State rules differ regarding background checks: 43 states require nursing homes to perform background checks against state records, ten of those require an additional FBI background check, and eight states don’t require background checks at all.

The rules also differ on what types of crimes disqualify workers. The report noted that of the workers with convictions, 44 percent had committed property crimes such as theft, vandalism or writing bad checks. Some 16 percent had drug-related crimes, and 13 percent had committed crimes against people, including sexual offenses.

Federal regulations prohibit nursing homes from employing workers convicted of “abusing, neglecting, or mistreating residents,” but because FBI data do not show whether the victims of the crimes were nursing home residents, it’s unclear whether these rules were violated.

The New York Times noted that the current system for background checks — which Wisconsin Democrat Sen. Herb Kohl criticized as “haphazard, inconsistent, and full of gaping holes” – has allowed people convicted of crimes in one state simply find jobs at nursing homes in another state.

We’ve noted a similar lack of oversight in the nursing field, which allowed problem nurses to cross state lines in order to keep working and avoid consequences. A national database was created decades ago to prevent this from happening, but reporting failures at both the state and federal level have left the database riddled with gaps.

The inspector general recommended that the federal government’s Centers for Medicare and Medicaid Services, or CMS, work with the states to develop background check procedures, including lists of convictions that would disqualify a potential hire.

CMS oversees nursing homes eligible for funding under Medicare and Medicaid. In a written response to the report, the agency agreed with the recommendation. CMS also runs Nursing Home Compare, a searchable database with ratings on nursing homes.

For more, read the full report. 

The United States has begun calling publicly for Libyan dictator Col. Muammar Qaddafi to step down. The first sign of this came over the weekend, when on a call with German Chancellor Angela Merkel, President Obama stated that “when a leader’s only means of staying in power is to use mass violence against his own people, he has lost the legitimacy to rule and needs to do what is right for his country by leaving now,” according to a readout of the call.

Secretary of State Hillary Clinton voiced that position again today, calling specifically for Qaddafi to go “now, without further violence or delay.” She told the UN Human Rights Council that the United States has been “reaching out” to the newly formed opposition government working to oust Qaddafi and is prepared to “offer any kind of assistance that anyone wishes to have from the United States.”

The latest statements mark a shift since last Friday, when State Department spokesman P.J. Crowley stated that “what happens to the leadership of Libya is up to the Libyan people,” and “it is for them to decide who should leave.” President Obama in particular has faced criticism for failing to speak up sooner to personally condemn the actions of the Libyan government. 

What the United States has done so far:

The U.S. announced it would be closing the American embassy in Libya and imposing unilateral sanctions. The announcement came just hours after the United States evacuated a final group of American citizens and embassy personnel on Friday.

“There has been great haste in moving to the point where we are today,” White House Press Secretary Jay Carney said, defending the timing of U.S. sanctions against the Libyan government.

Those sanctions included a freeze on the assets of the Libyan government, the Qaddafi family and other high-level Libyan officials. It also ordered the suspension of “all existing licenses and other approvals for the export of defense articles and services to Libya.” (See the State Department’s responses to us when we asked about the licensing of exports to Egypt and other Mideast countries that engaged in suppression of protests.) 

In coordination with the United States and the United Nations, the European Union announced on Monday it would be imposing its own sanctions. The UN also instructed the International Criminal Court to decide whether the Libyan government committed crimes against humanity.

What’s still being considered:

The United States and its European allies have yet to impose a no-fly zone over Libya, though Secretary Clinton has said that it is “an option we are actively considering” and is under discussion. The BBC reported today that the UK is working on a plan to impose it.

LIBYA

Relationship status with United States: De-friended
Libya and the United States have been in a slow thaw over the last decade. The United States restored full diplomatic relations with its government in 2006, after the country showed signs of cooperation in the areas of nonproliferation and counterterrorism, though the United States has long considered the country’s dictator, Col. Muammar Qaddafi, to be a bit strange and unpredictable, describing him as “notoriously mercurial” in U.S. diplomatic cables (more background on the U.S. relationship with Libya).

What’s been happening: Though it’s difficult getting an exact figure on how many have died in the escalating violence in Libya, by most accounts hundreds of protesters have been killed by the regime of Muammar Qaddafi and his hired mercenaries.

As we noted this week, Qaddafi has clung to power, vowing to fight “until the last drop of my blood.” Qaddafi’s maintains a stronghold in Tripoli, the besieged capital city, while the opposition has taken control of eastern Libya. On Thursday, Qaddafi blamed the uprising on the influence of al-Qaeda. Libyan officials told the State Department that the government now considers journalists who entered the country “illegally” to be “al-Qaeda collaborators.”

