Quick Answer

Yes, Altru Health System hires individuals with felony convictions for certain positions. As a community-owned, nonprofit healthcare system headquartered in Grand Forks, North Dakota, Altru employs approximately 3,500 health professionals and support staff serving over 230,000 residents across northeast North Dakota and northwest Minnesota. Employment decisions are conditional upon passing a comprehensive background check and are subject to Fair Chance Hiring principles, EEOC guidelines, and mandatory federal healthcare regulations.

The law prohibits companies from having a blanket policy excluding all felons. Instead, they must conduct an individualized assessment of the conviction to determine if it is job-related and consistent with business necessity.

The greatest barriers are created by the OIG Exclusion List (LEIE) which creates a permanent legal bar for healthcare fraud, patient abuse, or felony healthcare-related offenses. Additional barriers exist for convictions involving violent crimes (patient safety concerns), drug offenses (access to controlled substances), and theft or fraud (integrity concerns). Recent offenses within the past 7 years face the highest scrutiny regardless of type.

Best entry points include Environmental Services, Food Services, Supply Distribution, Laundry, and non-clinical administrative positions where OIG exclusion requirements and direct patient care concerns are minimized. These positions offer starting pay ranging from $15.50-$17.00/hr with opportunities for advancement within the health system.

Table of Content

1. Quick Answer

2. Felon-Friendly Scorecard

3. Eligibility Checklist

4. Critical Regulatory Information

5. Company Overview

6. Hiring Policy Analysis

7. Background Check Process

8. Application Strategy

9. Tips for Applicants with Records

10. Benefits Overview

11. Frequently Asked Questions

12. Alternative Second Chance Employers

13. Conclusion

14. Disclaimer

Felon-Friendly Scorecard

Eligibility Checklist

Before applying, honestly assess whether you meet these baseline requirements:

• OIG Exclusion Status: You must NOT be on the OIG List of Excluded Individuals/Entities (LEIE). This is a permanent legal bar that applies to all positions at healthcare organizations receiving federal funds. Check your status at exclusions.oig.hhs.gov before applying.

  
  

• No Blanket Exclusion: Must be aware that the company is not allowed to automatically exclude you solely for being a felon. EEOC guidelines require individualized assessment for non-excluded applicants.

  
  

• Job-Related Assessment: Must be prepared for the company to evaluate whether your felony is related to the job duties using the Green Factors (nature of crime, time elapsed, nature of job).

  
  

• Physical Requirements: Many positions require standing, walking, lifting 20-40 pounds, and working in hospital environments. Review specific job posting requirements carefully.

  
  

• Drug Screen: Must pass a mandatory pre-employment drug test. Altru Health System maintains a drug-free workplace policy. Most healthcare systems conduct urine screening.

  
  

• Honesty is Paramount: Must be completely honest about your criminal record when asked (after conditional offer). Lying is an automatic disqualifier and can result in termination if discovered later.

  
  

• Work Authorization: Must be legally authorized to work in the United States and able to provide required I-9 documentation. Altru participates in E-Verify.

Critical Regulatory Information

Understanding the legal landscape for criminal records in healthcare employment is essential for Second Chance applicants. Altru Health System operates primarily in North Dakota with clinics extending into Minnesota. Healthcare employment faces unique federal regulations that create additional barriers beyond standard employment background checks.

EEOC Guidelines

The Equal Employment Opportunity Commission advises employers not to automatically refuse to consider an applicant because of a criminal record. Employers must conduct an individualized assessment considering the Green Factors:

(1) Nature and gravity of the offense;

(2) Time elapsed since the offense and/or completion of sentence;

(3) Nature of the job sought and its relationship to the offense. Blanket policies excluding all felons are prohibited.

FCRA Requirements

If a third party conducts the background check and a job offer is denied based on the report, Altru must comply with the Fair Credit Reporting Act (FCRA) adverse action procedures:

(1) Provide pre-adverse action notice with a copy of the report and summary of FCRA rights;

(2) Allow reasonable time to dispute inaccuracies;

(3) Provide final adverse action notice if decision stands after review. The FCRA generally limits reporting of non-conviction records to 7 years.

State-Specific Considerations

North Dakota has enacted a Ban-the-Box law (N.D. Cent. Code § 12.1-33-05.1) that applies to both public and private employers with four or more employees. Employers cannot ask about criminal history on initial applications and may only inquire after a candidate is selected for an interview or receives a conditional job offer. North Dakota also allows record sealing after 3 years for misdemeanors and 5 years for felonies (with exceptions for violent and sex offenses). Minnesota, where some Altru clinics operate, has similar Ban-the-Box protections and expungement options.

