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Original
2026-02-21
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2026-03-01
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<p>Healthcare| 6 min. read | 2/9/2026</p>
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<p>Healthcare| 6 min. read | 2/9/2026</p>
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<h2>Expanding Smart Hiring Beyond State Fingerprinting</h2>
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<h2>Expanding Smart Hiring Beyond State Fingerprinting</h2>
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<p>Key Takeaways</p>
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<p>Key Takeaways</p>
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<ul><li><strong>Are state fingerprinting-based criminal record checks thorough enough for healthcare hiring?</strong>No, not by themselves. They offer a screening layer using a single biometric data source, but a thorough check may require additional steps.</li>
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<ul><li><strong>Are state fingerprinting-based criminal record checks thorough enough for healthcare hiring?</strong>No, not by themselves. They offer a screening layer using a single biometric data source, but a thorough check may require additional steps.</li>
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<li><strong>What important information do fingerprint-based criminal history checks miss?</strong>State fingerprint repositories don't contain all criminal cases. They may be missing information from various sources that do not contribute regularly to the database and may also miss crimes where a person, for many different reasons, was not fingerprinted. A few items that may be missing could include identity verification, licenses, credentials, exclusions or healthcare role-specific eligibility.</li>
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<li><strong>What important information do fingerprint-based criminal history checks miss?</strong>State fingerprint repositories don't contain all criminal cases. They may be missing information from various sources that do not contribute regularly to the database and may also miss crimes where a person, for many different reasons, was not fingerprinted. A few items that may be missing could include identity verification, licenses, credentials, exclusions or healthcare role-specific eligibility.</li>
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<li><strong>What type of screening does healthcare really need?</strong>A layered approach using many data sources provides the most thorough screening for healthcare hiring.</li>
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<li><strong>What type of screening does healthcare really need?</strong>A layered approach using many data sources provides the most thorough screening for healthcare hiring.</li>
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</ul><p>Healthcare organizations carry some of the highest stakes in talent acquisition. Every hire, from RNs and CNAs to allied health technologists, physicians, and behavioral health specialists, has a direct impact on patient safety, regulatory compliance, and organizational risk. While the state fingerprint-based checks are a valuable step in the hiring screening process, they provide only one layer of screening and rely on a single source of biometric data. In healthcare, an industry where identity-based hiring fraud, license falsification, and cross-state mobility have all sharply increased,1 relying solely on fingerprint-based Criminal History Record Information (CHRI) leaves information gaps. A layered approach using many data sources can provide thorough screening for healthcare hiring.</p>
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</ul><p>Healthcare organizations carry some of the highest stakes in talent acquisition. Every hire, from RNs and CNAs to allied health technologists, physicians, and behavioral health specialists, has a direct impact on patient safety, regulatory compliance, and organizational risk. While the state fingerprint-based checks are a valuable step in the hiring screening process, they provide only one layer of screening and rely on a single source of biometric data. In healthcare, an industry where identity-based hiring fraud, license falsification, and cross-state mobility have all sharply increased,1 relying solely on fingerprint-based Criminal History Record Information (CHRI) leaves information gaps. A layered approach using many data sources can provide thorough screening for healthcare hiring.</p>
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<h2>What fingerprint-based record checks do cover?</h2>
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<h2>What fingerprint-based record checks do cover?</h2>
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<p>State fingerprint repositories do not contain and are different from FBI information. They contain the records that the state collects from lower county jails and courts, which they then report up to the FBI.</p>
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<p>State fingerprint repositories do not contain and are different from FBI information. They contain the records that the state collects from lower county jails and courts, which they then report up to the FBI.</p>
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<p>State fingerprinting typically includes:</p>
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<p>State fingerprinting typically includes:</p>
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<ul><li><strong>Arrests and criminal submissions reported to the FBI</strong>The IAFIS compiles fingerprints and arrest information submitted by state and local law enforcement agencies. When the agency reports both fingerprints and the related disposition, the record is included.</li>
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<ul><li><strong>Arrests and criminal submissions reported to the FBI</strong>The IAFIS compiles fingerprints and arrest information submitted by state and local law enforcement agencies. When the agency reports both fingerprints and the related disposition, the record is included.</li>
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<li><strong>Federal crimes</strong>Federal arrests and convictions, such as fraud and narcotics, prosecuted by the federal court system, are generally included.</li>
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<li><strong>Federal crimes</strong>Federal arrests and convictions, such as fraud and narcotics, prosecuted by the federal court system, are generally included.</li>
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</ul><p>State fingerprint-based criminal history checks provide a centralized starting point for screening healthcare candidates, especially for positions that require trust and public safety. But a layered approach is necessary to be as thorough as possible.</p>
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</ul><p>State fingerprint-based criminal history checks provide a centralized starting point for screening healthcare candidates, especially for positions that require trust and public safety. But a layered approach is necessary to be as thorough as possible.</p>
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<h2>State fingerprint-based criminal background checks provide only one layer of screening</h2>
