“WWWWWWWWMWWI THESIS l ( I 7’5} 5 Date 0-7639 MICHI 'GANS IIIIIIIIIIIIIIII III III IIIIIIIII l LIBRARY Michigan State University This is to certify that the thesis entitled Background Investigations as a Pre-employment Screening Technique For Security Officers In Michigan Hospitals presented by Heather Moceri Gaunt has been accepted towards fulfillment of the requirements for Masters of Science degree in Criminal Justice Major pro/fessor November 5, 1996 MS U is an Affirmative Action/Equal Opportunity Institution ._. PLACE ll RETURN BOX to remove this chockommm your record. TO AVOID FINES return on or More duo duo. DATE DUE DATE DUE DATE DUE I‘IWiflfimf MSU Is An Affirmative Action/Equal Opportunity IMIWOH mm: BACKGROUND INVESTIGATIONS AS A PRE-EMPLOYMENT SCREENING TECHNIQUE FOR SECURITY OFFICERS IN MICHIGAN HOSPITALS By Heather Moceri Gaunt A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE School of Criminal Justice 1996 BACKGROUND INVESTIGATIONS AS A PRE-EMPLOYMENT SCREENING TECHNIQUE FOR SECURITY OFFICERS IN MICHIGAN HOSPITALS By Heather Moceri Gaunt As the security profession grows, so must security personnel selection techniques. Nowhere is this more important than in the healthcare industry, particularly in hospitals, where there exists a potential for injury or loss of life to employees, patients, and others. Violent incidents and other actions would not only affect the reputation and subsequent profitability of the organization, but could also lead to costly litigation. Hence, the personal backgrounds, skills and abilities of security personnel must be adequate to meet the diverse needs of the organization. Through the analysis of survey data on proprietary healthcare security departments, this thesis examined and explored pre—employment background investigative techniques that currently are used in the selection of hospital security personnel. Findings revealed that pre- employment selection techniques in Michigan hospitals were inferior or substandard when compared to those standards established by Donovan in the EutecticnntAssefilylanual (1988). In Memory of Catherine Banner iii ACKNOWLEDGMENTS As with any study undertaken at this point in one's educational career, the input of others oftentimes is more instrumental to the realization of the final product than one's own effort. This endeavor was no exception. Foremost I would like to thank Dr. Kenneth E. Christian, Chairman of the Committee, Professor Dr. Dennis M. Payne, and Professor Dr. Christina R. Polsenberg for their support, but most of all for their constructive criticism which is embodied in the final report. My deepest gratitude to Brian Johnson and Thomas Ackerman who let me use their research data for this thesis. Also to Brian Johnson for his guidance, insightful advice and criticism to rough drafts of this thesis. I would also like to thank my peers, Taniqua Carter, Donald Hallowell, Matthew DuBois, Scott Lindahl, and Todd Serrano for all of their laughter, friendship and support. Appreciation is also expressed to Cindy Driesenga, Beverly Bockes, Nancy Trumble, Armilla Simon, and Hazel Harden for all of their assistance. And finally, to my husband Bill, for all the love and patience he expresses while I was completing my graduate work and thesis. iv TABLE OF CONTENTS Chapter 1 THE PROBLEM ............................................................................................................. 1 Introduction ...................................................................................................... 1 Statement of the Problem .............................................................................. 2 Pre-employment Selection ............................................................................ 3 Liability and Negligence ................................................................................. 4 Negligent Hiring and Retention .................................................................. 5 Need for Research ............................................................................................ 8 Purpose of the Research ................................................................................. 10 Summary ........................................................................................................... 10 Chapter 2 REVIEW OF LITERATURE ....................................................................................... 11 The Role of Background Investigations ..................................................... 12 Individuals Involved in Background Investigations .............................. 12 Policies and Procedures .................................................................................. 14 Costs .................................................................................................................... 14 Bona Fide Occupational Qualifications ....................................................... 15 Legislation ......................................................................................................... 15 Problems With Background Investigations ............................................... 16 Resume .............................................................................................................. 17 Work History .................................................................................................... 18 Education ........................................................................................................... 18 Criminal History .............................................................................................. 19 Change of Occupations ................................................................................... 19 Character Reference Checks ........................................................................... 19 Conclusion ........................................................................................................ 20 Chapter 3 METHODOLOGY ......................................................................................................... 22 Introduction ...................................................................................................... 22 Hypothesis ......................................................................................................... 22 Hypothesis Testing .......................................................................................... 23 Sample ................................................................................................................ 23 Secondary Data Analysis ................................................................................ 24 The Survey Instrument .................................................................................. 26 The Survey Population .................................................................................. 26 Measures ............................................................................................................ 27 Demographic Information ................................................................. 27 The Applicant Screening Process ..................................................... 28 Percentage of Those Employees Hired Who Received a Background Investigation .................................................................. 28 Who Conducts Background Investigations For Security Personnel ............................................................................................... 28 PerCentage of Time Previous Employers are Contacted .............. 29 Percentage of the Time Character References are Contacted ............................................................................................... 29 Percentage of Those Individuals Conducting Background Investigations Who Have Been Trained in Performing Background Investigations ..................................... 29 Restrictions on the Background Investigation Process ............... 30 Credentials Used in the Background Investigation ..................... 30 Person Hours Consumed in Background Investigations ....................................................................................... 30 Analysis .............................................................................................................. 31 Chapter 4 ANALYSIS .................................................................................................................... 33 Introduction ...................................................................................................... 33 Data Analysis .................................................................................................... 33 Data Analysis .................................................................................................... 33 Summary ........................................................................................................... 44 Chapter 5 SUMMARY AND CONCLUSIONS ......................................................................... 47 Strengths of this Research .............................................................................. 55 Limitations of this Research .......................................................................... 56 Implications for Future Research ................................................................. 58 Appendix A ................................................................................................................... 59 REFERENCES ............................................................................................................... 64 vi LIST OF TABLES Table 4.0 - Demographic Information ..................................................................... 35 Table 4.1 - Coordination and the Applicant Screening Process by Department ................................................................................................................... 36 Table 4.2 - Department / Agency Responsible for Conducting Background Investigations ........................................................................................ 37 Table 4.3 - Percentage of Employees Hired Who Received a Background Investigation .......................................................................................... 38 Table 4.4 - Background Investigation Procedures - Prior Employer Contacts - Methods Employed ................................................................................... 39 Table 4.5 - Percentage of Those Individuals Conducting Background Investiations Who Have Been Trained in the Following Areas ...................... 41 Table 4.6 - Background Investigation Restrictions .............................................. 42 Table 4.7 - Percentage of the Time Credentials are Used to Verify the Background of Those Who are Eventually Hired ................................................ 44 Table 4.8 - Total Person Hours in Each Background Investigation .................. 45 vii LIST OF FIGURES Figure 1 — Survey Guide .............................................................................................. 34 viii Chapter 1 THE PROBLEM Introduction According to‘ the Hallgrest Rgpgrt II (1990), private security is America's primary personal and organizational protective resource in terms of spending and employment. Private security employs almost 1.5 million people, and annual expenditures for private security are $52 billion. By comparison, 600,000 people work in federal, state, and local public law enforcement, and expenditures for those services are only $30 billion annually (Cunningham, Taylor 8: Van Meter, 1990). Employment in private security is forecasted to grow at a rate of 2.3 percent annually until the year 2000, whereas law enforcement employment is expected to grow at an annual rate of only 1 percent. This suggests that the primary responsibility for protection has shifted from the public to the private sector (Wm 1990). In 1990, there were approximately 2.4 private security personnel for every law enforcement employee. In the year 2000, it is predicted that the total employment in protective services (private security plus law enforcement) will be 2.5 million individuals (Cunningham, et al., 1990). As the security profession develops, so must security personnel Selection techniques. Nowhere is this more important than security in the healthcare industry. This is due to the environment of a hospital, which is open to the public twenty-four hours a day, seven days a week. Security 2 organizations in hospitals risk injury and death to employees, patients, and others, if their security personnel are not properly selected, trained and effective in reducing, and ultimately preventing, crime and violence in the hospital. As a consequence: A hospital is understandably concerned that criminals may congregate in the parking lots, lobbies, or restrooms of its facilities, seeking to prey on the ill and infirm. Additionally, the presence of large quantities of controlled substances, albeit for legitimate medical purposes, can also be a magnet attracting individuals