Healthcare-Specific Considerations

Healthcare employment faces unique federal mandates. The OIG Exclusion List (LEIE) is a permanent legal bar for individuals convicted of Medicare/Medicaid fraud, patient abuse or neglect, or felony healthcare-related offenses. Healthcare organizations face severe civil monetary penalties for employing excluded individuals in any capacity paid by federal funds. All positions—clinical, administrative, and support require LEIE screening. The OIG is required by law to exclude individuals convicted of: Medicare or Medicaid fraud; patient abuse or neglect; felony healthcare fraud, theft, or financial misconduct; and felony convictions for controlled substance offenses. Minimum exclusion periods range from 5 years to permanent exclusion.

Company Overview

Altru Health System is a community-owned, nonprofit, integrated healthcare system headquartered in Grand Forks, North Dakota. With roots dating back to 1892 when St. Luke's Hospital was founded, Altru has provided healthcare to the region for over 130 years. The system includes a 257-bed acute care hospital (designated Level II trauma center), a 10-bed specialty center, and 14 clinics across eastern North Dakota and northwest Minnesota. A newly constructed hospital featuring 226 licensed beds, a 16-bed observation unit, and negative pressure isolation capabilities opened in early 2025.

Altru is the largest employer in Grand Forks County and the third-largest employer in North Dakota, employing approximately 3,500 health professionals and support staff. The organization is a proud member of the Mayo Clinic Care Network and a partner in the US Army PaYS program. Altru has been voted one of Prairie Business Magazine's 50 Best Places to Work for three consecutive years.

Company Fast Facts

• Founded: 1892 (Grand Forks, North Dakota)

• Headquarters: Grand Forks, North Dakota

• Employees: Approximately 3,500

• Service Area: 230,000+ residents in NE North Dakota and NW Minnesota

• Facilities: 257-bed acute care hospital, 10-bed specialty center, 14 regional clinics

• Status: Nonprofit, community-owned

• CEO: Todd Forkel

• Recognition: Best Hospital in North Dakota (U.S. News 2019), Newsweek Best Maternity Hospitals 2024, CHIME Digital Health Most Wired (10 years)

Hiring Policy Analysis

Altru Health System operates as an Equal Opportunity Employer and complies with North Dakota's Ban-the-Box law, which delays criminal history inquiries until after the interview stage. The organization conducts individualized assessments as required by EEOC guidelines and federal healthcare regulations. Background checks are conducted after conditional offers are extended, giving applicants the opportunity to demonstrate qualifications before criminal history is considered.

However, healthcare employment faces unique challenges. All positions require OIG exclusion screening regardless of job duties. Patient-facing roles face the highest scrutiny, while support services positions offer more accessible pathways. The hiring process typically includes online application, phone screening, interview(s), conditional offer, background check and drug screening, and final hiring decision.

Position-Specific Barriers

Barrier levels are determined by patient contact requirements, access to controlled substances, OIG exclusion applicability, and state licensing requirements.

Available Positions and Pay

Pay data compiled from Glassdoor, Indeed, and Altru job postings. Actual compensation varies by shift, experience, and department. Benefits begin for employees working 24+ hours per week.

Career Path Examples

Altru emphasizes internal advancement and has been recognized for employee development. Many leadership positions are filled through internal promotion. Advancement timelines depend on performance, certifications obtained, and position availability.

Environmental Services Track: EVS Worker ($16-$24/hr) → Lead EVS ($19-$27/hr) → EVS Supervisor ($45K-$55K/yr) → EVS Manager ($55K-$70K/yr). Requires demonstrating reliability, learning infection control protocols, and developing leadership skills.

Food Services Track: Food Service Worker ($15-$24/hr) → Cook ($17-$26/hr) → Lead Cook ($19-$28/hr) → Food Services Supervisor ($45K-$58K/yr). Advancement through food safety certifications and consistent performance.

Administrative Track: Receptionist ($16-$24/hr) → Registration Specialist ($17-$26/hr) → Patient Access Lead ($19-$28/hr) → Department Coordinator ($50K-$65K/yr). Requires computer proficiency and customer service excellence.

Background Check Process

Understanding Altru's background check process helps you prepare mentally and practically. The organization conducts comprehensive screening after extending conditional offers, in compliance with North Dakota's Ban-the-Box law.

What They Check: Criminal history (felonies and misdemeanors) at county, state, and federal levels; OIG/SAM Exclusion Lists (mandatory for all healthcare positions); National Sex Offender Registry; identity verification through SSN trace; employment history verification; education verification for credentialed positions; drug screening (mandatory for all positions).

