; (III) findings from State investigations and surveys conducted under subsection (g)(4), including a high number of substantiated complaints, the frequency and severity of substantiated complaints, and how the complaints are handled by the facility; (IV) situations involving changes of ownership, administration, or management of a nursing facility, or the director of nursing; (V) situations involving the inappropriate administration of medications by a facility; (VI) situations involving involuntary discharges of residents; and (VII) other factors determined appropriate by the Secretary. (iii) No reinstatement prior to next standard survey If a nursing facility’s designation is suspended under clause (i), such designation shall not be reinstated prior to a subsequent survey as specified under subsection (g)(2)(A)(iii). . (B) Assessment of high-rated designation in special surveys Section 1919(g)(2)(A)(iii)(II) of the Social Security Act ( 42 U.S.C. 1396r(g)(2)(A)(iii)(II) ) is amended— (i) by inserting (or, in the case of a facility that is designated as a high-rated nursing facility under subsection (f)(12), shall be conducted) after may be conducted ; and (ii) by adding at the end the following new sentence: On and after the date the Secretary implements the high-rated facility program under subsection (f)(12), any survey conducted, pursuant to the preceding sentence, of a facility that is designated as a high-rated nursing facility under such subsection shall include an assessment of whether such designation should continue or be suspended under subparagraph (D) of such subsection. . (2) Improvements to the special focus facility program (A) Appropriate participation Section 1919(f)(10) of the Social Security Act ( 42 U.S.C. 1395r(f)(10) ) is amended— (i) in subparagraph (A), by striking The Secretary and inserting Subject to the succeeding provisions of this subsection, the Secretary