with no good in mind. Adequate security measures are therefore essential (Inbau, Farber 8: Arnold, 1996, p. 194). Hospitals have an obligation to the public to provide a safe working and service environment. If hospitals cannot provide this, they risk costly litigation, their reputation in the community, injury and loss of lives. StatemenLQthLEmblem Private security is charged with protecting both assets and people-- employees, customers, vendors, and even passers—by. This responsibility cannot be met without security officers who are honest, trustworthy, law- abiding, and psychologically stable (Lipman, 1988). Prospective personnel should be reliable, stable, able to communicate clearly, and have a good attitude (Post, 1986). One of the major problems involved in private security, is the pre- employment and selection of security personnel. There is a definite lack of research and understanding of applicant screening techniques in security, and more specifically in the healthcare industry. This is apparent in the background investigation stage of the pre-employment process. Hospitals have many responsibilities to the public. The first is the moral responsibility to secure the outer surroundings of the hospital in order 3 to decrease the chance of injury or death to patients, employees, visitors or other people who enter the hospital (Colling, 1992). Hospital security personnel must be able to respond effectively to all situations. This includes workplace violence and liability issues, which can financially destroy a hospital. Hospitals also have a legal and ethical responsibility to provide efficient security services to the community. Though organizations differ in terms of size, complexity, mission and culture, hiring practices and screening techniques must be consistent within the individual organization. Turner , in his monograph W (1992), urges hospital administrators to carefully select and adequately train all security personnel. He further states that: pre-employment testing and evaluation, post-employ- ment training and evaluation and adequate supervision corresponding to carefully drafted guidelines and policies are the new protective shields. Failure to take these minimal precautions in the highly explosive medical care environment leaves the employee, the negligent supervisor and the entity facing liability unnecessarily (Turner, 1984, p. 8). According to Eubanks (1991), many hospital human resource professionals believe that employee selection methods, utilized in hospitals, are in need of significant improvement. Eubanks cited one authority as characterizing employee selection processes, utilized in US. hospitals, as "almost medieval," consisting largely of "chit-chat" interviews and reference checks. EmemploymenLfielection Pre-employment selection techniques determine who joins the organization. It is anticipated that these new hires will often spend decades with the organization. As a consequence, they will become the resource that the organization depends on for performance, flexibility in changing times, 4 and innovation (Milkovich &: Boudreau, 1991). The decision to hire each employee can cost the organization thousands of dollars in salary, training, benefits, and other costs. Selection activities can cost millions of dollars when applied to large numbers of employees (Bureau of National Affairs, 1983). These employees affect organizational outcomes for many years; the one-time effort to select individuals can produce extraordinary returns on the investment (Boudreau, 1988). This thesis will examine one component of the selection process -- background investigations. For the purpose of this thesis, background investigations are defined as an official inquiry and verification of an applicant’s personal experiences and character, work history, education, and criminal background. I . 1 TI 1 II 1' Controlling turnover and guarding against negligent hiring lawsuits are only two reasons for making the best possible hiring decision (Beaudette, 1992). As organizations become increasingly more cautious in providing information about former employees, this lack of information has exposed employers to lawsuits, including suits over negligent hiring and negligent retention. Liability is often based on the employer’s failure to perform reference checks or to verify past employment (Chiaramonte, 1995). According to Maxwell (1993): A security company has the duty to exercise ordinary care in hiring persons who, because of the nature of em— ployment, could present a threat of harm or injury to a third party. The pre-employment selection investigation is related to the degree of risk a potential employee poses and should be commensurate with the risk involved. In selecting employees, a security company may be duty-bound to exercise a greater amount of care to ascertain if the employ- ees are honest and not likely to commit theft (p. 29). 5 According to Milkovich and Boudreau (1991), organizations find it increasingly difficult to obtain information beyond basic employment facts. An example is slander suits, like the September 1991 case that produced a $25 million punitive damage award to Clifford Zalay from his former employer, John Hancock” WW (1991). Private security companies and employers need to take steps to minimize civil liability, especially in the context of potentially disastrous jury monetary awards. They should take great care in hiring security officers by conducting extensive background checks, not only for past criminal behavior, but also for dishonesty (Houska, 1995). I 1 1° 11' . 1 B | I' Negligent hiring occurs when an employer hires an applicant without properly confirming the information provided on the employment application, and it is later discovered that the individual had a background indicating a propensity for misconduct on the job. Negligent retention occurs when an employer has no reason to suspect that an employee was unfit when hired, but discovers after he or she is on the job that they might be dangerous, and keeps that person on the payroll (Chuvala 8: Gilmere, 1992). The terminating organization can be sued for negligence if someone, responding to reference checks, fails to disclose data indicating that the terminated employee might commit some injurious act. The new organization can also be held liable if the employer fails in its common law duty to hire persons who are not likely to injure others (French, 1994). Lawsuits regarding negligent hiring have resulted in tremendous compensatory and punitive damage awards. In the case of Siege: 3:, Steinbmnn (1986), a Pennsylvania court ruled that a company and its high- 6 ranking executives were liable for $100,000 in compensatory damages to a former employee, $35,000 for loss of consortium to his wife, and $50,000 in punitive damages. This award was based on the plaintiff’s poor recom- mendation that caused the former employee to be terminated from his new job. The employment reference falsely stated that the plaintiff had missed work because of his drinking and that he was still being investigated for possible forgery of checks, when in actuality the employer knew that someone else was the forger. In the case of WW (1988), the plaintiff alleged that there was a professional contract whereby the hospital agreed to provide her with a safe, secure environment for her care and to protect her privacy, safety, and security. The plaintiff was sexually assaulted by a male nurse employed by the hospital. This case also deals with negligent hiring which can destroy an organization financially along with their reputation. Concerns over negligent hiring and negligent retention have significantly increased the importance of criminal record searches as part of the screening process. The problem is that criminal record searches are difficult and expensive because records are not centralized or easily accessible (Odom, 1995). Security officers are in a position of extreme trust, therefore, they should possess a clean record. A clean record in this case should be consistent with the needs of the organization. This is a key issue in many states today due to rights of privacy. In the case of W9 (1979), the court found a security company negligent in the hiring of a security officer entrusted with a passkey for an apartment building. The evidence revealed that the company did not check any of the prior addresses or personal references listed by the guard on his 7 application, nor did it require the guard to take any intelligence or psychological tests. Current rules and regulations, however, do not authorize dissemi- nation of non-conviction data to private security personnel. It is up to . individual states whether to allow criminal justice agencies to have access to arrest data. If states allowed this information to be obtained by private security agencies, it would assist in screening potential employees. In the case of WW NY. (1988), the Kings County Supreme Court awarded a $1.4 million settlement in the killing of a store customer by a security guard. The suit alleged that the guard was negligently hired and entrusted with weapons. Another case that involves negligent hiring is W M111]; (1984), the plaintiff brought suit against a security guard company for losses sustained as a result of three major thefts. Welsh claimed that Pinkerton's was negligent in the hiring, training, supervision, or assignment of a guard who was later found to have been a co-conspirator in connection with the Welsh thefts and that such negligence was the proximate cause of its losses. A Superior court jury returned a verdict in favor of Welsh. On appeal, Pinkerton's contends that there was insufficient evidence relative to each theory of liability to warrant their individual submission to the jury. Additionally, it challenged the propriety of the trial. Current rules and regulations do not authorize dissemination of non-conviction data to private security personnel. In the case of W (1988), the plaintiff was sexually assaulted by an employee while she was a patient. She claimed that the hospital contracted to provide adequate care, safety, treatment and security for her while she was an in-patient, that the defendant is strictly liable for its employee’s intentional tort and that the defendant was negligent, in that it knew or should have known of the employee’s 8 propensities and failed to take protective action. The court found, after lengthy discussion of implied contracts, that an act of admission does not make the hospital absolutely responsible for the safety of a patient. Therefore, the hospital is not liable. According to the WW (1995), tort law might impose liability upon a company for the improper disclosure of investigative information about the candidate to third parties. "This could be because 1) the information was actually false and constituted a defamation; or 2) while true, the disclosure violated the candidate's right to privacy as locally defined" (p. 16-64). W13 Currently in the healthcare industry, personnel selection has become a critical issue in management. Legal considerations, liability problems, false claims, hiring costs, workplace violence and employee theft are all greatly affected by personnel selection. The hospital's inability to effectively screen employees can lead to the loss of their reputation, which would ultimately cause a reduction in their market share in the community. Conducting pre- employment screening can be extremely time-consuming and costly, but cost- effective in the long run. General research on personnel selection has been conducted by many scholars. However, there is a lack of current information on the selection techniques utilized in the healthcare industry. Healthcare facilities pose special protection problems that are not normally encountered in other organizations. It has been said that quicker decisions and rapid reactions are required in hospitals, for more reasons than in almost any other type of business or industry group (Colling, 1992). 9 As the number of people in a given area increases, so does the number of probable negative interactions. A hospital operates twenty-four hours a day, seven days a week. This causes special problems that other organizations do not have to face. The facility must remain open to admit the sick and injured at any hour, permit visitors to see patients, and to carry on normal business including gift shops, cashier, the pharmacy, and physicians’ offices. With peOple entering and exiting through numerous entrances at all hours, it is extremely difficult to determine who belongs and who does not belong (Colling, 1992). Hospitals directly serve the public, therefore, they owe the public a safe and secure environment. Hospitals must secure the safety and well being of patients who cannot properly protect themselves. This is crucial to the organization’s status in the community. Good public relations with the hospital are crucial in order for the organization to survive (Colling, 1992). The integrity of the hospital is extremely important for the future of the hospital and the safety of those in and around the hospital. Healthcare organizations require a secure and safe environment. This is mandated by the Joint Commission on Accreditation of Healthcare Organizations, and the Occupational Safety and Health Care Act (Fennelly, 1989). The Occupational Safety and Health Act (OSHA) is intended to remedy health and safety problems, on the job, by establishing safety standards which affect all aspects of the workplace. OSHA puts full responsibility for employee health and safety on management. Therefore, many employers screen individuals for factors that may affect health and safety on the job (Mendelsohn &: Morrison, 1988) such as drug and alcohol abuse and medical problems. 