The Centers for Medicaid and Medicare (CMS) promulgate guidelines for nursing homes that must be met in order to receive federal money.  An annual inspection is done at every nursing home receiving federal money to be sure the facility is in compliance with these regulations. 

State workers, whom typically carry out these surveys, also enforce state laws and regulations during these inspections.  Troubled facilities that are not in substantial compliance with regulations are re-visited – sometimes numerous times in a year. 

To handle the worst offenders, CMS has developed the Special Focus Facilities program.  Nursing homes that have more problems than other nursing homes, more serious problems than other nursing homes, or a pattern of serious problems that persists over a long period of time, now appear on a nationwide list of Special Focus Facilities.  These facilities get more government attention, enforcement actions and penalties.

You can get the list of Special Focus Facilities online here.