当你在伦敦乘坐地铁时，每次火车门打开和关闭时，播音员都会说“注意间隙”，以防止乘客在下车时摔倒。许多医疗保健雇主还需要“注意”其就业前筛查计划中的隐藏差距。

在就业前筛查方面符合联邦和州法规的医疗保健组织可能仍然面临雇用被排除在外的个人的风险。当组织雇用不符合资格的人员时，面临罚款、处罚和声誉受损的风险更大。

在不知情的情况下雇用在联邦或州制裁名单上的人是最大的威胁之一，但还有其他威胁。下面我们将分享有关如何避免医疗保健就业前筛查计划中的五个隐藏差距的提示。

隐藏差距#1：仅在州内进行许可证验证
医疗保健组织可能不会跨越州界寻找先前的问题，例如被吊销的许可证。不幸的是，各州不需要就候选人的执照历史相互交流。可能存在隐藏在员工过去的州外问题，而这些问题在背景审查期间未被注意到。在不知不觉中雇用具有可疑许可证历史的个人会增加组织的责任风险，并对患者和员工的安全构成更大的风险。

弥合差距：为了更轻松地检查跨州的许可问题，请使用电子健康检查解决方案。确保该解决方案涵盖所有州许可委员会，允许该软件填补候选人先前历史中的任何空白，这些空白仅在州内搜索可能找不到。

隐藏差距#2：单独使用医疗事故作为医生的绩效指标
在授予医生特权时，许多组织将重点关注先前的医疗事故解决方案，以确定个人的潜在责任风险。仅通过医疗事故来判断医生的能力并不是表明表现的最佳方式。甚至监察长办公室 (OIG) 也敦促医疗机构在授予特权之前查看许可历史和不当行为：“国家许可委员会和医疗保健提供者的纪律处分比医疗事故付款更好地表明专业无能。”

弥合差距：医院对候选人的专业历史了解得越多，授予特权的决定就越明智。为了降低疏忽的认证责任的风险，不要停止不当行为。在授予特权之前，使用显示医生整个国家许可历史的电子筛选数据库来显示任何其他危险信号。

隐藏差距#3：隐形制裁
医院和卫生组织被授权检查OIG和总务管理局 (GSA)数据库和制裁名单，以确保员工不会被禁止参与联邦计划，如医疗保险或医疗补助。一些雇主可能没有意识到这些联邦系统中不存在州级制裁。即使一家医院符合规定，并且新员工没有出现在联邦名单上的制裁名单中，该人也可能会受到州级制裁，而且很快就会上升到联邦级。如果医院使用联邦批准的员工从 Medicaid 或 Medicare 中报销服务费用，可能会导致罚款，有时还会以企业诚信协议 (CIA) 的形式进行更多监督。CIA 是 OIG 与医疗保健提供者之间的协议，对组织实施严格的合规举措。

弥合差距：超越强制筛选要求的组织将得到更好的保护，不会雇用受制裁的个人。检查隐藏制裁的最佳方法是使用涵盖候选人州和联邦制裁历史的国家电子筛选数据库。

隐藏差距#4：糟糕的就业历史分析
没有多少公司对以前的就业历史进行足够深入的分析和验证。由于对研究生教育的投资和接受的专业培训，医护人员很少离开这个行业。因此，医疗保健专业人员简历中的任何空白都值得仔细考虑。很多时候，这些差距中隐藏着许可和完整性问题。

弥合差距：如果候选人在就业方面存在差距，请要求候选人解释差距。询问他们是否在医疗保健行业之外工作以及为什么。通过全面的医疗保健筛查数据库和联系以前的雇主来验证个人提供的信息。

危险信号的另一个重要领域是与就业差距相吻合的州居民身份的变化，因为个人可能已经越过州界以隐藏先前的犯罪或许可证问题。

隐藏差距#5：最小的虐待和刑事检查
性犯罪者往往会从一个州转移到另一个州以隐藏他们的历史。在医院的当地登记处，州外犯罪可能未被发现。如果一个组织只检查自己的状态是否存在性虐待，就会使医院的员工，尤其是患者处于危险之中。

许多背景调查只检查州内的犯罪活动，并且可以追溯到七年前。最少的搜索会留下大量信息，这些信息可能表明欺诈、滥用和其他使候选人面临高风险的诚信问题。

弥合差距：只需很少的时间和投资，公司就可以在州级搜索之上对滥用、欺诈和其他犯罪进行分层搜索。扩大搜索范围并投放更广泛的网络可以填补仅在全州范围内搜索无法涵盖的信息空白。

在对医疗保健员工进行预筛选时，仅仅遵循最低的州和联邦法规是不够的。通过更广泛的就业前筛选计划覆盖所有隐藏的差距。从长远来看，它通常会更好地保护您的医疗保健组织。

Health care organizations, who meet federal and state regulations when it comes to pre-employment screening, may still be at risk for employing excluded individuals. When an organization employs someone who is ineligible, it is at a greater risk of incurring fines, penalties and reputation damage.