1 0 WW Based on the need for research, the purpose of this thesis is to examine how background investigations for proprietary security personnel are currently being conducted in Michigan hospitals. Through survey research and a review of the existing literature on background investigations, this study will provide security professionals a greater understanding of the factors or elements which are deficient in their hiring procedures. Those elements needed to increase the effectiveness of hiring security personnel in Michigan Hospitals will also be discussed. This thesis will compare recommended industry standards with the current background investigative techniques utilized in small and large hospitals. Summary The development of an effective security program relies on well- qualified security personnel. The review of the literature will illustrate that the recruitment and selection of qualified officers is of the highest priority -- no other single element within a security program has the potential for determining the overall quality of the program than the background investigation. Through the methodology discussed in Chapter Three, analysis will be conducted on the variables associated with background investigations currently being conducted in the healthcare industry. Chapter 2 REVIEW OF LITERATURE Introductien A background investigation is a pre-employment selection technique utilized by employers in order to acquire additional information about the applicant. This can include sources such as credit bureaus, previous residences, employers, and educators (Milkovich 8: Boudrea, 1991). The background investigation, like all other employment practices, should reflect a fundamental concern for fairness to the applicant. In the case of the background investigation, at a minimum, the applicant must be notified of the decision reached on the basis of the investigation, and must be given a meaningful opportunity to rebut any findings or conclusions which would have the effect of disqualifying the applicant from employment or which would adversely affect the candidate's employment opportunities (Information Resource Service..., 1990). The evaluation of an applicant's background should be documented in writing and become a permanent part of the applicant's file. An evaluation summary form should be an essential component of the background investigation. If the investigation were ever to be challenged in an administrative proceeding or litigation, the evaluation summary may well prove to be the most significant document in the applicant's file. Such a document provides tangible evidence of the precise factors that were considered in reaching the decision and the significance that the evaluator 11 l 2 attached to each at the time the decision was made (Wollack, Waibel & Guenther, 1977). The Role of Background Investigations The background investigation is one element of the pre-employment selection process that is initiated before a candidate is selected to be hired. This process allows the employer to find out if the candidate is qualified for the position and if the candidate is motivated and enthusiastic about the position. Previous studies and literature have shown that background data, such as educational level and work experience, are generally a good predictor of job performance (French, 1994). Unfortunately, when not properly conducted, background investigations are not always dependable. Peter Schweizer's Friendly Spies (1993) is one contemporary example that illustrates the effects of poor background investigations. Schweizer provides examples of personnel who were hired without adequate and effective background checks. These individuals eventually attempted to destroy the organization, through the theft of intellectual and other proprietary information. I In 'vidul Invl di Bak rundIv ti atin Related to security positions, some components of an "ideal" background investigation program will begin with who is involved in the process. A background investigation program should verify or coordinate which individuals or units in the organization are responsible for the entire process or stages thereof. As a result, background investigation programs can include a host of different techniques, procedures, and individuals involved, depending upon the perceived needs and objectives of the organization. Background ‘ investigations may also differ according to the employment position, with l 3 some positions requiring extensive procedures, while others receive little, if any. Wm - One unit in the organization that may be involved in the pre-employment process is the Human Resource Department. According to Milkovich and Boudrea (1991), the role of the human resource professional is quite diverse. However, the primary goal is to influence the relationship between the organization and hiring new applicants. Without effective people, it is simply impossible for an organization to achieve its objectives. Human resource management (HRM) professionals play key roles in the external selection process. They are often called upon to recommend and design specific selection techniques and to interpret the results of selection activities. They also ensure that the activities meet legal and ethical requirements (Milkovich & Boudreau, 1991). The right screening service becomes a natural extension of the human resource function and contributes to the employer’s plan for success (Beaudette, 1992). WEED-Z5 - Background investigations may be conducted through contracted or proprietary personnel. Using contracted investigators for recruiting, background checks, reference checks, and conducting written tests may make sense for one company, but not for another. The advantage of an outside service conducting background investigations is getting the information in a timely manner with an unbiased opinion (Beaudette, 1992). W - According to Beaudette (1992), large companies may be able to devote resources to pre-employment screening without the assistance of an outside service. If the minimum screening objectives cannot be met internally within a required time frame, then 1 4 outside help must be utilized. Using specific departments in the organization to conduct background investigations has advantages and disadvantages. One disadvantage is that the individual conducting the investigation will possibly have to work with the applicant, therefore taking more time and caution investigating the applicant. Other disadvantages include: the investigation may not be completed in a timely manner and there may be some bias when performing the investigation. Hudzik and Cordner (1983) state that employment and training standards for private detectives and guards are minimal or nonexistent. B l' . I E I Policies provide the necessary guidance for achievements of an organization's goals and objectives while procedures furnish specific guidelines for performance. Once the policy is established, it must be documented and published. This is not only for the employees‘ benefit, but also for liability reduction and ethical reasons for the employer. An organization should establish a clear, well-written recruitment policy providing guidelines on the appropriate responses to given situations (Bates, 1988). Costs Employee selection is one of the most costly decisions made. Therefore, organizations need to spend their resources wisely. According to Odom (1995), recruiting new employees is time consuming and expensive. Chiaramonte (1995), through his background investigation process known as Sunscreen: can conduct a pre-employment background investigation for approximately $50.00 an applicant. Those costs are based on salaries, benefits, and equipment allocations for four employees as well as the cost of outside services needed to obtain various 15 public records. Security estimates that the program saves the company approximately $500,000 to $800,000 a year (p. 62). According to Stoner and Freeman (1991), bona fide occupational qualifications (BFOQ) are instances where discriminatory hiring requirements are permitted and justified in employment decisions. BFOQ criteria are utilized in circumstances where race, religion, gender, color, or national origin is "reasonably necessary to the normal operations of the particular business or enterprise,". BFOQ is still recognized in cases of age discrimination, especially where public safety is involved (Milkovich & Boudreau, 1991). Some examples may include hiring only males to play male roles in theater productions. However, those "practices or policies that adversely affected employment opportunities for any race, sex, or ethnic group are prohibited unless the restriction is a justifiable job requirement" (Stoner & Freeman, 1991, p. 338) . . One problem is determining what a BFOQ is. However, there are some guidelines as indicated through the WW Seleeflonfiroeedmee issued in 1978. Under these guidelines, managers receive practical assistance in implementing their responses to equal employment opportunity legislation 1 . l |° Various forms of legislation also control what can be used or conducted in background investigations. One example is the Americans With Disabilities Act (ADA) that has brought into question the idea of having an outside agency conduct employment reference checks. The ADA has also 1 6 forced employers to review questions carefully to ensure that persons with disabilities are not discriminated against (Beaudette, 1992). The ADA raises even greater challenges in the security industry and in pre-employment screening. Job-relatedness is the key to compliance with the employment section of ADA. E 1] III] B 1 ll . . In the case of WW): (1985), the court noted that one of the failures of Howard Johnson's included the failure to investigate the employee's prior employment history and personal background. Liability for negligently hiring a guard with a prior criminal record is also illustrated in the case of W W. (1984). In this case, Burns International Security Services, Inc., was held liable for negligently hiring a security guard who had a prior criminal record. Potter (1975) discussed personnel turnover in the security industry as the "vicious cycle". He described how little or no training, low salaries, ineffective performance, marginal personnel, little or no promotional opportunities and high turnover could result in selection and retention of unsuitable security personnel. According to Hess and Wrobleski (1992), the first step in breaking the vicious cycle described by Potter (in an address to the First Annual Conference on Private Security in 1975), is to hire qualified people who will perform effectively and who will make private security their career. Due to the high turnover rate in the security field, management is sometimes unwilling to invest much time or money in screening security personnel. This decision can accelerate the "vicious cycle". 