U.S. response: President Obama addressed the situation in Libya on Wednesday at length, announcing that Secretary Clinton would be traveling to Geneva on Monday to discuss the situation in Libya with international leaders.

“We will hold the Libyan Government fully responsible for this,” State Department spokesman P.J. Crowley told reporters this week. The U.S. has focused on getting American citizens in Libya to safety and said all options are on the table in terms of potential sanctions against the country. So far none have been announced, and the United States has not called for Qaddafi’s ouster, saying that “what happens to the leadership of Libya is up to the Libyan people.”

BAHRAIN

Relationship status with United States: BFF, though a bit awkward lately
The small oil-producing country and financial center has played host to a robust U.S. military presence as home of the U.S. Navy’s Fifth Fleet. Bahrain’s Sunni rulers — who rule over a majority-Shi’ite population — keep “close to their American protectors,” according to a 2008 WikiLeaks cable.

What’s been happening: Last week, government forces unleashed brutal attacks on crowds of protesters and mourners, wounding hundreds and killing seven after they had declared the protests illegal. Last Thursday, the Bahraini government defended the crackdown as “a very important step that had to happen” to prevent the country from falling into “a sectarian abyss.”

The situation has recently calmed down, and security forces have been ordered off the streets. Though the opposition doesn’t agree on everything — some protesters have rejected the Sunni ruling family altogether — their core demands have included the release of political prisoners and a fully elected government, Reuters reported. The government has signaled intentions to begin a national dialogue and this week released hundreds of political prisoners.

U.S. response: Secretary of State Hillary Clinton praised Bahrain’s leaders earlier this week for opening dialogue after last week’s violence. She called on the government to follow with “concrete actions and reforms.”

Last week, after days of issuing statements of concern about the violence, Clinton spoke by phone with Bahrain’s foreign minister and “stressed the need to seriously engage all sectors of society in a constructive, consultative dialogue.” She cited the need for continued reform and reiterated that Bahrain is a “friend and ally.” (Related: See our post about the praise that the United States lavished on Bahrain just two months prior to these attacks.)

The Washington Post reported on Sunday that the U.S. government had used public encouragement and private pressure on the Bahraini government to end its crackdown on protesters. Adm. Mike Mullen arrived in Bahrain yesterday as part of a trip to the Middle East and met with the king and the crown prince. National Security Adviser Tom Donilon also spoke with Bahrain’s crown prince yesterday, expressing “strong support” for steps taken to open dialogue.

YEMEN

Relationship status with United States: Frenemies
In a press briefing earlier this month, Press Secretary Robert Gibbs stated, “Our relationship with the government of Yemen is incredibly important in addressing the counterterrorism threat that exists there.” As WikiLeaks cables revealed last fall, the country’s president, Ali Abdullah Saleh, has allowed secret U.S. air strikes against suspected al-Qaeda sites and covered them up, claiming they were conducted by the Yemeni military. However, some analysts have said Yemen is playing a double game — diverting U.S. aid to not go after al-Qaeda and instead to fight domestic rebels.

What’s been happening: At least a dozen people are reported to have been killed since the protests began in Yemen. Though demonstrations appeared to be peaceful on Friday, some protesters last week were beaten by Yemeni security forces, according to Human Rights Watch. The Financial Times reported on Wednesday that nine members of parliament have resigned in protest of the government’s violence against demonstrators.

Yemen’s President Ali Abdullah Saleh said this week that he won’t step down but will open a dialogue with protesters. On Wednesday he instructed security forces to “thwart all clashes” between pro- and anti-government protesters — and to offer protection for demonstrators.

U.S. response: Earlier this month, President Obama called Yemen’s President Saleh and “asked that Yemeni security forces show restraint and refrain from violence” against demonstrators. He also urged Yemen to take forceful action against al-Qaeda, according to the State Department. The State Department’s P.J. Crowley also tweeted about the necessity of foreign aid to Yemen, saying that potential cuts would “constrain our ability to help Yemen” confront al-Qaeda.”

ALGERIA

Relationship status with U.S.: It’s complicated
As U.S. diplomatic cables show, relations between the United States and Algeria have warmed gradually in recent years. In a February 2008 cable, U.S. diplomats called Algerian military intelligence “a prickly, paranoid group to work with,” but noted that cooperation had paid dividends. A cable sent early last year noted Algeria’s strategic importance in the fight against al-Qaeda in the region.

What’s been happening:
According to the BBC, sporadic protests in Algeria have been continuing since early January, mostly triggered by economic conditions. Algerian security forces arrested dozens of protesters and police attacked some journalists in crackdowns, but the government has since promised reforms and lifted an emergency law that had banned protests and gave police broad powers to detain citizens.

