Nurse background check
Nurse hires — RN, LPN, LVN, NP, CNA, and travel nurses — face the most compliance-heavy screening in any industry. Every hire touches state Board of Nursing licensure, federal healthcare exclusion lists, and state Medicaid programs, with vulnerable-population contact triggering additional registry checks.
Why it matters
A single billing claim submitted for services rendered by an OIG-excluded individual creates a per-claim civil monetary penalty under 42 U.S.C. §1320a-7a and can be recovered from the employer as well as the excluded party. Verified nursing licensure is a Medicare/Medicaid Conditions of Participation requirement.
Recommended package
| Search | Why |
|---|---|
| SSN trace + address history | Establishes county footprint for the criminal search. |
| National criminal database + sex offender registry | Baseline. Registry hits are near-automatic disqualifiers for direct-patient-care roles. |
| County criminal (7-year lookback per county) | Primary source of truth; every county the candidate has lived or worked in. |
| Federal criminal | Catches healthcare fraud, controlled-substance diversion, wire fraud. |
| OIG-LEIE + SAM.gov + state Medicaid exclusion | Federal + state exclusion sweep required for any Medicare/Medicaid reimbursement. |
| FACIS Level 3 | State licensing boards, MFCU actions, state exclusion lists across all jurisdictions. |
| Professional license verification (Board of Nursing) | Confirms active license, discipline history, endorsement status via Nursys or the state board. |
| Education verification (nursing program) | Confirms accredited program completion. |
| Employment verification (7-year) | Prior nursing facility employment, gaps, reason for leaving where lawful. |
| 5-panel drug screen + TB test + Hep B titer | Standard healthcare pre-employment health package. |
Governing regulations
- 42 U.S.C. §1320a-7 (OIG exclusion authority) — Mandatory exclusion for felony convictions related to healthcare, controlled substances, or patient neglect.
- 42 U.S.C. §1320a-7a (CMPs for employing excluded individuals) — Per-claim penalties for billing federal programs for services by an excluded person.
- Medicare/Medicaid Conditions of Participation — Require verified licensure and exclusion screening at hire and on an ongoing basis.
- State Board of Nursing statutes — Each state has its own license verification and disciplinary reporting mechanism (e.g., Nursys, California BRN, Texas BON).
- State-mandated abuse registries — Elder abuse registry, child abuse and neglect registry — required in most states for long-term care and pediatric roles.
Turnaround time
3–5 business days end-to-end when Nursys reports back same-day and county courts are electronic. Manual counties and slow state boards can extend to 5–7 days.
Common disqualifiers
- Active OIG-LEIE exclusion
- Suspended, surrendered, or revoked nursing license
- Sex offender registry match
- Recent felony conviction for patient abuse, neglect, or controlled-substance diversion
- Medicare/Medicaid fraud conviction
Frequently asked questions
Do I need FACIS Level 3 for a nurse hire?
For any role touching federal healthcare programs — Medicare, Medicaid, TRICARE — yes. FACIS Level 3 sweeps every state licensing board, state Medicaid exclusion list, and Medicaid Fraud Control Unit action. Level 1M covers only the primary OIG-LEIE and SAM.gov sources.
How often should nursing exclusion screens be re-run?
OIG guidance recommends monthly re-screening against LEIE for any employed clinician who bills federal programs. SafestHires runs continuous exclusion monitoring as an add-on.
Can we hire a nurse with a criminal record?
Yes, subject to the state Board of Nursing's character standards and any individualized-assessment obligations under state Fair Chance law. Non-disqualifying records — old misdemeanors, non-violent offenses unrelated to patient care — are common.