1 7 According to Christian (1996), contemporary security management does not have established guidelines or standards to regulate or guide the pre- employment process in the security profession. One of the principle references for human resources and security is the We Manual (1989). This manual calls for an analytical approach over the traditional reactive investigative model. This is because regulatory and cultural changes have altered the traditional role of the personnel investigations function for the security profession. Some of the components of this manual include analyzing the employment application form, which includes probing into the applicant's background: education, criminal history, military service, employment history, employment gaps, etc. I l E l' I' The job application provides initial information for the background investigation. This application is the first step for the employer to obtain insight on the applicant. The job application, however, must meet all current legislation, including, but not limited to the Americans with Disabilities Act (ADA) and Title VII regulations. According to Walsh (1989), approximately one in ten of the completed applications will probably have falsifications serious enough to warrant a management level review before making an offer of employment. Applicant falsifications fall into two general categories: 1) willful omissions of material fact and 2) misrepresentations of education or work experience. This is a tremendous problem, but can be alleviated with a proper background investigation. Resume Hiring from resumes is no longer advocated, due to false claims and the limited information provided on many resumes. Research has found 1 8 that approximately one half-million people falsify college degrees on their resumes and one-third of job seekers knowingly submit false resumes (To catch a phony..., 1993). According to Walsh (1989), a resume is generally recognized as an advertising promotional device, and it is extremely difficult to hold an applicant strictly accountable for this kind of information. It is extremely important for an organization not to accept a resume instead of an employment application that provides the employer a complete work history. Wm An applicant's work history is also an important area for investigation and generally provides information relevant to an evaluation of his or her dependability and initiative as an employee. The applicant's work history also provides examples of prior conduct which are relevant to an evaluation of the candidate's interpersonal skill, integrity, self-control and situational reasoning ability (Wollack, Waibel & Guenther, 1977). Gaps in an applicant’s employment history may occur for a number of reasons and the employer needs to know what these reasons are and how they can affect the organization. Employment gaps can include jail or prison time, leave of absences due to a medical problem, psychological problems, or an alcohol or substance abuse problem. Applicants may leave this area on the application unanswered in anticipation of not being questioned for this particular time period. If they are questioned, they may state that they forgot or they wanted to explain the situation (Walsh, 1989). Education According to Walsh (1989), approximately five percent of all professional applicants will falsify some aspect of their educational background. Some examples include not listing the dates of attendance at school, listing ”diploma mills” as evidence of formal education, and falsely l 9 assuming the name and degree of a bona fide graduate (Walsh, 1989). In order to alleviate this problem, applicant screening should include phone calls to the institution in order to verify the information. This is an obvious, but sometimes an overlooked solution. C . . l H | Even though employers are unable by law to inquire into arrest records, they may require an applicant to list criminal convictions (Walsh, 1989). Some applicants leave this item unanswered if they have something to hide; therefore, the applicant cannot be accused later of having falsified the information. Employers need information on prior conviction records before an employment decision is made (Walsh, 1989). ' Changecfflscupations Employers must also be aware of drastic changes in occupations made by the applicant; Walsh (1989), states that most people tend to follow a general line of work most of their lives and any indications of an abnormal employment pattern should be closely examined. Such examples include returning to a professional field, positions involving money handling, and if the applicant is over-qualified (Walsh, 1989). These are all situations that need to be investigated in order to decrease the chances of hiring a problem. CharacteLReferenceChecks Reference checks verify information on application forms. This involves communicating with previous employers and others who can provide information about the applicant. The checks serve two purposes: they verify or contradict what the applicant has told the organization and they produce supplemental information that can be useful in a hiring decision. Reference checks are commonly conducted by telephone or mail, and some organizations use private investigators (French, 1994; Bureau of National 2 0 Affairs, 1988). According to Milkovich and Boudreau (1991), references recommended by applicants frequently give uniformly positive responses, which make it impossible to distinguish among the candidates. One way to alleviate this problem is for the investigator to talk to the candidate’s neighbors, who may know something of value. Conclusion The use of effective background investigation techniques is an imperative proactive measure to prevent unqualified employees from entering the workplace. Although there are virtually no restrictions upon what can be asked of an individual after an offer of employment has been made, most companies require a probationary period for all new employees during which a decision to terminate the individual can be made without recourse (Walsh, 1989). The key in employee selection is to exercise reasonable care to make sure that an employee is not a threat to the public or other employees during the course of employment. Effective personnel security procedures begin with specific recommendations on how to evaluate and select job applicants so that the unstable and unsuitable will not be accepted. The placement of the new employee in the working environment should inspire enthusiasm and increase motivation (Gorrille, 1974). The duty of the employer is to act reasonably and responsibly in ensuring that the customers, clients, and fellow employees are protected. Protective steps include: 1) carefully inspecting all information provided by job applicants, paying special attention to gaps in employment and patterns of brief employment; (This may occur due to an unfavorable termination or worse yet, incarceration.) 2) obtaining the applicant's consent to gather information from former employers, personal references, and other sources; 2 1 and, 3) considering the use of a service which can quickly and cost effectively supply the organization with criminal records, public filings, credit history (if legally applicable), motor vehicle records or other related information (French, 1994). There are no pre-employment security standards that are recognized by all security professionals. However, the W is considered the accepted "standard" for security administrators and personnel. Hess and Wrobleski (1992) state their pre-employment security recommendations as: 1) minimum age of eighteen, 2) high-school diploma or equivalent written examination, 3) no record of conviction (of a serious crime), 4) minimum physical standards which includes armed personnel- vision correctable to 20 / 20 in each eye and capable of hearing ordinary conversation at a distance of ten feet with each ear without benefit of a hearing aid. Other standards include that the applicant not have any physical defects that would hinder job performance (BFOQ). Meanwhile, other organizations, in other states, have different standards for security personnel. Each state is different, therefore organizations must take this into account when hiring individuals for positions within their company. Chapter 3 METHODOLOGY W I As the review of the literature has indicated, there is a need to improve pre—employment screening techniques in all organizations. The literature indicates a deficiency in the applicant screening methods that are currently used in the healthcare industry. This is especially apparent in the context of background investigations--an important component of the pre-employment process. The purpose of this research is to fill this void by gaining an understanding of the screening techniques used by Michigan hospitals when hiring their security personnel. Controlling for hospital size, it is anticipated that the larger the facility the more comprehensive the background investigation process will be for security personnel. Hypothesis The null hypothesis is that there is no difference between the pre- employment selection procedures used in small or large hospitals in the state of Michigan. To test this null hypothesis, the data set will dichotomize the size of the hospital into small and large institutions. To successfully determine this, the number of beds in the hospital will be used. This measure is a reliable and valid one because the number of beds is a proxy measure of the size of the hospital in terms of geographical size, and the number of staff and patients. The alternative hypothesis is that the size of the hospital will not impact the quality of the background investigation. 22 2 3 Ho = Background investigations will not differ by the size of the hospital. Ha = The size of the hospital will impact the quality of the background investigations. II I] . I . Analysis of variance (ANOVA) and descriptive statistics will be utilized in this research to compare and contrast pre-employment background investigation techniques by the size of the hospital. Sample Based on the review of literature which extensively discusses problems and liability in pre-employment screening, the null hypothesis is an efficient indicator. That is, according to Fitzgerald and Cox (1994) and Babbie (1992) the null hypothesis possesses face validity as it appears to represent or measure what the researcher claims it does. The null hypothesis was validated through secondary data analysis procedures. Through secondary analysis of data related to pre-employment selection techniques of security personnel in Michigan Hospitals, the null hypothesis should be valid. Likewise, a greater understanding and subsequent recommendations can be made to improve the quality of pre-employment selection techniques. In doing so, the quality and professionalism of security administration can also be enhanced. Data for this thesis were obtained from earlier research conducted by the School of Criminal Justice at Grand Valley State University. The data used for this research come from a larger data set that examined the pre- 2 4 employment screening process for nursing staff, security personnel and housekeeping personnel in Michigan hospitals. The original data were collected from January 1996 to March 1996 and coded in the Statistical Package for the Social Sciences (SPSS) program. The analysis will be descriptive in nature. According to Fitzgerald and Cox (1994), descriptive research identifies and communicates important properties or characteristics of a particular category of objects or events. Descriptive statistics show relationships between variables or describe and summarize a particular data set. The original data were collected through a mail survey. According to Parten (1950), almost all surveys conducted by mail are failures from the scientific viewpoint. However, it is possible to conduct a mail survey which will stand the test of scientific scrutiny where the returns tabulated will come from or be representative of the population solicited. The aim of descriptive statistics is to describe some phenomenon as it exists, not to determine why the phenomenon is as it is. Therefore, the research conducted here will not deal with a null or alternative hypothesis. This thesis will describe a number of different attributes such as the department which coordinated and conducts the applicant screening process, percentage of employees hired who received a background investigation, how previous employers and character references were contacted, and other such attributes. SegondarxllataAmesis In order to gain an understanding of pre-employment screening procedures for security personnel in the healthcare industry, secondary data analysis will be conducted in this thesis. Secondary data analysis, according to 2 5 Fitzgerald and Cox (1994) is "a research technique in which the researcher reexamines the method, data, and the results of the earlier research" ( p. 104). The use of secondary data analysis was chosen over survey research for a variety reasons. First, according to Babbie (1992), this type of research requires extensive time commitments in terms of questionnaire construction, sample selection, and data collection through either interviewing or self- administered questionnaires. In fact, they can take up to a year to conduct. Secondary data analysis also eliminates those costs associated with data entry. Likewise, the distribution of a similar survey in the short period of time to the same population would result in a poor response rate. This could result in a decreased response rate on account of asking the same population to complete another similar survey on background investigations for pre- employment screening. As with all methodological and statistical techniques in the social sciences, there are, advantages and disadvantages to this type of research. There are some disadvantages with using secondary analysis. According to Babbie (1992), the key problem with using secondary analysis involves the recurrent question of validity. This occurs because when one researcher collects data for one particular purpose there is no assurance that those data will be appropriate for the research that the current researcher may want to conduct (Babbie, 1992). However, with this research, validity is not an issue, as this research will take a subset of the data and analyze it with the same research agenda as the original data. Another disadvantage as indicated by Parten (1950), is that the data may not be up-to-date. As this data was collected in 1996, this problem with secondary data analysis is not a concern. 