U.S. response:
On Thursday the president made a statement commending Algeria’s government for taking “an important step forward” by lifting the emergency law, calling it a “positive sign” that Algeria is listening to the concerns of its people.

The State Department’s Crowley had previously released a statement noting the protests and calling “for restraint on the part of the security services.” 

IRAN

Relationship status with United States: Enemies
The U.S. currently has sanctions against Iran and has a now 30-year history of tension.

What’s been happening:
Members of the Iranian Parliament called for the leaders of the protest movement to be executed. The government has also clamped down hard on protest organizers. At least three protestors have been reported killed.

U.S. response:
The U.S. response to Iran has been harsher than to some of the other governments suppressing protests. Secretary of State Hillary Clinton issued a statement on Wednesday calling out Iranian security forces for having beaten, detained and killed peaceful protesters and for persecuting ethnic minorities, human rights advocates and political activists. “The steady deterioration in human rights conditions in Iran has obliged the international community to speak out time and time again,” Clinton said, while sanctioning two more Iranian officials for the abuses.

State Department spokesman P.J. Crowley had previously stated that the United States condemned the violence in Iran “in the strongest terms.” Asked in an early briefing why the State Department is “condemning what is happening in Iran” and not taking the same position on crackdowns elsewhere, Crowley said, “Well, actually, in the other countries there is greater respect for the rights of the citizens. I mean, we are watching developments in other countries, including Yemen, including Algeria, including Bahrain. And our advice is the same.”

STILL DEVELOPING:

IRAQ

At least nine protesters were killed in Iraq on Friday as protesters in several cities participated in “Day of Rage” demonstrations to call for an end to corruption, the Washington Post reports. Iraqi officials had urged the people to stay away, warning that the protests seem “suspicious” and could be infiltrated by terrorists, but tens of thousands turned out anyway — in some cities, police and security guards opened fire on the crowds.

SAUDI ARABIA

While some protests have been going on in parts of Saudi Arabia, in an effort to stave off larger protests, Saudi King Abdullah this week announced an estimated $37 billion in pay raises, unemployment benefits and housing help. Critics have warned that the gesture isn’t a substitute for meaningful political reform, the Guardian reported. The State Department said Thursday that it was “in touch with the Saudis” but did not have further comment.

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The country’s dictator, Col. Muammar Qaddafi, said on Tuesday that the protesters who have been killed “deserved to die,” and he vowed to fight “until the last drop of my blood.”

The U.S. and Libya have a complicated history. Under the recent Bush administration, the U.S. lifted sanctions and formally restored full diplomatic relations with Libya after its government renounced terrorism and dismantled its nuclear weapons program in 2003. At the time, the shift was heralded by State Department officials as “a success in our foreign policy.” A BBC correspondent went so far as to call it a “fairy tale.”

The State Department said that normalizing relations with Libya would “enable us to engage with Libyans more effectively on all issues,” naming human rights as one of the top priorities. A 2010 Congressional Research Service report described the U.S. rationale this way:

From 2004 onward, Bush Administration officials argued that broader normalization of U.S.-Libyan relations would provide opportunities for the United States to address specific issues of concern to Congress, including the outstanding legal claims, political and economic reform, the development of Libyan energy resources, and human rights.

Critics, however, said that as the U.S. restored diplomatic ties with the repressive regime, it put narrow strategic interests ahead of democracy and human rights.

“The State Department continues to engage Arab dictators at the expense of dissidents who support transitions to peaceful, modern societies,” Libyan-American activist Mohamed Eljahmi wrote in a Washington Post column in 2008. Eljahmi’s brother, Fathi Eljahmi, was a prominent Libyan democracy activist who died in 2009 after years of persecution and imprisonment by the Libyan government. As a U.S. senator, Joe Biden interceded on Eljahmi’s behalf, leading to his release, but it was temporary — Eljahmi was abducted again two weeks later.

“It’s tricky,” Tom Malinowski, Washington Director of Human Rights Watch, told me. Malinowski said that Human Rights Watch was not against diplomatic normalization, but said that “at times during that period, human rights were downplayed more than we felt appropriate to smooth the path to more normal relations.”

“Dealing with Qaddafi’s Libya was never easy,” he said. “The judgment was made that Libyans did not react well to public pressure. I think in retrospect that was a misjudgment.”

A U.S. embassy cable from 2008 noted the disappointment of “a number of Libyans” that the United States did not “more publicly and directly urge greater respect for human rights” immediately after diplomatic relations were re-established.

“Absent a clear message that engagement on human rights will be a necessary adjunct of an expanded U.S.-Libya relationship, meaningful progress in this area is unlikely,” read the cable, which was released as part of the WikiLeaks cache.