Lookback Period: Standard 7-year criminal lookback under FCRA. However, OIG exclusions have no time limit—they remain on the LEIE until formally reinstated. Serious violent or sexual offenses may be considered regardless of age. Employment verification typically extends 7-10 years.

Timeline: The hiring process averages 2-4 weeks from application to hire based on employee reports. Background checks typically take 1-2 weeks to complete after conditional offer. Some positions with additional licensing requirements may take longer.

Process Flow: Application submitted → Phone screening → Interview(s) conducted → Conditional offer extended → Background check and drug test authorization signed → OIG/LEIE screening → Criminal background check → Drug screening → Results reviewed using individualized assessment → Final hiring decision → Pre-adverse or adverse action notice if applicable → Start date confirmed → Orientation.

Disqualifying Factors

Automatic Disqualification: Presence on OIG Exclusion List (LEIE); conviction for Medicare/Medicaid fraud; conviction for patient abuse or neglect; felony healthcare fraud; dishonesty on application.

High Risk for Disqualification: Violent felonies (assault, battery, homicide); sexual offenses; drug trafficking or distribution; theft or fraud convictions (especially for positions with financial access); recent drug offenses (within 5-7 years).

Lower Risk (Case-by-Case): Non-violent property crimes; old DUI convictions (7+ years); possession charges (non-distribution); offenses clearly unrelated to healthcare duties. All subject to individualized assessment considering rehabilitation evidence.

Your Rights as Applicant

• FCRA Protections: You must receive written notice and provide consent before a background check. If denied based on the report, you're entitled to a copy and the right to dispute inaccuracies.

  
  

• Pre-Adverse Action Notice: Before a final decision, you must receive notice with a copy of the report and summary of your rights. You have reasonable time to respond and provide rehabilitation evidence.

  
  

• EEOC Protection: You have the right to an individualized assessment. Blanket exclusions based solely on criminal record are prohibited for non-OIG-excluded applicants.

  
  

• Ban-the-Box: Under North Dakota law, employers cannot ask about criminal history until after interview selection or conditional offer.

  
  

• Dispute Rights: You can dispute inaccurate information on background reports with the reporting agency. Check your own records beforehand at exclusions.oig.hhs.gov.

Application Strategy

1. Verify OIG Status First: Before applying anywhere in healthcare, check that you are NOT on the OIG Exclusion List at exclusions.oig.hhs.gov. This is a non-negotiable legal bar. If excluded, you must complete the formal reinstatement process before seeking healthcare employment.

   
   

2. Target Support Services Positions: Focus on Environmental Services, Food Services, Supply Distribution, and Laundry positions which have the lowest barriers while still requiring OIG clearance. Avoid clinical and patient-facing roles initially if your record is recent or includes relevant offenses.

   
   

3. Apply Through Official Channels: Submit your application through Altru's careers website at altru.org/careers. Positions are also posted on Indeed, LinkedIn, and Glassdoor. Check regularly as EVS and Food Service positions are posted frequently.

   
   

4. Prepare for the Interview: Research Altru's mission and values. Emphasize reliability, teamwork, and commitment to patient care environment. Healthcare employers value consistency and dependability above all.

   
   

5. Be Completely Honest: Never lie about your criminal history. Dishonesty is an automatic disqualifier and can result in termination if discovered later. Wait until asked or until after conditional offer to discuss your record.

   
   

6. Prepare Your Narrative: Have a brief, honest explanation ready: acknowledge the offense without excuses, describe what you learned, and explain your commitment to healthcare values. Focus on rehabilitation and stability. Keep it concise (30-60 seconds).

   
   

7. Document Rehabilitation: Gather evidence of positive changes: completion of treatment programs, educational certificates, stable employment history, community involvement, and character references from employers or community members.

   
   

8. Check Expungement Eligibility: North Dakota allows record sealing after 3 years for misdemeanors and 5 years for felonies. Contact Legal Services of North Dakota (legalassist.org) for assistance. Sealed records cannot be reported on background checks.

Tips for Applicants with Records

1. Healthcare Has Constant Hiring Needs: Altru is the largest employer in Grand Forks County with approximately 3,500 employees. Support services departments experience consistent turnover and regular hiring. Don't be discouraged by rejections—keep applying.

   
   

2. Start Entry-Level, Advance Within: Many successful healthcare careers begin in Environmental Services or Food Services. Prove reliability through consistent attendance and quality work. Internal advancement is common—supervisory roles become accessible with demonstrated performance.

   
   

3. Run Your Own Background Check First: Know what will appear before the employer sees it. Order your criminal background check and verify your OIG status. Dispute any errors or outdated information before applying.

