. Accrediting bodies such as The Joint Commission and Centers for Medicare and Medicaid Services (CMS) also emphasize the importance of background checks as part of comprehensive risk management strategies.

Key Questions and Considerations

To develop effective background check policies, organizations need to address several key questions. These include:

  1. Why should background checks be conducted for independent contractors?
  2. Why are state licensure board checks insufficient?
  3. How far back should criminal background checks go?
  4. How frequently should background checks be performed?
  5. What "red flags" should organizations be alert to during checks?
  6. What actions should organizations take if a red flag is discovered?

Organizations should tailor their policies based on their unique circumstances and state-specific employment laws, ensuring they strike a balance between patient safety and fair employment practices.

Enhancing Background Check Processes with CredentialStream

CredentialStream®, an integrated solution, streamlines the background check process for healthcare organizations. By partnering with trusted vendors like PreCheck or Sterling Talent Solutions, organizations can efficiently purchase desired background check packages. CredentialStream users can submit provider requests, retrieve comprehensive reports, and seamlessly integrate them into their credentialing processes, ensuring a standardized and efficient approach to background checks.


Thorough background checks in healthcare are essential for organizations to uphold patient safety, minimize risks, and comply with regulatory requirements. By implementing comprehensive policies and leveraging technology solutions like CredentialStream, organizations can enhance their background check processes, ensuring the highest standards of care and reducing potential liabilities. Prioritizing background checks demonstrates a commitment to patient welfare and fosters a culture of safety within the healthcare industry.