42 C.F.R. § 488.318 : Public Health — CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES — STANDARDS AND CERTIFICATION — SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES — SURVEY AND CERTIFICATION OF LONG-TERM CARE FACILITIES — Inadequate survey performance

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

42 C.F.R. §488.318