   
   

4. Healthcare Environment Preparation: Understand infection control basics, patient confidentiality (HIPAA), and the importance of reliability in healthcare. Consider completing a basic healthcare certification course to demonstrate commitment.

   
   

5. Pass the Drug Test: If you have substance issues, address them completely before applying. Healthcare systems have zero tolerance for drug use due to patient safety and controlled substance access concerns.

   
   

6. Highlight Stability and Reliability: Emphasize stable housing, reliable transportation, and any consistent work history. Healthcare employers especially value dependability for maintaining patient care standards.

   
   

7. Be Flexible on Scheduling: Willingness to work evenings, nights, weekends, and holidays significantly increases your chances. Healthcare operates 24/7 and shift flexibility is highly valued.

   
   

8. Network Through Workforce Programs: North Dakota Job Service (jobsnd.com) and local workforce development programs can provide referrals, resume assistance, and connections to employers with second chance hiring practices.

Benefits Overview

Altru Health System offers a comprehensive benefits package to employees working 24 or more hours per week. Benefits begin the first of the month following your start date.

401(k) and Retirement: 401(k) plan with employer match: 100% match on first 4% of contributions, 50% match on next 2%. If you contribute 6%, Altru contributes 5%. Administered by Alerus.

Health Benefits: Self-funded medical coverage through UMR network with access to 40+ primary care clinics and 17 hospitals in NE North Dakota and NW Minnesota. Coverage for employees and dependents.

Dental and Vision: Dental coverage through Delta Dental of Minnesota. Vision plan through EyeMed covering eyeglasses and contacts.

Paid Time Off: PTO accrual based on tenure. Used for vacation, sick time, and personal needs.

Parental Leave: Four weeks paid parental leave at 100% income for bonding with newborn or newly adopted child (age 17 or younger).

Additional Benefits: Life and disability insurance; education assistance; regional business discounts; employee wellness programs.

Employee Perspectives

Pros: Strong benefits package; 401k match; good parental leave; supportive coworkers; community impact; career advancement opportunities.

Cons: Health insurance limited to Altru network; staffing challenges in some departments; variable PTO approval; high stress periods; management concerns reported.

Frequently Asked Questions

1. Does Altru Health System hire people with felonies?

   Yes, Altru Health System does hire individuals with felony convictions for certain positions, primarily in support services like Environmental Services, Food Services, and Supply Distribution. However, all applicants must pass OIG exclusion screening—those on the List of Excluded Individuals/Entities (LEIE) are legally barred from healthcare employment. For non-excluded applicants, Altru conducts individualized assessments considering the nature of the offense, time elapsed, and job relationship. Support roles with minimal patient contact offer the best opportunities.

   
   

2. What is the background check process at Altru Health System?

   Background checks are conducted after a conditional job offer is extended, in compliance with North Dakota's Ban-the-Box law. The process includes OIG/SAM exclusion screening, national criminal database search, county and state criminal records, sex offender registry check, employment and education verification, and mandatory drug screening. You must provide written consent before the check begins. If issues arise, you'll receive a pre-adverse action notice with an opportunity to respond.

   
   

3. How far back does the background check go at Altru—what is the lookback period?

   Standard criminal background checks look back 7 years under FCRA guidelines. However, OIG exclusions have no time limit—they remain until formal reinstatement. Serious violent felonies or sexual offenses may be considered regardless of age due to patient safety concerns. Employment verification typically extends 7-10 years. North Dakota allows record sealing after 3 years (misdemeanors) or 5 years (felonies), except for violent and sexual offenses.

   
   

4. What types of convictions make hiring more difficult at Altru Health System?

   Automatic bars: OIG exclusion for healthcare fraud, patient abuse, or felony healthcare-related offenses. High difficulty: violent crimes (assault, battery), sexual offenses, drug trafficking, theft or fraud (especially for financial positions), recent drug offenses. Moderate difficulty: DUI (for driving positions), non-violent property crimes. Lower difficulty: old non-violent offenses unrelated to healthcare, minor possession charges (7+ years). All undergo individualized assessment for non-OIG-excluded applicants.

   
   

5. What are the best entry-level roles at Altru Health System for applicants with a record?

   Environmental Services Hospital/Clinic ($16.26-$24.38/hr): Cleaning and sanitation with minimal patient contact. Food Service Worker ($15.50-$24.38/hr): Food preparation and cash handling. Supply Distribution Associate ($16.26-$24.38/hr): Medical supply fulfillment. Courier: Delivery and transport of supplies. These positions require OIG clearance but have the lowest barriers for non-excluded applicants with criminal records.