American oil companies eager to tap Libya’s oil reserves had also put pressure on the U.S. to normalize its relations with the country. David Goldwyn, a longtime State Department official and then head of the U.S.-Libya Business Association — a trade group founded by oil companies — told Bloomberg in 2007 that American companies were losing business because the U.S. wasn’t courting the country as aggressively as other European countries were. Goldwyn currently works as the State Department’s Coordinator for International Energy Affairs. His official bio lists that he was president of his own energy consulting firm, but does not mention his work with Libya.

The trade group’s website, which happens to be down at the moment, describes it as the “only U.S. trade association focusing on the United States and Libya” and says it was “organized to enhance the US-Libya relationship.” (See the cached version from four days ago.)

We’ve asked the State Department for comment on Goldwyn’s work for the U.S.-Libya Business Group but have not yet received a response. The White House said on Tuesday that it was “looking at” a proposal by Sen. John Kerry to re-impose sanctions on Libya.

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My question is related to the declines in many areas. When Bahrain was chosen as a strategic ally to United States, we were in the thick in term of many areas, in term of civil society, in term of human rights, in term of democracy. A lot of declines happened in the last period, and you are aware about all these things. Many people are arrested, lawyers and human rights activists. Sometime we feel that there is no, let’s say, red lines or constraints between United States and their allies. The situation was perfect, but now it is changed. So my question is: Do you review the policies of your allies from time to time, and how can we see our relation with United States as an opportunity for, let’s say, a growth for the democracy?

Clinton’s answer? The U.S. is “constantly reviewing” its allies, she said. “Nothing is perfect, nothing is done, there’s a lot of work that still lies ahead.” She continued:

And yes, I mean, people are arrested and people should have due process, and there should be the rule of law, and people should have good defense counsel. We believe in all of that and we say all of that. But on the other hand, the election was widely validated because it was free and fair and had high participation. So you have to look at the entire picture.

Clinton repeated such praise throughout her visit, stating that she was impressed by Bahrain’s progress “on all fronts — economically politically, socially” — and by the commitment that the government has to the democratic path that Bahrain is walking on.”

Apparently, Bahrain’s people — a majority Shi’ite population governed by a Sunni royal family — were less impressed. Two months after Clinton’s visit, that same government unleashed an attack on protestors who had been peacefully calling for economic and political reform. Bahrain’s foreign minister defended its crackdown on Thursday, calling it “a very important step that had to happen” to prevent the country from falling into “a sectarian abyss.” Hundreds were wounded and as many as five protesters were killed on Thursday — those deaths were “unfortunate,” the country’s foreign minister said.

The Obama administration responded with criticism of the violence, but said it was not looking to dictate events or outcomes. Secretary Clinton spoke with the foreign minister and “expressed ‘deep concern‘ about actions of security forces against peaceful protesters.”

“I stressed the need to seriously engage all sectors of society in a constructive, consultative dialogue to meet the way forward in accordance with the aspirations of the people. And there have been reform steps taken which we want to see continue, we want to see strengthened,” she told the press after the call. (Hear her statement.) “Bahrain is a friend and an ally and has been for many years, and while all governments have a responsibility to provide citizens with security and stability, we call on restraint.”

Bahrain and the United States have long been close strategic allies. (We described them as “BFFs” in our overview of Middle East crackdowns.) In December, Clinton described the relationship this way:

Our nations cooperate closely across a range of issues. We work together to support entrepreneurs. Our scientists collaborate. Our students, and so many others, have developed close ties between our two people. And the sailors of our ships’ fleets have lived and worked alongside you for decades, as part of our close security partnership.

Asked about the Secretary’s recent praise for Bahrain, State Department spokesman Mark Toner said on Thursday, “Well, the Secretary was speaking, obviously, several weeks ago and was talking about some efforts that were made by the Bahraini Government towards political reform and to address some of the concerns that we’re now seeing expressed on the Pearl roundabout by the Bahraini people. But clearly, this is something that the Bahraini Government needs to address in a greater fashion.”

U.S. diplomatic cables show that underneath its glass-half-full view of Bahrain’s progress, the State Department has long been aware of the country’s internal tensions.

“Conditions in Bahrain continue to simmer. Small but violent bands of Shi’a underclass youth, frustrated with persistent discrimination and what they perceive as too gradual a pace of reform, clash with police nearly every week,” noted one cable. “Discrimination against Shia persists,” noted another.

Reuters reported Thursday that the UK, another of Bahrain’s allies, is formally reviewing its recent export licenses to Bahrain in light of the violence. We asked the State Department if it’s considering a similar review and received the following response: “We continue to review our foreign assistance and export licenses, consistent with our legal obligations and foreign policy goals, to ensure that exports advance U.S. objectives and are being used for the right purposes.”