When you need a new clinician for your practice or healthcare business, you’re likely focused more on getting help fast than avoiding a negligent hiring claim. However, the legal implications of a claim can be severe, including lawsuits, hefty fines and a tarnished reputation.
A robust hiring checklist can help safeguard your healthcare business against negligent hiring claims, ensuring your practice remains compliant, secure and focused on excellent patient care.
What is a private practice negligent hiring claim
A negligent hiring claim is a civil lawsuit that occurs when an employee harms others on the job. The lawsuit alleges an employer failed to investigate an applicant’s background before hiring them. The claim often argues that the employer knew or should have known about the employee’s history, such as a criminal record, lack of qualifications or negative track record of poor performance.
Healthcare business and practice owners are particularly vulnerable to negligent hiring claims.
Robust hiring practices for healthcare technology platforms
Large healthcare technology platforms that match patients to clinicians are one business model that is sometimes exposed to unexpected risk. This is because the larger digital platforms sometimes assume they have less liability for clinicians who are independent contractors.
From a plaintiff’s perspective, a business entity is more equipped to pay a significant claim than an individual clinician. This makes them more likely to sue the larger entity for harm. A well-known lawsuit against Care.com occurred in 2014 when a Wisconsin couple’s baby died. The parents used the website and its background check system to hire a nanny for their infant, who died of a head injury in the nanny’s care.
“We’ve seen the most danger with folks who are not doing extensive background checks in the onboarding processes,” says William Sullivan, executive vice president of CM&F Group. “We walk through how to make our clients’ onboarding process more prudent by integrating best practices.”
Pre-hiring phase checklist
A hiring checklist is more than just a tool for staying organized — it’s a comprehensive framework designed to minimize risk by ensuring that every hiring process is conducted with diligence and thoroughness.
There are three basics every employer needs to cover when hiring a new clinician:
- Understand the applicant’s background and experiences
- Verify their credentialing and license
- Conduct a criminal background check
“The goal is that if you get sued, you can show you’ve done your due diligence, and you’re not getting pinned down on something you just flat out ignored because you didn’t do the proper reasonable process in the hiring,” says Sullivan.
Clarify the job description:
The job posting should clearly define the job responsibilities, required qualifications and expectations. This will help you hire the right candidate and set standard expectations.
Once an employee is hired, you can compare their performance to the job description to determine whether they’re meeting, exceeding or failing to meet expectations.
Verify credentials:
Sullivan recommends using a third-party source to verify all necessary credentials, licenses and certifications through primary sources, such as state licensing boards. Because an applicant may have worked in many states and roles over the years, it’s difficult for an employer to know if there was an incident such as a license suspension.
Check references:
Conduct thorough reference checks with past employers to assess the clinician’s reliability, professionalism and performance.
Perform an independent background check:
The main defense against a negligent hiring claim is exercising due diligence and reasonable care in the hiring process, including conducting a background check.
Work with a third party to do a comprehensive background check, including criminal records, drug testing (if applicable) and a history of malpractice claims or disciplinary actions.
“Background checks from a criminal standpoint are almost like Swiss cheese because different municipalities, the Federal government and states operate differently. Make sure you use an outside vendor who can pull everything together in an answer,” says Sullivan.
Interview and evaluation checklist
Interviews are a chance to assess a candidate’s clinical skills and determine their decision-making abilities and cultural fit within your practice. Many new business owners make the mistake of hiring people based on personality fit. While finding candidates who fit your company culture is important, the most critical factor is their ability to perform the job well.
Behavioral-based questions to assess candidates’ decision-making, problem-solving and communication skills guide you through a structured interview process, ensuring all candidates are evaluated based on the same criteria.
Incorporating clinical skills assessments into your checklist allows you to verify that candidates possess the practical expertise required for their role, reducing the risk of negligent hiring.
Assess experience and clinical skills:
Confirm the candidates have the required experience, specialized skills and competencies relevant to the role.
Don’t assume a candidate has the skills you require for your practice or business without administering standard skill tests or speaking to former employers or training programs. This is especially true in professions like aesthetic nursing, where some training programs provide a certificate after a short weekend workshop.
Malpractice insurance coverage:
Confirm the clinician has adequate malpractice insurance or that your practice provides coverage.
Onboarding and post-hiring phase
Risk management doesn’t stop once a clinician is hired. A hiring checklist should also include provisions for post-hiring activities, such as onboarding and ongoing performance reviews. By continuously monitoring and supporting your clinicians, you can identify and address potential issues before they escalate, protecting your practice from liability.
Onboarding and training:
Provide comprehensive onboarding, including training on practice policies, EMR systems, and legal requirements.
Sullivan recommends working with an HR payroll partner that offers small business operation support. They can help you implement HR best practices for onboarding, as well as perform background checks.
Ongoing support and supervision:
Implement regular performance evaluations and peer reviews to monitor clinical performance, adherence to standards and patient safety.
Document employees’ performance so you can recognize them for excellent patient care and manage any negative performance. This is not only good management, but it also protects your practice in the event of a claim. “You need to demonstrate whatever steps you take to effectively manage your employees to either lead them to a positive outcome going forward or terminate them,” says Sullivan.
Provide robust continuing education:
Encourage and track continuing education to ensure clinicians remain up-to-date on the latest medical practices and state and local licensing requirements.
Retain updated employee documents:
Maintain detailed records of all hiring and credentialing documents, including interview notes, reference checks and background check results.
Clarify an action plan for issues:
Develop a clear plan for addressing any issues during the clinician’s tenure, including a process for corrective action or termination if necessary.
Including these elements on your checklist will help private practice owners mitigate risks, comply with legal requirements, and ensure they hire qualified and reliable clinicians.
Notify your insurance of any employee changes
While CM&F Group business entity policies include blanket language to cover employees who come and go in a specific year of coverage, many insurance carriers require you to notify them every time an employee starts or leaves.
Whether you’re hiring your first employee or your thousandth, CM&F Group can advise you on maximizing your ability to hire the best clinicians for your business. “Our goal is to be consultative as advisors to help our clients lower their risks and build successful businesses. We’re good at quarterbacking and understanding what people need and then pointing them to those resources,” says Sullivan.
