(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.

(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.