Unknowingly hiring someone who is on a federal or state sanction list is one the biggest threats, but there are others. Below we’ll share tips on how to avoid the five hidden gaps in health care pre-employment screening programs.

Hidden Gap #1: In-state only license validation
Health care organizations may not look across state lines for prior problems, like a revoked license. Unfortunately, states are not required to communicate with one another about a candidate’s license history. There may be out-of-state problems hiding in an employee’s past that go unnoticed during background screening. Unknowingly hiring an individual with a questionable license history increases an organization’s liability risk and poses increased risks to patient and employee safety.

Bridge the Gap: To more easily check for licensing problems across state lines, use an electronic health care screening solution. Be sure the solution covers all of the state licensing boards, allowing the software will fill in any gaps in a candidate’s prior history that an in-state only search may not find.

Hidden Gap # 2: Using malpractice alone as a performance indicator for physicians
When it comes to granting privileges to physicians, many organizations will focus on prior malpractice settlements to determine the potential liability risk for the individual. Judging a physician’s competency by malpractice alone is not the best way to indicate performance. Even the Office of Inspector General (OIG) urges health care institutions to look at both licensing history and malpractice before granting privileges: “Disciplinary actions by state licensing boards and health care providers are better indicators of professional incompetence than malpractice payments.”

Bridge the Gap: The more a hospital knows about a candidate’s professional history, the more informed privileging decisions will be. To mitigate the risk of negligent credentialing liability, don’t stop with malpractice. Use an electronic screening database that reveals a physician’s entire national licensing history to reveal any additional red flags before granting privileges.

Hidden Gap # 3: Invisible sanctions
Hospitals and health organizations are mandated to check against the OIG and General Service Administration (GSA) databases and sanction lists to be sure employees are not barred from participating in federal programs like Medicare or Medicaid. Some employers may not realize that there are state level sanctions which are not present in these federal systems. Even if a hospital meets the regulations, and the new hire does not show up as sanctioned on the federal lists, the individual might be carrying state level sanctions that will soon rise to the federal level. If the hospital bills for services to be reimbursed from Medicaid or Medicare using federally sanctioned employees, it can result in fines and sometimes more oversight in the form of a Corporate Integrity Agreement (CIA). CIAs are agreements between the OIG and a health care provider that impose rigorous compliance initiatives on an organization. These agreements can last up to five years and are meant to ensure the organization is compliant and able to participate in federal programs in the future.

Bridge the Gap: Organizations that go above and beyond the mandated screening requirements will be better protected against employing sanctioned individuals. The best way to check for hidden sanctions is to use a national electronic screening database that covers a candidate’s state and federal sanction history.

Hidden Gap # 4: Poor employment history analysis
Not many companies do a deep enough analysis and verification of prior employment history. Due to the investment in post-graduate education and the specialized training received, health care workers rarely leave the industry. Therefore, any gap in a health care professional’s resume deserves careful consideration. Many times there are licensing and integrity issues hiding in those gaps.

Bridge the Gap: If a candidate has a gap in their employment, ask the candidate to explain the gap. Ask whether they were working outside of the health care industry and why. Verify the information the individual provides through a comprehensive health care screening database and by contacting previous employers.

Another big area for red flags is a change in state residency that coincides with an employment gap, because the individual may have crossed state lines in order to hide a prior offense or license issue.

Hidden Gap #5: Minimal abuse and criminal checks
Sex offenders tend to move from state to state to hide their histories. An out-of-state offense can remain undetected on a hospital’s local registry. If an organization only checks its own state for sexual abuse, it is putting the hospital’s employees and especially patients at risk.

Many background checks only check for in-state criminal activity and reach back as little as seven years. Minimal searches leave huge areas of information uncovered that can indicate fraud, abuse and other integrity issues that make a candidate high risk.

Bridge the Gap: With very little time and investment, a company can layer national searches on top of their state level searches for abuse, fraud and other offenses. Broadening the scope of the search and casting a wider net can fill in gaps of information not covered by state-wide searches alone.

When it comes to pre-screening health care employees, it’s not enough to simply follow minimum state and federal regulations. Cover all of the hidden gaps with a more extensive pre-employment screening program. It will often better protect your health care organization in the long run.。