Background Checks for Dental Staff: FCRA Steps and State Rules

A background check for hiring is not one product.

When a screening company prepares a report on your candidate, that report is a consumer report under the Fair Credit Reporting Act (FCRA), and every obligation below attaches to it.

If the screening company also builds its report from interviews about the candidate's character, general reputation, personal characteristics or lifestyle — reference interviews run by the company, for example — the result is an "investigative consumer report," and it carries additional FCRA obligations on top of the standard ones.

Two boundaries mark the edges of this process.

The checks your own team makes — phoning a reference, looking a license up on your state dental board's website — are not reports from a screening company, though license verification for clinical hires is its own step.

And credit data carries a tripwire: the FTC notes that state law may restrict an employer's use of consumer reports — usually credit reports — for employment purposes, so check your state's rule before you add credit data to the order.

Where each check sits in the wider hiring sequence is walked through in the dental hiring process guide.

Before you order a report, the FCRA requires two documents.

First, the disclosure: a clear written statement that you may obtain a background report for employment purposes, delivered in a document that consists solely of that disclosure (FCRA, 15 USC 1681b(b)(2)).

The FTC's guidance for employers is blunt about the format — the notice must be in writing, stand-alone, and cannot be part of the employment application.

Practically, the disclosure lives on its own page in your application packet, not tucked into the application or another form.

Second, the authorization: the applicant's written permission to run the check.

If you want the authorization to cover checks throughout employment — periodic re-checks, not just this hire — it has to say so clearly and conspicuously, so decide before you draft it whether the consent ends at this hire or continues.

There is one step on your side of the table: you certify to the screening company that you are complying with the FCRA.

The disclosure and authorization documents should exist before you order the first report — not after something comes back that you have to act on.

The report comes back and something in it gives you pause.

This is where the FCRA slows you down on purpose, with two notices.

Before you decide.

If you are considering rejecting the applicant because of what the report says, you first give a pre-adverse action notice: a copy of the report itself and the FTC's document "A Summary of Your Rights Under the Fair Credit Reporting Act."

The same package applies before any other adverse action based on a report — the FTC's examples include reassignment, termination and a denied promotion.

The pause matters because the report goes to the candidate too: the FCRA gives the person the right to dispute the accuracy or completeness of what the screening company furnished, and the copy of the report is what lets them do that — or explain the circumstances — before your decision is final.

After you decide.

If you go ahead — the application is rejected — you send a second notice.

The adverse action notice must include the person's right to dispute the accuracy or completeness of what the screening company furnished, and their right to an additional free report from that company if they ask for it within 60 days.

One more duty follows whichever way the decision goes: when you are done using a background report, you must dispose of it — and any information you gathered from it — securely.

If your practice has 15 or more employees, federal rules also require you to keep personnel and employment records, hiring records included, for one year from the date the record was made or the personnel action, whichever is later (29 CFR 1602.14), so time the disposal for after that period.

The FCRA tells you how to run a check; fair-chance ("ban-the-box") laws tell you when you may ask about criminal history at all.

They vary state by state and locally, so the first step is knowing which rules cover your practice.

The statutes verified for this guide:

Washington adds a rule aimed at the check itself: employers there may not ask about or obtain an applicant's criminal record — including through a background check — until after they have initially determined the applicant is otherwise qualified.

Colorado cuts differently: all employers have been barred since September 1, 2021 from asking about criminal history on the initial written or electronic application, though a publicly available criminal background report may be obtained at any time.

This page deliberately gives no national count: ban-the-box coverage changes as legislatures meet, and trackers such as the National Employment Law Project's state and local guide are a starting point, not a substitute for your own state's statute.

If your state is not covered above, that is not a clean answer — confirm the current rule with your state labor agency or employment counsel before a conviction question appears anywhere in your process.

What may be asked on the application and in the interview — criminal history among salary history, health and family questions — is the other half of this topic, and the interview questions a dental practice can't ask guide covers it.

Once a conviction record is in front of you, EEOC guidance under Title VII sets out how it may be used.

Title VII covers employers with 15 or more employees, so a smaller practice may fall outside it — but the same approach is sound practice at any size, and state fair-chance laws such as California's reach employers with five or more.

Four points carry most of the weight for a dental practice.

An arrest is not a conviction.

The EEOC's guidance is that the fact of an arrest does not establish that criminal conduct occurred, and excluding a candidate based only on an arrest is not job related and consistent with business necessity.

A pending arrest record should not be doing your deciding for you.

Convictions get three questions.

The EEOC applies the Green factors: the nature and gravity of the offense or conduct, the time that has passed since the offense, conduct and/or completion of the sentence, and the nature of the job held or sought.

That third factor does a lot of work in a dental office — the same offense reads differently for a role handling the practice's payments at the front desk than for a role limited to chairside assistance, and your assessment should say so specifically.

The three questions to answer in writing: how serious was the conduct, how long ago was it, and what does this job actually expose?

Assess the person, not just the record.

The EEOC is explicit that Title VII does not require an individualized assessment in every case — but that a screen without one is more likely to violate Title VII.

Whatever your headcount, the practical choice is the same: assess each conviction record against the actual role, and keep a short written note of the reasoning.

Ask only what you need.

The EEOC's general principle for the pre-employment process is that the information requested should be limited to what is essential for determining whether a person is qualified for the job.

That principle is what the fair-chance timing rules and the background-report sequence have in common: order the check for the role's real needs, read it against the role's real risks, and leave the rest alone.

The FCRA sequence is the same for every hire; what changes is what you order and what weighs when you read the results.

Screening healthcare workers adds checks a general employer may not think about.

Clinical roles — dentists, hygienists, assistants.

The license check comes first, and it is separate from the background report: confirm the license yourself on the issuing state board's own lookup rather than relying on a screening report.

For dentists, also ask about the National Practitioner Data Bank: eligibility to query it directly is narrow — a hospital, or a health care entity that provides care and runs a formal peer review process — so the practical route for a hiring practice is the candidate's own self-query, which the NPDB releases only to the practitioner and which they can choose to share with you.

A practice that bills Medicaid or CHIP.

Medicaid and CHIP fall inside the federal health care program definitions, so a practice that bills either is covered by the exclusion rules — and HHS-OIG advises checking its List of Excluded Individuals and Entities so that new hires and current employees are not on it, before hiring and periodically afterward.

The payment ban is not clinician-only: it reaches administrative and management services — even when they are not separately billable — so an excluded person in a front-desk, billing or management role can create liability, not just a clinician.

OIG says that where federal health care programs do not pay, directly or indirectly, for an excluded person's items or services, a provider may employ that person for them — so a practice with no federal program billing has much lower exposure, but confirm how your plans pay before you skip the check.

Front-office roles.

The criminal check and the FCRA steps above are the core.

A credit report is where state restrictions bite, so order one only if the role needs it and your state allows it.

And whichever role you are screening, the Form I-9 is universal: every U.S. employer completes one for every hire, citizens and noncitizens alike, and it is not part of a background report.

That is the whole sequence: know your state's timing, disclose and authorize in writing, read the report against the job, and use both notices if the report changes your decision.

For where each step sits in the wider hiring cycle, start from the dental hiring hub.