; and (B) by adding at the end the following new subparagraphs: (C) Distinctions for high-rated and low-rated facilities On and after the date the Secretary implements the high-rated facility program under subsection (f)(10) and makes the conversion under subsection (f)(8)(D), the Secretary shall ensure that graphics, including an appropriate explanation of such graphics, are prominently displayed on the website described in subparagraph (A) in order to distinguish each of the following: (i) Skilled nursing facilities that are designated as high-rated skilled nursing facilities under subsection (f)(10). (ii) Skilled nursing facilities that are participating in the low-rated facility program under subsection (f)(8), with information on facilities that have been placed in such program more than one time over the course of the last 10 years (including the number of times such skilled nursing facilities have been placed in the program). (D) Focus groups and consumer testing In order to help limit confusion, particularly among older adults, individuals with disabilities, and family caregivers, the Secretary shall utilize focus groups and other consumer testing methods prior to including the additional information under subparagraph (A)(vi) and implementing the distinctions under subparagraph (C). . (c) Medicaid program revisions (1) Establishment of rankings and high-rated facility program (A) In general Section 1919(f) of the Social Security Act ( 42 U.S.C. 1396r(f) ) is amended by adding at the end the following new paragraphs: (11) Ranking process (A) Process (i) Establishment The Secretary shall establish a process to rank nursing facilities based on compliance with the applicable requirements of this Act. (ii) Data The process established under clause (i) shall include the use of at least the preceding 3 years of health inspection data, if appropriate, and other data as determined appropriate by the Secretary. (iii) Findings and recommendations of the Advisory Council on Skilled Nursing Facility Rankings under