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<h2>State fingerprint-based criminal background checks provide only one layer of screening</h2>
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<p>Healthcare hiring requires more than a criminal history search, as fingerprint-based checks do not cover:</p>
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<p>Healthcare hiring requires more than a criminal history search, as fingerprint-based checks do not cover:</p>
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<ul><li>State Board of Nursing and Medical Board disciplinary actions</li>
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<ul><li>State Board of Nursing and Medical Board disciplinary actions</li>
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<li>Residency status or employment history</li>
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<li>Residency status or employment history</li>
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<li>Civil malpractice judgments</li>
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<li>Civil malpractice judgments</li>
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<li>Abuse registry checks (e.g., OIG, SAM, state Medicaid exclusion lists)</li>
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<li>Abuse registry checks (e.g., OIG, SAM, state Medicaid exclusion lists)</li>
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<li>County-level misdemeanors that were never fingerprinted</li>
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<li>County-level misdemeanors that were never fingerprinted</li>
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<li>Non-finger-printable offenses such as DUIs, simple assault, or certain theft categories</li>
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<li>Non-finger-printable offenses such as DUIs, simple assault, or certain theft categories</li>
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</ul><p>In practice, for example, a nurse could be disciplined in one state, practice in another, and pass a fingerprint-based criminal record check with no red flags appearing.</p>
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</ul><p>In practice, for example, a nurse could be disciplined in one state, practice in another, and pass a fingerprint-based criminal record check with no red flags appearing.</p>
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<h2>Why thorough screening matters more now than ever in healthcare</h2>
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<h2>Why thorough screening matters more now than ever in healthcare</h2>
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<p>Shifting market dynamics are increasing the complexity of healthcare hiring and raising</p>
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<p>Shifting market dynamics are increasing the complexity of healthcare hiring and raising</p>
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<p>the stakes for thorough, consistent candidate screening. For example:</p>
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<p>the stakes for thorough, consistent candidate screening. For example:</p>
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<ul><li><strong>Fraud and impostors are on the rise</strong>First Advantage, staffing agencies, and health systems across the U.S. report sharp increases in impostor applicants using forged credentials, modified IDs, or falsified licenses. This added layer of complexity is important to note in this context because a fingerprint capture alone cannot confirm whether the person presenting that ID is the same person associated with the fingerprinted record.</li>
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<ul><li><strong>Fraud and impostors are on the rise</strong>First Advantage, staffing agencies, and health systems across the U.S. report sharp increases in impostor applicants using forged credentials, modified IDs, or falsified licenses. This added layer of complexity is important to note in this context because a fingerprint capture alone cannot confirm whether the person presenting that ID is the same person associated with the fingerprinted record.</li>
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<li><strong>Clinicians are highly mobile</strong>RNs, CNAs, and allied health professionals often move across states or work multiple travel assignments. Fingerprint-based criminal history will not catch licensure actions in other states or state-level abuse findings.</li>
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<li><strong>Clinicians are highly mobile</strong>RNs, CNAs, and allied health professionals often move across states or work multiple travel assignments. Fingerprint-based criminal history will not catch licensure actions in other states or state-level abuse findings.</li>
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<li><strong>Remote and global hiring increases the risk</strong>Many telehealth, teleradiology, and virtual behavioral health workers live and work outside the state where the employer is based. There are gaps when relying only on IAFIS fingerprint-based checks, as they do not include international criminal history, global sanctions or foreign identity documents.</li>
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<li><strong>Remote and global hiring increases the risk</strong>Many telehealth, teleradiology, and virtual behavioral health workers live and work outside the state where the employer is based. There are gaps when relying only on IAFIS fingerprint-based checks, as they do not include international criminal history, global sanctions or foreign identity documents.</li>
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</ul><h2>Hiring fundamentals to look for when screening</h2>
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</ul><h2>Hiring fundamentals to look for when screening</h2>
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<p>Healthcare organizations require more thorough checks because patient-facing roles are prone to risk and serve vulnerable populations. Best practice healthcare hiring fundamentals should include answers to questions such as:</p>
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<p>Healthcare organizations require more thorough checks because patient-facing roles are prone to risk and serve vulnerable populations. Best practice healthcare hiring fundamentals should include answers to questions such as:</p>
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<ul><li>Is this the clinician they claim to be?</li>
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<ul><li>Is this the clinician they claim to be?</li>
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<li>Are their licenses valid and free of disciplinary action?</li>
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<li>Are their licenses valid and free of disciplinary action?</li>
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<li>Have they been excluded from Medicare/Medicaid programs?</li>
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<li>Have they been excluded from Medicare/Medicaid programs?</li>
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<li>Are there county-level convictions that never reached the FBI?</li>
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<li>Are there county-level convictions that never reached the FBI?</li>
