42 CFR §488.318

1. (a)CMS considers survey performance to be inadequate if the State survey agency—
   1. (1)Indicates a pattern of failure to—
      1. (i)Identify deficiencies and the failure cannot be explained by changed conditions in the facility or other case specific factors;
      2. (ii)Cite only valid deficiencies;
      3. (iii)Conduct surveys in accordance with the requirements of this subpart; or
      4. (iv)Use Federal standards, protocols, and the forms, methods and procedures specified by CMS in manual instructions; or
   2. (2)Fails to identify an immediate jeopardy situation.
2. (b)Inadequate survey performance does not—
   1. (1)Relieve a SNF or NF of its obligation to meet all requirements for program participation; or
   2. (2)Invalidate adequately documented deficiencies.