26 W The survey instrument, used in this study, consisted of 27 statements and questions that examined the pre-employment screening techniques used in selecting nurses, security, and housekeeping personnel (see Appendix A). Questions on the survey were closed-ended and focused primarily upon ordinal level data in a Likert-style format. Nominal level, open-ended questions regarding crime rates and other demographic information were also included. The questionnaire was divided into categories related to interviewing techniques, background investigation techniques, and demographic categories. This research will only use data from the section related to background investigations on security applicants. Questionnaires were addressed to the human resource departments of each hospital. The questionnaire packages contained a self-addressed stamped envelope for their convenience. Those organizations which did not respond to the survey in four weeks received follow-up phone calls. A total of fifty usable questionnaires were coded into the data set, comprising a response rate of 27 percent. Whom The original data set consisted of an anonymous and confidential questionnaire that was mailed to the population of 188 hospitals located in the state of Michigan. Hospitals were defined as those institutions that provide primary care for patients, including all member and non-member institutions published listed in the 1994 American Hospital Association (AHA) Directory. This directory listed all Michigan hospitals by the municipality in which they are located. The AHA Guide also provided demographic information, including utilization data such as the number of 2 7 beds, the hospital's census, outpatient treatment data, and information related to hospital expenditures such as payroll and the number of personnel employed. From the survey population of 188 agencies, the resulting dissemination of the survey resulted in 47 returned and usable surveys for this analysis. This comprised a 27 percent response rate for this study. According to Babbie (1992), the optimal response rate for a mail survey is 50 percent. As stated by Babbie (1992), however, the determination of adequacy is only a "rough guide...have no statistical basis, and a demonstrated lack of response bias is far more appropriate." (p. 267). Thus, although low, the response rate of 27 percent is acceptable as there is no response bias based on the frequency analysis of the returned survey instruments. Measures The measures utilized in this research were collected from the survey questionnaire. Based on the statement of the problem and the limitations associated with the use of secondary data analysis, the following list of measures were used for analysis in this research: D l . I E I' Since the null hypothesis in this research examines the relationship between the size .of the hospital (measured in beds) and thoroughness of the background investigation, this information was recorded in the data set from the American Hospital Association (1994). Additional demographic information that will be reported from the same data source includes admissions, outpatient visits, and the number of personnel employed by the organization. 2 8 IhvoplicarLSsreeningLLoress The applicant screening process may be important in the context of which department coordinated or organized the background investigation process. For instance, human resource departments may have the time and resources, but they may lack the expertise in investigating security personnel applicants. Meanwhile, security departments may lack the time and resources, but have the expertise in selecting security personnel. (See Appendix A, question 1 for this research question. ' ‘l ,1- o In ' _no 0 “If! A‘ o .\’ ‘ ‘0. 13- :0 -10. I I' a|° Consistent with the screening process is that prospective candidates must also receive a background check. As indicated by Chuvala and Gilmere, however, (1992), a very low percentage of employees ever receive background investigations, while the Rand Corporation Report (1972) also indicated that security guards are under screened. Those employees hired who received a background investigation is illustrated in Table 4.3. (See Appendix A, question 8 for this research question). to o 0- 3- kwrnd nvti_oai F0 1‘ ' _'r0 _-1 No research currently exists on who conducts background investigations for security personnel in Michigan hospitals. As a consequence, determining who conducts the background investigation may provide some insight into the quality, efficiency, and effectiveness of the background investigation process (see Appendix A, for this research question). 2 9 Wow This research will also report the use of previous employers in the background investigation process. Many organizations rely upon former employers for background information. Although somewhat effective, many employers take a "no talk" position, resulting in little or no information. Therefore, the organization may attempt to re-structure questions directed to the reference ("Reference checking..." 1995). According to the Protection of Assets Manual (1989) this is an extremely important and meaningful component of the background investigation. (See Appendix A, questions 10 and 11 for this research question). Wmochamctecfiefemmmfionmod According to the BroteetionofAssetiMonoal (1989), character references are an extremely important component of the background investigation as they allow the investigator in-depth information on the applicant's personal attributes. As indicated by Hemphill (1975), character reference checks are important as they may provide additional unstructured responses or candor that will provide additional and in-depth answers. See Appendix A, question 12 for this research question. " ‘1 -.:' 0 In '10. '0--1010- 1: 3.. _.:40.10. .1V‘ °- 0_ A10 ‘ 3“i 411‘! -1 ‘ 01'01413' 1010-10.11 ‘ :1. Those conducting background investigations must be trained in background investigation techniques (field interviewing, detecting deception, and verbal and non-verbal behavior analysis) to have an effective pre- employment selection strategy (See Appendix A, question 13 for this research question.) 30 a r 1 1 The background investigation process can be and usually is restricted by time constraints, budgetary constraints, and demands from department heads to immediately hire. As a consequence, these factors may hinder the pre- employment selection process and subsequently impede the background investigation (See Question 14 on the survey will report these findings in Appendix A.) Another important component of a background investigation involves credential verification. Some information already exists on the necessity of verifying credentials and the percentage of time they are utilized as a verification tools For instance, Adler (1993) conducted research into verification of employee information. In his survey of twenty-five corporations, it was found that 31% verified educational information for all applications, while over 80% verified educational records for some positions. It was also found that only 12% conducted criminal record checks, while approximately one-half conducted them for particular positions in the organization. (See questions 15 and 16 of the survey instrument in Appendix A.) E H C l . B l l 1 Ii |' Time may be a proxy measure of the effectiveness and efficiency of the background investigation process. (See Question 17 of the survey instrument in Appendix A) reports the approximate person hours used in each background investigation. 3 1 Anemia As this research is limited to the survey data, those statistical techniques consistent with the available data will be used. One of the primary and essential descriptive statistical techniques that will be used in this analysis is frequency distributions. The use of frequency distributions will allow the researcher to provide general characteristics of the population in terms of categories and percentage distributions. Analysis of variance (ANOVA) was used. It is a statistical technique that is used to test hypotheses about two or more population means (Norusis, 1995). Coupled with the frequency test, descriptive statistics was conducted with other methods. These will include measures of central tendencies. In order to gain an understanding of differences in the population, tabular analysis was used. Characteristics of the actual heath care institution will be compared against the pre-employment screening techniques employed. Some of the variables will include the size of the hospital and how that compares to the percentage of those employees hired who received a background investigation, who conducts the background investigation and other such descriptive variables. Included with tabular analysis, raw and aggregate percentages will also be incorporated in the research findings. One of the strengths associated with these statistical procedures is that a better understanding of the relationship between size of the institution and other variables should be revealed. This research will also illustrate how background investigations, verifying credentials, and the percentage of total person hours extended per employee for background investigations, determines the standards of personnel selection utilized by security departments. 3 2 As discussed in Chapter 2, there are no established guidelines in the security profession for background investigations. Therefore, this data will be compared against the Donovan's (1988) hoteofioniAeseteMenoel recommendations that are currently used by professionals in the security field. Results of this comparison will be discussed in Chapter 5. Chapter 4 ANALYSIS Introduction This research, through secondary data analysis, will compare and contrast background investigation techniques that are currently being used in Michigan hospitals in the selection of security officers with existing "industry standards," as indicated by Donovan (1989). One of the primary attributes that will be examined includes how the size of the hospital may affect the depth or extent of the background investigation. Other attributes that will be examined include: the frequency and percentage of time that previous employers are contacted during the employment screening process; types of training that background investigators have; restrictions of background investigations; and, credentials used to verify the backgrounds of those individuals who are eventually hired by the organization. Dam—mm Frequency analysis will be conducted on the returned and completed surveys in aggregate form, and then they will be dichotomized into groups consisting of: small hospitals and large hospitals. The dichotomization of hospital size was based on the number of beds; 127 beds or fewer were established as small hospitals and 128 beds or more were established as large hospitals. This will allow the data to be compared and contrasted in order to determine if there are any significant differences between hospitals in terms of size and their background investigation practices. 33 3 4 Advanced statistical analysis techniques will also be performed to analyze the information from the surveys. One statistical technique or process used was Analysis of Variance (ANOVA). ANOVA is a statistical technique that is used to test hypotheses about two or more population means which includes the F ratio (Norusis, 1995). Demographics The demographic variables for this research include the size of the institution (in beds), the number of personnel in the organization, the number of admissions, and the hospital census. These provide an understanding of the overall size of the institution in terms of in-house patients. Demographics for all of the hospitals in aggregate and dichotomized form are reported in Table 4.0. The number of beds (measured in terms of actual available beds for hospital clients) range from 18 to 843 for all of the hospitals. The mean number of personnel is 1,223, while the median is 493 for all hospitals. The number of admissions, measured in the number of clients admitted to the hospital in a given year, is also an important demographic variable to report as this will reflect the rate of patient size and the rate of clients leaving and entering the health care facility. The range of admissions is 108-39,041 individuals, while the mean is 6,551 and the median is 3,237. The hospital census, which is the complete population of the hospital, ranges from 1-696, with a mean value of 128 and a median of 62 clients. 