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<li>Did they work under a different name previously?</li>
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<li>Did they work under a different name previously?</li>
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<li>Is there an international criminal history, sanction, or identity risk?</li>
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<li>Is there an international criminal history, sanction, or identity risk?</li>
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</ul><p>Further, all of these questions should be answered in relation to the specific role and responsibilities being filled. These need to be mapped to the screening necessary to confirm that the person hired has the qualifications appropriate for the position.</p>
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</ul><p>Further, all of these questions should be answered in relation to the specific role and responsibilities being filled. These need to be mapped to the screening necessary to confirm that the person hired has the qualifications appropriate for the position.</p>
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<h2>How healthcare employers can build a stronger, layered screening program</h2>
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<h2>How healthcare employers can build a stronger, layered screening program</h2>
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<p>Fingerprint-based CHRI or national databases can be part of a broader strategy and a valuable source of information when used as part of a layered screening approach. Best practice suggestions for healthcare organizations include a multi-tiered screening model that includes:</p>
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<p>Fingerprint-based CHRI or national databases can be part of a broader strategy and a valuable source of information when used as part of a layered screening approach. Best practice suggestions for healthcare organizations include a multi-tiered screening model that includes:</p>
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<ul><li><strong>Verifying identity at the start</strong>Use modern, biometric document-authentication tools to confirm identity before screening begins. This helps catch impostors, stolen identities, and manipulated documents.</li>
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<ul><li><strong>Verifying identity at the start</strong>Use modern, biometric document-authentication tools to confirm identity before screening begins. This helps catch impostors, stolen identities, and manipulated documents.</li>
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<li><strong>County-level criminal searches</strong>Go directly to the source, as this is the gold standard for screening. County courts hold the most up-to-date information on crimes committed in places where people live and frequent.</li>
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<li><strong>County-level criminal searches</strong>Go directly to the source, as this is the gold standard for screening. County courts hold the most up-to-date information on crimes committed in places where people live and frequent.</li>
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<li><strong>Statewide checks</strong>Combine local court searches with statewide repositories to close jurisdictional gaps. Statewide databases aggregate county data but may also include additional information relevant to the candidate.</li>
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<li><strong>Statewide checks</strong>Combine local court searches with statewide repositories to close jurisdictional gaps. Statewide databases aggregate county data but may also include additional information relevant to the candidate.</li>
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<li><strong>Federal checks</strong>The federal courts are a fully separate court system and include federal-level crimes such as kidnapping, terrorism, money laundering, or criminal activities that cross borders - activities that would not be reported at the state or county level.</li>
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<li><strong>Federal checks</strong>The federal courts are a fully separate court system and include federal-level crimes such as kidnapping, terrorism, money laundering, or criminal activities that cross borders - activities that would not be reported at the state or county level.</li>
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<li><strong>Healthcare-specific registries</strong>These are essential for clinical hiring:<ul><li>OIG and SAM exclusion lists</li>
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<li><strong>Healthcare-specific registries</strong>These are essential for clinical hiring:<ul><li>OIG and SAM exclusion lists</li>
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<li>State abuse and neglect registries</li>
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<li>State abuse and neglect registries</li>
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<li>Professional licensing boards</li>
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<li>Professional licensing boards</li>
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<li>National Practitioner Data Bank (NPDB)</li>
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<li>National Practitioner Data Bank (NPDB)</li>
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</ul></li>
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</ul></li>
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<li><strong>Credentialing and license verification</strong>Confirm that licenses are active, valid, and unencumbered, and continuously monitor them.</li>
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<li><strong>Credentialing and license verification</strong>Confirm that licenses are active, valid, and unencumbered, and continuously monitor them.</li>
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<li><strong>Drug screening and occupational health screening</strong>Assess clinicians so they are fit for duty and meet regulatory requirements.</li>
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<li><strong>Drug screening and occupational health screening</strong>Assess clinicians so they are fit for duty and meet regulatory requirements.</li>
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<li><strong>International checks for global or remote roles</strong>For clinicians who live or previously lived abroad, conduct:<ul><li>International criminal history</li>
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<li><strong>International checks for global or remote roles</strong>For clinicians who live or previously lived abroad, conduct:<ul><li>International criminal history</li>
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<li>Global sanctions and watchlists</li>
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<li>Global sanctions and watchlists</li>
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<li>Identity document verification</li>
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<li>Identity document verification</li>
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<li>Local employment reference checks</li>
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<li>Local employment reference checks</li>
