The entire national group of Nursing homes is under the complete jurisdiction of the Center for Medicare and Medicaid Services. (CMS.gov) All activity within this industry group is completely implemented and defined within the parameters of the current MDS 3.0 RAI regulations CMS Medicare does not directly regulate each nursing facility. These responsibilities are assigned to the Health Board of each specific state. All Funding to SNF facilities is dispersed through each state Health Board. Accurate adherence to the requirements is maintained by State Board inspections, citations and even closure of facilities who are non-compliant. Strict adherence to all 15K plus SNF facilities cannot be compromised. The system is uniform throughout all fifty states and territories.