35 Table 4.0 Demographic Information Variables Total H n=4 Number of Beds Number of Personnel Number Admissions Census Small Number of Beds Number of Personnel Number Admissions Census H tals n=24 Number of Beds Number of Personnel Number Admissions Census 18-843 48-7243 108-39041 1-696 18-127 48-569 108-4043 1-65 132-843 321 265 385-7243 1843 1085 156-39041 11736 9591 60-696 229 187 Returned surveys were also dichotomized according to the size of the hospital for further statistical analysis and to examine the similarities and differences of the pre-employrnent selection techniques utilized. For small hospitals (1-127 beds) the mean number of beds is 60 with a median of 48. The mean for large hospitals is 321 and the median is 265. The mean for the number of personnel, for small hospitals is 604, compared to 1,843 for large hospitals. The number of admissions, for small hospitals, ranges from 108- 4043 compared to 385—7,243 for large hospitals Knowing which department coordinated the screening process is crucial to the organization, as each brings some advantages and disadvantages to the screening process. The most common means (65 percent) of coordination of the screening process for all hospital organizations is 3 6 conducted by human resource departments (see Table 4.1). This was followed in frequency by the specific department filling the position being the one to coordinate the screening process (23 percent of the time). The findings also report that security is involved only 5 percent of the time in the coordination of the hiring of security personnel. Table 4.1 Coordination and the Applicant Screening Process by Department Variables Frequency All (n=38) Human Resources Securi Outside the Small Hospitals Human Resources Securi Outside the Large Hospitals Valid Percent Human Resources 51 t 52 Securi 51 Outside the 51 Controlling for the size of the organization illustrates similarities and differences in the coordination of background investigations. In small hospitals, the human resources function or department coordinated the screening process 9 percent of the time, compared to large hospitals where 3 7 human resources coordinates screening 51 percent of the time. It was also found that the security department coordinates the screening process 9 percent of the time for small hospitals compared to 51 percent of the time in large hospitals. Therefore, there is no difference in terms of the functions of security in the coordination in both large and small hospitals. The background investigation is also an important component to effectively hiring security personnel. As indicated in Table 4.2, the department most commonly employed for conducting background investigations is human resources (71.4%), followed by the specific department filling the position (26.5%). Outside security agencies conduct background investigations 5.7 percent of the time. Table 4.2 Department / Agency Responsible for Conducting Background Investigations Variables N Yes Valid Percent Human Resources 71.4 ' Position 26.5 5.7 Outside 5.7 ‘Number of Most hospitals that responded conducted background investigations on their security personnel (66.6%). However, 30 percent of the respondents reported that they do not conduct any background investigations on job applicants at all. Controlling for hospital size, no statistically significant differences were found (f = .5102), suggesting that the size of the organization does not influence the use of the background investigation (Table 4.3). 38 Table 4.3 Percentage of Employees Hired Who Received a Background Investigation Employees who Received a Frequency None 1-25% 26-50% 51-75% 76-100% T Cases Total Mean: 66.4% Controlled by Hospital Size Std Dev Sm ' 50.54 Large 45.42 = .4810 The background investigation allows prospective employers to contact previous employers to obtain information on the applicant. One of the findings as noted in Table 4.4 shows that previous employers are never contacted by telephone(46.2%), never contact previous employers by mail(47.6 % of the time) , by fax (87.1% of the time) or in person (90.0 % of the time). Also, previous employers are seldom (1-25%) contacted by telephone, mail, fax or in-person. However, the data also indicates that of the four methods employed in contacting previous prior employers, the use of the telephone, followed by mailings are occasionally used by the responding hospital administrators. This suggests that if previous employers are contacted they will be contacted by telephone or mail. 39 The findings on the use of character references in the background investigation are found in Table 4.4. Similar to the above findings, the four methods (telephone, mail, fax and in-person) listed are seldom used to their full potential, with the majority of respondents indicating that the four methods listed are used most frequently in only 1-25% of the background investigations that are conducted in the organization for security personnel. Similar to employer contacts, those methods used more than 25% of the time included telephone (19.2%) and mail contacts (14.3%). The use of the fax and in-person interviews were reported as not being used at all in the categories from 26 to 100 % of the time. Table 4.4 Background Investigation Procedures - Prior Employer Contacts - Methods Employed - When Previous Employers are Never 1-25% 26-50% 51-75% 76 - 100% Contacted, how are of time of time of time of time they Conducted? Telephone (12) 46.2% (6) 23.1% (5) 19.2 % (2) 7.7 % (1) 3.8 % Mail (10) 47.6 % (6) 28.6 % (3) 14.3 % (1) 4.8 % (1) 4.8 % Fax (27) 87.1 % (3) 9.7 % (0) 0 % (0) 0 % (1) 3.2 % lnPerson (27) 90.0 % (3) 10.0 % (0) O % (O) 0 % (0) 0 % Character References Never 1-25% 26-50% 51-75% 76-100% Contacted of time of time of time of time Telephone (18) 52.9 % (6) 17.6 % (4) 11.8 % (4) 11.8 % (2) 5.9 % Mail (15) 51.7 % (3) 10.3 % (4) 13.8 % (1) 3.4 % (6) .20.7 % Fax (27) 96.4 % (1) 3.6 % (0) 0 % (0) 0 % (0) 0 % lnPerson (27) 96.4 % (1) 3.6 % (0) 0 % (0) 0 % (0) 0 % Training in background investigations is just as important as conducting the actual background investigation. As reported in Table 4.5, a high percentage (in excess of 73% and above) of employers admit that those conducting background investigations have never been trained in: field 4 0 interviewing, background investigations, basic investigations, detecting deception, verbal behavior analysis and non-verbal analysis. Background investigators also receive minimal amounts of training (1-25%) in field interviewing, background investigations, basic investigations, detecting deception, and verbal and non-verbal behavioral analysis as noted in Table 4.5. Examining those categories where individuals have received the most training (76-100%), it was found that basic investigations, followed by background investigation training, were the most frequently reported form of training. Controlling for the size of the agency, statistically significant differences (at .05) were found between large and small organizations for background and basic investigations training. This suggests that personnel conducting these investigations in large hospitals receive varying levels of training, compared to those individuals in small hospitals. Other variables related to training of background investigators revealed some differences (at the .10 level), as large hospitals also provided more training ( in percent) in field interviewing, detecting deception and verbal and non-verbal behavioral analysis, than small hospitals. i 41 Table 4.5 Percentage of Those Individuals Conducting Background Investigations Who Have Been Trained in the Following Areas: Frequencies All Hospitals - 1-25% 26-50% 51-75% 76-100% Level of Training for Never of the of the of the of the Employees staff staff staff staff Field Interviewing (17) 73.9 % (2) 4.3 % (0) O % (0) 0 % (4) 17.4 (n=23) % Background (18) 78.3 % (2) 8.7 % (0) 0 % (0) 0 % (3) 13.0 Investigations (n=23) % Basic Investigations (18) 78.3 % (2) 8.7 % (0) 0 % (0) O % (3) 13.0 (n=23) % Detecting Deception (17) 77.3 % (2) 9.1 % (1) 4.5 % (0) 0 % (2) 9.1 % (n=22) Verbal Behavior (20) 86.9 % (2) 4.3 % (0) 0 % (0) 0 % (1) 4.3 % Analysis (n=23) Non-verbal (19) 82.6 % (2) 4.3 % (0) O % (0) 0 % (2) 8.7 % Behavior Analysis (n=23) Total Hospital Mean 18.69 Small 8: Large Mean F Test Sig Hospitals - Level of Training Field Interviewing Small 6.1429 3.5208 .0728" Large 33.333 Background Investigations Small .8571 6.1120 .0209" Large 33.333 Basic Investigations Small .8571 8.8265 .0066* Large 41.667 Detecting Deception Small .8571 4.0070 .0572" Large 22.727 Verbal Behavior Analysis Small .8571 2.3126 .1414 Large 16.667 Non-verbal Behavior Analysis Small .8571 4.0007 .0569" Large 25.000 sig at .05 ** sig at .10 4 2 That time constraints, budgetary constraints and demands from department heads to immediately hire influence the background investigation prcicess are shown in Table 4.6. Sixty percent stated these factors restrained their background investigation processes. When controlling for the size of the hospital, time constraints were found to be a statistically significant difference, as large hospitals reported time constraints as a major restriction to background investigations (Significant at .0455). Table 4.6 Background Investigation Restrictions Frequencies Background 1-25% 26-50% of 51-75% 76-100% of Investigation process Never of the time the time of the time the time restricted by Time Constraints (6) 35.3 % (11) 64.7% (0) 0 % (0) 0 % (0) 0 % Budgetary Constraints (9) 52.9 % (8) 47.1% (0) 0 % (0) 0 % (0) 0 % Demands from dept. (9) 52.9 % (8) 47.1% (0) 0 % (0)0 % (O) 0 % heads to immediately hire N Mean F Test Sig Time Constraints Small 11 .2000 4.4715 .0455" Large 9 28.6667 Budgetary Constraints Small 11 10.300 .0031 .9564 Large 9 9.6154 Demands from dept. heads to immediately hire Small 11 20.200 .7018 .4116 Large 9 36.0769 " Sig at .05 Another factor that is important in the pre-employment process is the verification of credentials. As indicated in Table 4.7, the majority of respondents do not fully verify the credentials of security'applicants. In fact, 4 3 the most common response to this question was that credentials are verified by 51.3 % of the respondents in only 1-25 percent of the cases, followed by a response that they are never used to verify (35.9 %) the applicant's background. When controlling for hospital size, a statistically significant difference was found between small and large hospitals in the context of verifying educational transcripts and diplomas. Verifications of educational transcripts and diplomas for small hospitals have a mean percent of 2 percent while large hospitals have a mean percent of 28.67. This finding, significant at the .05 level, suggests that large hospitals verify these credentials more than small hospitals. When examining the differences between verifying occupational and other licenses, controlling for the hospital size, no significant differences were found. In the context of never verifying credentials in the hiring process, no significant differences were found between the two categories. 44 Table 4.7 Percentage of the Time Credentials are Used to Verify the Background of Those Who are Eventually Hired Variables Never 0-25% 26-50% 51-75% 76-100 % Educational (14) 35.9 % (20) 51.3 % (1) 2.6 % (1) 2.6 % (3) 7.7 % Transcri / Di lomas Occu tional Licenses 1 39.5 % 1 55.3 % 0 0 % 0 0 % 5.3 % Other Licenses/ Certificates 10 30.3 % 16 48.5 % 0 0 % 1 3.0 % 6 18.2 % None 1 42.5 % 55.0 % O % O O % 1 2.5 % N Mean % F Test 8 Educational T ts/ Di lomas Small .2000 28.6667 Occu tional Licenses Small 10.3000 9.6154 Other Licenses / Certificates Small 20.2000 36.0769 .4000 8.1538 The amount of time dedicated to background investigations is examined in Table 4.8. The most frequent length of time, measured in hours, is none (32 percent). That is, background investigations are not conducted 32 percent of the time for all hospitals. Seventy-two percent of the respondents reported spending less than one hour conducting background investigations. Controlling for hospital size, the mean hours consumed for background investigations for small hospitals is 1.00 hour(s) compared to 1.27 hour(s) for large hospitals. This indicates that there is no significant difference between large and small hospitals in the context of the number of hours used in background investigations. 