Legal Issues: Employee Verification

Employee Verification

Because employees of medical practices and medspas have easy access to patient information, employers must conscientiously verify information provided by applicants. One way to decrease the risk of hiring staff members who may jeopardize patient or practice safety is to perform reference and background checks. Some of the key areas medical practices are wise to review include: past employment history, educational experience and credentials, credit history, and civil and criminal records.

Although background checks for employment are legal in all states, there are some qualifications. For example, in Illinois, employers cannot base hiring decisions on credit histories. Therefore, we recommend confirming your state’s regulations prior to implementing background checks.

Questionable Degrees

When an applicant provides a resume outlining his or her educational background and training, most employers take that information at face value. Unfortunately, this is one area where applicants feel comfortable exaggerating or expressly lying in order to meet the stated employment requirements. Following are just some of the misrepresentations we have uncovered when confirming the facts of employment candidates:

  • An administrator hired by a plastic surgery group had fabricated both an undergraduate degree and a master’s degree. When confronted, he said, “Well, I always meant to do it.”
  • A woman in her 50s told me that, “No plastic surgery group I’ve ever worked for checked my educational background.” She was indignant that we were going to do so. It turned out she didn’t have a college degree, just three lackluster semesters at a top university. She’d successfully faked her educational background for close to 30 years.
  • An applicant for a managerial position was two courses short of his master’s degree. Rather than state on his resume, “Degree expected after completion of two courses,” he graduated himself.
  • One young esthetician had a series of last names—seven to be exact—and she was only 29 years old.
  • An LPN who listed certifications for two pieces of aesthetic equipment, in fact, did not have any training or certification in those devices.

Applicants are often selective about which jobs they include on their resumes. In a worst-case scenario, they may fabricate jobs or credentials they have never held. The question for practice owners is, “How can I trust someone with my financial and patient records when they’ve lied to me on their application?” The answer is, you can’t and you shouldn’t.

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Credit Histories

Performing credit checks on prospective employees is uncomfortable for many employers, especially in this day and age. While it is true that the great recession hurt many people who otherwise had good credit histories, there are benefits to gaining some knowledge about a candidate’s history with finances.

We don’t recommend dismissing a candidate based on a low credit score alone; in fact, we have hired people with credit issues. However, we do recommend these individuals not be placed in key positions with cash-handling responsibilities. Knowing ahead of time that an individual might have a motivation for “creative bookkeeping” allows practices to institute financial checks and balances. This may include having a daily financial close to review cash and payments made each day, or breaking up responsibilities so that one person doesn’t handle all steps of the payables or billing cycle process.

These protocols help prevent embezzlement and are good strategies for all practices to adopt. If you have employees who are struggling with creditors, it is a must. In some cases, an otherwise honest person may be tempted to “borrow” money with good intentions to pay it back—but the debt gets bigger and bigger until they can’t replace the stolen funds.

Criminal and Civil Violations

One of the most important reasons for running a background check on applicants who will be responsible for patient care and/or financial duties is to confirm that they have no criminal history. Candidates who have past records of identity theft, drug convictions, financial crimes or sexual offenses represent a huge hiring risk. If this information surfaces during a background check, we recommend consulting with a labor lawyer before making any final decisions or communicating with the applicant regarding the outcome of their application.

Unfortunately, some managers are indiscreet in the way they communicate with employees and applicants. Statements like, “We can’t hire you because you were arrested for smoking dope,” are not without consequence. You want to be sure all information is gathered and handled in accordance with all state and federal laws.

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Informing Applicants

We recommend running checks on only your final two to three candidates. If your practice opts to perform background checks on applicants, it is good practice to include this in the employment ad. This will dissuade some candidates with spotty records from applying and reduce discomfort when the topic is raised during the interview process. We include the following form for applicants to sign, which contains specific language outlining the use of background checks in our applications:

Applicant Certification and Agreement:
I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize the practice to verify their accuracy and to obtain reference information on my work performance. I hereby release the practice from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information. I understand that, if employed, falsified statements of any kind or omission of facts called for on this application shall be considered sufficient basis for dismissal.
I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules and regulations of employment of the practice. However, I further understand that neither policies, rules, regulations of employment or anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration and at will and that either I or the Employer may terminate my employment at any time with or without notice or cause.

This language provides protection to the practice should questionable information arise in the background check and, in my experience, more than one applicant upon reading this has gone back to make edits or corrections to his or her resume.

There are several companies that provide background check services for employers—we use Trusted Employees ( These companies will provide a form, which must be signed by the applicant, that gives the practice permission to run the background check. Employers can choose which information they would like confirmed or investigated.

A report typically costs between $65 and $90, depending on the number of states in which the applicant has lived. Credit and driving records come back most quickly. (Driving records are important if you expect the candidate to transport patients or travel from office to office with other staff or equipment.) Educational background checks typically take the longest.

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What if There Is an Issue?

If a discrepancy arises in the course of the background check, ask the applicant if he or she would like to provide you with more information. In my experience, solid applicants will mention credit difficulties and past issues with employers before the report is run.

Do remember that the information you receive is sensitive and personal. If you print the report out to review, shred it when you are finished. Do not throw it in the trash or leave it where staff can see it.

There are several issues you want to take into account as you search for the right team members for your practice or medspa. We recommend that our clients base hiring decisions on several factors, including the face-to-face interview, the background check, skill testing and reference checks.

The cost of replacing a bad hire is outweighed by the value of performing due diligence. By investing a little time and a small amount of money, you can maintain the reputation of your practice and hire people with the right skills, a will to work hard and an honest record.

Karen Zupko is the president of Karen Zupko & Associates, a practice management consulting and training firm. Contact her at 312.642.5616,

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