   
   

6. Does Altru Health System drug test, and what kind of test do they use?

   Yes, Altru requires mandatory pre-employment drug screening for all positions due to healthcare regulations and patient safety requirements. The test is typically a urine screening conducted after a conditional offer is extended. Healthcare environments have zero tolerance for drug use due to access to controlled substances and vulnerable patients. Random and post-incident testing may also occur during employment.

   
   

7. When during the hiring process will Altru Health System ask about criminal history?

   Under North Dakota's Ban-the-Box law, Altru cannot ask about criminal history on the initial application. Criminal history inquiry occurs after you're selected for an interview or receive a conditional job offer. The background check is conducted after the conditional offer, giving you the opportunity to demonstrate your qualifications first. You should be prepared to discuss your history honestly at the interview or post-offer stage.

   
   

8. Can someone advance to management at Altru Health System if they have a felony?

   Yes, advancement to supervisory and management positions is possible for employees with felony convictions, provided they're not on the OIG exclusion list and maintain excellent performance. Altru emphasizes internal advancement, and many leadership positions are filled through promotion. Demonstrated reliability, quality work, and time since offense all factor into advancement decisions. Support services tracks like EVS and Food Services offer clear pathways from entry-level to supervisory roles.

   
   

9. How long does the hiring and background check process take at Altru Health System?

   The total hiring process averages 2-4 weeks from application to start date based on employee reports. Background checks typically take 1-2 weeks after the conditional offer. Factors affecting timeline include position type (licensed positions take longer), completeness of your employment history, and any issues requiring additional review. OIG screening is usually completed within a few days. Plan for additional time if disputes arise.

   
   

10. What can applicants do to improve their chances of getting hired at Altru Health System?

    Key strategies:

    (1) Verify you're not on the OIG exclusion list before applying;

    (2) Target support services positions with lower barriers;

    (3) Be completely honest about your history—dishonesty is an automatic disqualifier;

    (4) Prepare a brief narrative acknowledging your offense and demonstrating rehabilitation;

    (5) Document positive changes with certificates, references, and stable employment history;

    (6) Check expungement eligibility for older offenses;

    (7) Be flexible on scheduling—willingness to work nights and weekends is highly valued;

    (8) Apply persistently—healthcare has constant hiring needs.

Alternative Second Chance Employers

If Altru Health System doesn't work out, consider these employers known for fair chance hiring in healthcare and related industries in the region:

Conclusion

Altru Health System offers conditional opportunities for individuals with criminal records, particularly in support services roles like Environmental Services, Food Services, and Supply Distribution. As the largest employer in Grand Forks County and third-largest in North Dakota, the organization provides a realistic pathway to stable employment with comprehensive benefits including a strong 401(k) match, health coverage, and paid parental leave.

The primary barrier is the mandatory OIG exclusion screening—individuals on the LEIE for healthcare fraud, patient abuse, or felony healthcare-related offenses face a permanent legal bar from healthcare employment. For non-excluded applicants, Altru follows EEOC individualized assessment guidelines and North Dakota's Ban-the-Box requirements, evaluating convictions based on nature, recency, and job relevance.

The work in support services is physically demanding, often requiring rotating shifts, weekends, and holidays. However, the compensation is competitive for the region ($15-$25/hr), benefits begin at 24 hours per week, and internal advancement opportunities exist. Entry-level positions can lead to supervisory roles for employees demonstrating reliability and quality work.

Key Success Factors: Verify OIG exclusion status before applying; target support services positions; be completely honest about your record; document rehabilitation thoroughly; be flexible on scheduling; apply persistently.

Biggest Barriers: OIG exclusion list (permanent bar); violent crime history; drug-related offenses; theft/fraud convictions; recent offenses within 7 years.

If you meet the eligibility requirements—particularly OIG clearance—and are willing to start in support services, Altru Health System represents a genuine opportunity for stable healthcare employment in the Grand Forks region. With approximately 3,500 employees and consistent hiring needs, persistence and honesty can lead to a second chance in this community-focused health system.

Disclaimer

This guide provides general information and should not be considered legal advice. Hiring policies vary by position, location, and individual circumstances. While we strive for accuracy using publicly available sources including company websites, job postings, employee reviews (Glassdoor, Indeed), and salary databases, employment information and company policies may change without notice. Always verify current practices directly with Altru Health System.

Inclusion in this guide does not guarantee employment. Background check laws, expungement procedures, and fair chance hiring requirements vary by state and should be confirmed with legal professionals. OIG exclusion status is a federal requirement that cannot be waived. Consult with an employment attorney or legal aid organization such as Legal Services of North Dakota (legalassist.org) for specific legal advice about your situation.

Apply Now: https://www.altru.org/careers