45 Table 4.8 Total Person Hours in Each Background Investigation Number of hours taken in N Valid Cum each background Percent Percent in None .5 hour 1 hour 1.5 hours 2.0 hours 3.0 hours 5.0 hours Total Cases Total Mean of all H tals 66.40 Number of hours controlled by Size of Std Dev Hos ital Small Summary of Analyses This research has found that many Michigan hospitals, regardless of size, use inferior procedures in their selection of security personnel. These inferior procedures include: 1) chit-chat interviews, 2) non-thorough investigations in regards to examining educational transcripts and diplomas. Of importance, however, is the fact that this research has found deficiencies in the background investigations of hospital security personnel. As indicated in Chapter 2, effective pre-employment screening is critical to achieving the goals of the healthcare industry. Hospitals must recognize the importance of 4 6 examining internal controls through emphasis upon making sound hiring decisions based upon credible and acceptable personnel screening techniques. Chapter 5 SUMMARY AND CONCLUSIONS Sommary In order to improve the quality of security personnel, while reducing costly litigation awards related to poor selection techniques, organizations must begin with effective pre-employment selection techniques. Marginal personnel, little screening, and minimal or no training are a combination that is not conducive to excellence in security services (Lipman, 1988). Hospitals have an obligation to the community to provide a safe environment for patients, visitors, employees, and all others who enter the facility. Therefore, the pre-employment selection process must be effective and efficient for that particular industry. Strategies recommended by a number of scholars (i.e. Christian, Inbau, et a1, and Cunningham, et al) in the field include the appropriate application forms to gather background information, applying specific techniques during interviews, and obtaining written permission to conduct background investigations. Other recommendations include that the background investigator be properly trained in field interviewing, background investigations, detecting deception and verbal and non-verbal behavior analysis. These recommendations can provide the necessary information in order for an employer to make a well-informed decision on whether or not to hire an applicant. The findings from this research report are mixed regarding the quality and extent of pre-employment techniques used for security personnel. 47 4 8 Although there are no legal or legislative standards, Donovan's Broteetiooof Ass'etsMeooel (1988) is often followed by organizations that employ security personnel. The BroteetionoflAssetsMaoool (1988) is a document which aids security professionals in the field. The Manual states suggestions for all aspects of security from hiring applicants to termination techniques. This manual was utilized in obtaining information on pre- employment selection techniques. One crucial area in the selection of candidates is the individual or organizational unit responsible for the coordination of the background investigations. As indicated by Donovan (1988), there are three sources of investigative services: personnel department, security department within the organization, or an outside contract agency. Donovan (1988) also states that written inquiries, telephone inquiries, and personal interviews may be conducted in order to identify individuals furnishing the requested or required information. Donovan (1988) states that any information sought or developed in background investigations should meet all of the following tests: it should be relevant to the hiring decision, it should be reliable and if unfavorable, it should be confirmed by at least one reliable source in addition to the original source. Without effective pre-employment selection techniques, hospitals may not only lose their reputation, but also be subjected to costly litigation and diminishing market share. Donovan (1988) recommends standards for the security profession which are somewhat different from the hospital respondents surveyed in this research. The Mongol offers an analytical approach which is scientific, logical and perceptive. Donovan (1988) focuses on the applicant’s name and signature, applicant date, date of birth, education, criminal records and 4 9 employment history. These factors are not always verified to the extent that is necessary for an in-depth background investigation. Threats to the organization are reasons for human resource administrators to develop effective pre-employment selection techniques. Any threat to security can be classified into one of two broad categories: 1) threats that occur naturally in the environment (external threats) or 2) internal threats that are generated by humans, whether accidental or intentional (Ricks, et al., 1994). Organizations have a moral and legal responsibility to employees and to the public to provide a safe environment in which to work and receive medical treatment. More important, is an injury or loss of life that could occur if the proper steps are not taken to ensure that the threats from internal and external factors are reduced or eliminated. Some important aspects of this research were the demographic variables. The demographics for this study allowed the researcher to gain some general knowledge about the hospitals used in the research. Some of the attributes that were examined included the number of beds, personnel, admissions, and the census (See Table 4.0). This information also allowed the researcher to compare and contrast the differences between small and large hospitals. Coordination of the screening process is extremely critical to the background investigation. The findings (Table 4.1) report that the most common means of coordinating the screening process is conducted by the human resource department in the organization. This indicates that security is not directly involved in the pre—employment screening process (See Table 4.1). Donovan (1988) recommends that personnel from the security department or an outside contract agency coordinate the background 5 0 investigation process. This recommendation is consistent with findings of this research as hospital organizations use the same methods as recommended by the Donovan (1988), regardless of size. However, an issue to consider that has been raised by the findings of this research is which department is best-suited to select applicants for the positions in security. On one hand, the personnel or human resource agency may have those requisite skills on hiring, related labor legislation, and adequate resources. Meanwhile, the security department may have the practical educatiOn and experience in security administration to coordinate the background investigation on what particular techniques or processes are best-suited to properly select security personnel. Regardless of this issue, hospitals that responded to the survey are operating consistently with the parameters suggested by Donovan (1988). The research findings also show that most hospitals' human resource departments conduct background investigations on their security personnel (Table 4.2). What is of interest, however, is that approximately one-fifth (18 percent) of the responding hospitals do not conduct any background investigations at all. As indicated in Chapter 2, there exists a great deal of potential liability when background investigations are not administered or are conducted improperly. When controlling for size, the findings also indicate that the size of the organization does not influence the use of background investigations. This finding is interesting, as one of the hypotheses of this research was that there would be differences in background investigation techniques, depending upon the size of the organization. With larger organizations, it could be inferred that the human resource and security functions would be larger and possibly more professionalized. However, this research does not confirm 5 1 this, as there is no difference in the administration of background investigations related to the size of the organization. As a consequence, this finding suggests and is supported by Donovan (1988), that current practices in many hospitals are inferior as background investigations are not conducted at all times. This is due to the increasing difficulties in obtaining comprehensive background information on employment applicants, liability and negligence factors. Most hospitals that responded conducted background investigations on their security personnel (Table 4.3). However, 30 percent of the respondents do not conduct any background investigations at all. The ramifications of this finding indicate that hospitals are unnecessarily exposing themselves to liability risks. As discussed in Chapter 2, the improper investigation of applicants and subsequent employees exposes the organization to inferior employees who may possess criminal backgrounds, unsatisfactory employment records, and violent propensities to name a few issues that background investigators might uncover. Of possibly more importance, with the issue of workplace violence being paramount in the 1990's, the organization may be hiring security personnel who expose patients and employees to unnecessary risks. When controlling for size, the results also indicate that the size of the organization does not influence the use of background investigations. The methods used to verify applicant information also provided insight into hospital security administration. When previous employers and character references were contacted, the method most often used was by telephone, if they were contacted at all (Table 4.4). The second most common means of contacting previous employers was by mail. A large percentage of the respondents never contacted previous employers by telephone, mail, fax or in-person. This may suggest that contacting previous employers is not 5 2 perceived as an essential component to the background investigation by those who responded. As supported by the literature, the organization may again be exposing itself to undue liability by neglecting this component in the background investigation. Consistent with previous employers, it was also found that character references are seldom investigated by telephone, mail, fax or in-person. The most common response to this question was that character references are never contacted. Again, this may expose the organization to unnecessary liability risks and employee risks. Besides techniques or methods, this research also found deficiencies in the training of personnel conducting background investigations. Background investigators receive minimal amounts of training in field interviewing, background investigations, basic investigations, detecting deception, and verbal and non-verbal behavioral analysis (Table 4.5). However, when comparing the mean levels of training controlling for the size of the hospital, the findings indicate that those personnel who conduct background investigations in. large hospitals have more extensive training in background investigation techniques. Training in these areas of the background investigation is crucial to a thorough and effective background investigation. Although, Donovan's WM (1988) does not have any information on this area of the background investigations, this is not to say that this is unimportant. In fact, this deficiency suggests that more research should be conducted in this area due to the lack of existing material in the security literature. Impediments to effective background investigations were also discovered. Time constraints, budgetary constraints and demands from 5 3 department heads to immediately hire were found to influence the background investigation process in less than 25% of the time (Table 4.6). Although this may not appear to be a serious problem for hospitals and security administrators, the findings suggest that in some situations or circumstances, organization factors lead to restrictions in the hiring process. This is especially apparent in the context of time restraints for smaller hospitals where significant differences were found, suggesting that smaller hospitals, may have more limited resources than large hospitals. This finding may also suggest that hospital administration must consider and evaluate these organizational demands to assure that they do not infringe upon the selection of hospital security personnel. For instance, if budgetary problems create a constraint, other creative and cost-savings strategies should be employed. Meanwhile, if demands from the security department impair the hiring process, a proactive, long-range plan should be developed to assure that security departments do not have to hastily hire individuals. Verification of credentials was also examined. The findings indicated that credentials, including educational transcripts or diplomas, occupational licenses or certificates, are not verified at an acceptable rate to validate the background of'those individuals who are eventually hired (Table 4.7). Occupational licenses were seldom verified nor were educational transcripts and diplomas. Compared to Donovan (1988) who states that "all education required for the position involved should be verified" (p. 16-63), the research findings indicate that hospitals are also deficient in this area of the pre- employment background selection process. Small hospitals did not verify transcripts and diplomas (at a statistically significant difference) compared to large hospitals. Again, one must consider 5 4 the culture of the organization which may not emphasize the validation of these documents, organizational constraints that may include budget and personnel allocation, and pressures from other units in the organization requesting a speedy, but possibly inadequate, filling of the position. As a consequence of these findings, hospitals may want to emphasize that background investigators should place a greater emphasis on verification of credentials - - a relatively easy process in comparison to other stages in the background investigation process. Likewise, smaller hospitals, although possibly constrained because of limited or fixed resources, should be cognizant that they are deficient in this stage of the background investigation process. Although Donovan (1988) did not specifically refer to how much time (in hours) should be spent in conducting background investigation for security personnel, this research found some interesting and significant findings. Approximately one-third of the respondents did not spend any time at all (in hours) conducting the background investigations). The findings were that 72 percent of the respondents spend less than 1 hour conducting background investigations. When controlling for hospital size and the number of hours used in background investigations, there is no significant difference in terms of hours consumed. This again. raises the issue of the quality of background investigations for security personnel in hospitals. If no time is being spent at all, or only one hour is used in the background investigation process, then organizations cannot expect to have complete and thorough backgrounds on their employee applicants. Practices of this nature may again expose the organization to unnecessary personnel problems including a heightened risk for liability- related incidents with their security personnel. 