State-by-state fragmentation. Nursing facilities have had federal quality standards since 1987. When HHS OIG reviewed state requirements in 2009 (report, 2011), 43 jurisdictions, D.C. among them, required a criminal check against state records, 10 of those also required an FBI check, and 8 states required no criminal background check for nursing-facility staff. Teacher screening differs by state: in GAO’s 2013 survey, 46 of the 50 states and D.C. required checks for public school job applicants.
Non-compliance even where mandates exist. As of 2022, fewer than half of states, territories and tribes were in full compliance with the CCDBG background-check requirements (Congressional Research Service, 2024). A 2019 Boston Globe and ProPublica survey of 49 states, D.C. and Puerto Rico found not one agency fully compliant with five of CAPTA’s 27 provisions. Federal screening duties are enforced through funding risk, not through evidence that a specific person was screened before being given access. A mandate on paper is not a check in practice.
Identity fraud and cross-jurisdiction silos. Shared names, aliases and stolen or synthetic identities all defeat a name-and-date-of-birth match, and counterfeit documents arrive by the thousand: in the first half of 2020, CBP officers at one Chicago mail facility seized 19,888 counterfeit U.S. driver’s licenses. The records are incomplete too: Virginia’s State Crime Commission reported, from State Police data, at least 751,154 offenses in the state’s “Hold File” in 2018 that had not been applied to criminal histories; 90% lacked fingerprints. Clearances and disqualifications do not automatically travel, and state rules differ, so a person barred in one state can be cleared under the next state’s rules.