These are agencies of State governments, typically the agency that licenses health facilities within the State Health Departments. The Centers for Medicare and Medicaid Services has entered into agreements with these agencies, to conduct inspections of providers and suppliers in order to determine if they comply with Medicare requirements. In Missouri, the state survey agency is located in the Missouri Department of Health and Senior Services. See the link below for information about how nursing homes are inspected. The department inspects each home at least annually to ensure residents are receiving the proper care. Inspectors also investigate complaints at nursing homes as often as necessary to ensure residents’ health and safety How Are Nursing Homes Inspected.