5 S This research also found that the background investigative techniques, utilized in hospital security, do not measure up to those found in the review of literature. According to the Donovan (1988), background investigations should include investigative coverage of prior employment, claimed education, personal history and criminal history. It was also found that differences do not always depend on the size of the hospital. Although it was assumed that the larger the hospital the more efficient the background investigation, this assumption was refuted in this research. As a consequence more research should be conducted. Donovan (1988) states that background investigations of employment applicants are appropriate and useful to "verify the accuracy and completeness of statements made by the candidate in connection with the position and to develop additional relevant information concerning the candidate, necessary to an informed decision" (pp. 16-60). The Broteetionof W (1988) also states that a properly conducted employment investigation assures that what the candidate has said about history and qualifications, through the application and resume, is truthful and sufficiently extensive to allow fair evaluation of that candidate's suitability. W This research contains many strengths. Research of this nature has never been conducted before in the state of Michigan. As a result, this research will serve as a means of evaluation for interested hospital security personnel, so they can compare their existing practices to those that exist with other hospitals in the State of Michigan. The findings from this research will also provide security and hospital administration a means of comparison, self-evaluation or introspection, and recommendations in order to increase 5 6 the efficiency and effectiveness of the pre—employment screening process. Through the dichotomization of hospitals according to size, more precise and accurate evaluations may be performed by those interested security professionals. Therefore, this was an innovative way to gain knowledge of the security field. This research also provides a foundation for further research. Through self-evaluation, introspection, and the recognized need to improve security hiring practices, additional research may be conducted by organizations regarding background investigations. The evaluation of this research and survey instrument may serve as a precursor to more in-depth and thorough research in background investigations. Likewise, the evaluation of hiring practices in hospital security may serve to improve the administration of, and delivery of security services in the health care industry. This research also adds to the literature available in this field and contributes to the ”professionalism of security”, where a limited amount of research currently exists. This is extremely important due to the fact that the security profession is considered somewhat contemporary in nature. I . . . E l . B 1 There are a number of limitations with this research. As indicated in Chapter 3, all hospitals in the state of Michigan were surveyed. Unfortu- nately, there was only a 27 percent response rate. This raises the question of why some hospitals did respond while others did not. For instance, the possibility exists that those hospitals that did respond believed that their hiring procedures for security personnel were superior. As a consequence, findings from this research could be skewed on the positive side of background investigations in hospital security administration. Conversely, 5 7 those that responded may also have responded out of the perceived need for more extensive research to improve their hiring practices. Some methods that could have helped to obtain a higher response rate include re-administering the survey or asking a well established medical group to endorse the survey. This would also include adding questions to the survey that were neglected in the first survey. This would allow the future researcher more data and knowledge of the techniques utilized in the pre- employment selection process and why they were utilized. This research only concentrated on the State of Michigan. As a consequence, generalization to other states may be inappropriate, as licensing laws related to security may be more stringent. For example, the Brim ' g . o : 0.1,: 5... 01-. at. '0; 0n!!!“ u iflja MW (1976) reports variations in application procedures for security employees that illustrate a number of potential pre-employment deficiencies and strengths when contrasted with the Donovan's P_rote_c_tion_of AssetsMeooel (1988). Likewise, various states may possess varying degrees of legislation that affect the healthcare industry in the context of hiring and background investigations. Another weakness in this study is whether or not a halo affect occurred during the survey. Were respondents provided socially desirable responses to the question? This is always a concern when dealing with research of this nature. According to Northcraft and Neale (1990), the halo effect occurs when the perception of an object or event on one dimension influences the construction of perceptions of that object or event on other dimensions. This, in turn, affects the reliability and validity of this research. Another possible weakness is the person who completed the survey. Did that person have enough knowledge about the question? Were the instructions clearly 5 8 . understood? As this thesis is solely based on secondary data analysis, the researcher. had no input into the initial construction of the questionnaire or survey from which the data were collected. I 1' . E E B 1 Findings from this research will assist in aiding security professionals in the healthcare industry to develop better background investigation techniques for hiring security personnel. The security profession is considered to be somewhat new; therefore, any and all information available can aid and support the security profession. This research also adds a foundation for continued research into security and pre—employment selection techniques. APPENDIX A Genergj Instructions: Beside each of the following questions or statements, please indicate with a check mark (which signifies a "Yes") of what statement(s) are appropriate or apply to your organization's practices related to the selection techniques of all three employee groups. You will also note there are some questions that require the respondent to provide a numerical response. Any additional comments (please indicate the question number) may be noted on the bottom of each page. INTERVIEWING QUESTIONS (Answer for all three categories to the right) Nursing Security Housekeeping 1. Which department coordinates the applicant screening process? a . Human Resource Department b. Specific department filling the position c. Security department d. Agency outside the hospital (please specify) e Other (please specify) 2. Do interviewers take notes (please check all that apply)? a. No b. Yes, during the interview c. Yes immediately after the interview 3. If interviewers take notes, please indicate the most common format(s) used: a. Notes taken on a writing tablet 6. Notes taken on prepared evaluation forms c. Other: 4. What greenLage of personnel conducting applicant interviews have completed training in the following subjects? a. Basic Applicant interviewing techniques b. Detecting deception c. Verbal behavior analysis d. Non-verbal behavioral analysis e. Other (please specify) 5. Are personal interviews recorded on video tape? a. Yes b. No c. Other (please specify) 6. Are personnel interviews recorded on audio tape? a. Yes b. No c. Other (please specify) (over) 6l INTERVIEWING QUESTIONS (continued) (Answer for all three categories to the right) Nursing Security Housekeeping 7. Types of interviews conducted: a. Traditional style by unit head b. Traditional style by HR dept. c. By peers d Panel interviews (please specify members) e. Assessment centers f. Other (please specify) BACKGROUND INVESTIGATION QUESTIONS Approximately what greentage of those employees hired received a background investigation? Who conducts background investigations for these employee groups? Human Resources Department b. Specific department filling the position C. Security department d. Other department within the organization (please specify) e. Private Investigation firm f. Other (please specify) - ' 10. Approximately what greengge of the time are previous employers contacted during the employment screening process for those who are eventually hired? By telephone By mail By fax In person eve-n5?!” Other (please specify) 11. W en previous employers are contacted, approximately what percentage of contacts are done in the following manner? a. By telephone b. By mail c. By fax d. In person e. Other (please specify) 62 BACKGROUND INVESTIGATION QUESTIONS (continued) (Answer for all three categories to the right) Nursing Security Housekeeping 12. Approximately what percentage of the time are character references contacted during the employment screening process for those who are eventually hired? a. By telephone b. By mail c. By fax d. In person e. Other (please specify) 13. Approximately what arcentage of those individuals conducting background investigations have been trained in the following: a. Field Interviewing b. Background Investigations c. Basic Investigations d. Detecting deception e. Verbal behavior analysis f. Non-verbal behavioral analysis g. Other (please specify) 14. Is the background investigation process restricted by: a. Time constraints b. Budgetary Constraints c. Demands from department heads to immediately hire d. Other (please specify) 15. Which of the following credentials are verified in the background investigation process for those who are eventually hired? a. Educational transcripts] diplomas b. Occupational Licenses c. Other licenses/ certificates d. None e. Other (please specify) 16. Approximately what percentage of the time are the following credentials used to verify the background of those individuals who are eventually hired? a. Educational transcripts/diplomas Occupational Licenses Other licenses/certificates None WG-99” Other (please specify) (over) 63 ADDITIONAL INFORMATION (Answer for all three categories to the right) Nursing Maintenance Housekeeping 17. Approximate total arson hours taken/ consumed in each background investigation 18. Approximate number of known incidents committed by the employee group in 1995: a. Sexual Harassment incidents against hospital staff b. Sexual harassment incidents against non hospital staff (patients, visitors, etc...) c. Threats on hospital staff d. Threats against non-hospital staff (patients, visitors, etc...) e. Assaults on hospital staff f. Assaults against non-hospital staff (patients, visitors, etc...) Theft of hospital assets g. h. Theft from non-hospital staff (i.e., patients, visitors, etc...) i. Theft from hospital staff j. Vandalism k. Other crimes reported (please list) 19. Approximate number of employee termination’s based on theft 20. Approximate umber of employee termination’s based on assault 21. Approximate number of employee termination’s based on other criminal activities (please list) Does the employment application utilized by your hospital for the following categories include a comprehensive release of liability statement? Number of full-time employees 24. Number of part-time employees Number of volunteers 26. Number of contract full-time employees 27. 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