42 CFR § 488.318 - Inadequate survey performance.

---
identifier: "/us/cfr/t42/s488.318"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 488.318 - Inadequate survey performance."
title_number: 42
title_name: "Public Health"
section_number: "488.318"
section_name: "Inadequate survey performance."
chapter_name: "CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "G"
subchapter_name: "STANDARDS AND CERTIFICATION"
part_number: "488"
part_name: "SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES"
positive_law: false
currency: "2026-04-05"
last_updated: "2026-04-05"
format_version: "1.1.0"
generator: "[email protected]"
authority: "42 U.S.C 1302 and 1395hh."
regulatory_source: "53 FR 22859, June 17, 1988, unless otherwise noted."
cfr_part: "488"
---


# 488.318 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.