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</ul></li>
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</ul></li>
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<li><strong>Ongoing monitoring</strong>Continuous monitoring for license updates, sanctions, and convictions helps organizations respond to emerging risks early.</li>
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<li><strong>Ongoing monitoring</strong>Continuous monitoring for license updates, sanctions, and convictions helps organizations respond to emerging risks early.</li>
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</ul><h2>The bottom line</h2>
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</ul><h2>The bottom line</h2>
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<p>Fingerprint-based criminal record checks are an important tool in the process of screening healthcare candidates. They were never designed to be the only source of truth in healthcare hiring. By building a layered screening program and addressing the specific roles and responsibilities they are required to fulfill, healthcare organizations can better mitigate risks and fraud and hire with greater confidence in an increasingly complex and global workforce.</p>
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<p>Fingerprint-based criminal record checks are an important tool in the process of screening healthcare candidates. They were never designed to be the only source of truth in healthcare hiring. By building a layered screening program and addressing the specific roles and responsibilities they are required to fulfill, healthcare organizations can better mitigate risks and fraud and hire with greater confidence in an increasingly complex and global workforce.</p>
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<h3>Know your peopleTM</h3>
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<h3>Know your peopleTM</h3>
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<h2>Frequently Asked Questions</h2>
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<h2>Frequently Asked Questions</h2>
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<p>They help mitigate risk by revealing past offenses that may disqualify them from certain roles when making a hiring decision.</p>
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<p>They help mitigate risk by revealing past offenses that may disqualify them from certain roles when making a hiring decision.</p>
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<p>No. Fingerprint-based CHRI is only one level of screening and relies on a single biometric data source. A layered approach is required for more thorough screening.</p>
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<p>No. Fingerprint-based CHRI is only one level of screening and relies on a single biometric data source. A layered approach is required for more thorough screening.</p>
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<p>County-level and state court searches can reveal updated, thorough case information that fingerprint files may not have on record. The federal courts are a fully separate court system and include terrorism, money laundering, kidnapping, and more.</p>
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<p>County-level and state court searches can reveal updated, thorough case information that fingerprint files may not have on record. The federal courts are a fully separate court system and include terrorism, money laundering, kidnapping, and more.</p>
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<p>About the author</p>
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<p>About the author</p>
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<p>Cindy Clinton</p>
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<p>Cindy Clinton</p>
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<p>Senior Product Marketing Manager</p>
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<p>Senior Product Marketing Manager</p>
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<p>Cindy leads the go-to-market processes and content for First Advantage’s core screening products in the US and globally. With 14 years of experience in the screening industry, she has a strong background in customer success enablement and product marketing. Cindy is passionate about leveraging her expertise to connect product development with sales enablement, empowering organizations to hire smarter and faster.</p>
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<p>Cindy leads the go-to-market processes and content for First Advantage’s core screening products in the US and globally. With 14 years of experience in the screening industry, she has a strong background in customer success enablement and product marketing. Cindy is passionate about leveraging her expertise to connect product development with sales enablement, empowering organizations to hire smarter and faster.</p>
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<p>Sources:</p>
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<p>Sources:</p>
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<p>1 Snappt. “Identity Fraud Statistics for 2025.” Sept. 15, 2025.<a>https://snappt.com/blog/identity-fraud-statistics/</a></p>
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<p>1 Snappt. “Identity Fraud Statistics for 2025.” Sept. 15, 2025.<a>https://snappt.com/blog/identity-fraud-statistics/</a></p>
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<p>This content is offered for informational purposes only. First Advantage is not a law firm, and this content does not, and is not intended to, constitute legal advice. Information in this may not constitute the most up-to-date legal or other information.</p>
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<p>This content is offered for informational purposes only. First Advantage is not a law firm, and this content does not, and is not intended to, constitute legal advice. Information in this may not constitute the most up-to-date legal or other information.</p>
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<p>Readers of this content should contact their own legal advisors concerning for their particular circumstance. No reader, or user of this content, should act or refrain from acting on the basis of information in this content. Only your individual attorney or legal advisor can provide assurances that the information contained herein - and your interpretation of it - is applicable or appropriate to your particular situation. Use of, and access to, this content does not create an attorney-client relationship between the reader, or user of this presentation and First Advantage.</p>
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<p>Readers of this content should contact their own legal advisors concerning for their particular circumstance. No reader, or user of this content, should act or refrain from acting on the basis of information in this content. Only your individual attorney or legal advisor can provide assurances that the information contained herein - and your interpretation of it - is applicable or appropriate to your particular situation. Use of, and access to, this content does not create an attorney-client relationship between the reader, or user of this presentation and First Advantage.</p>
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