Cultural Competence as a Requirement of Trauma-Informed Care
Jeannine LeCompte, Compliance Research Specialist
Paragraph “m” of Title 42 of the Code of Federal Regulations (CFR) §483.25 — which is being implemented November 28, 2019 — requires that all long-term care (LTC) facilities provide “culturally-competent” care for all residents who may be suffering from trauma. Understanding what is meant by “culturally competent” is an important part of any program designed to successfully meet the requirements of this rule.
The Centers for Medicare & Medicaid Services (CMS) also requires of all facilities that they have “qualified persons” (F-Tag 659). This means that the facility must ensure that services provided or arranged are delivered by individuals who have the skills, experience, and knowledge to do a particular task or activity, as well as having proper licensure or certification, if required.
In addition, all facilities must have “sufficient competent staff,” to meet behavioral health needs (F-Tag 741). This means that facilities housing residents with a history of trauma and/or post-traumatic stress disorder, who have been identified as such in the facility assessment, must have sufficient staff on hand to provide full-time care to such persons.
Georgetown University’s Health Policy Institute, at the McCourt School of Public Policy, has pointed out that of the more than 37 million adults in the US who speak a language other than English, some 18 million — 48 percent — report that they speak English less than “very well.” Language and communication barriers can affect the amount and quality of healthcare received, and may also lead to resident dissatisfaction, poor comprehension and adherence, and lower quality of care.
Cultural competence in the healthcare environment can be broadly defined as the ability of providers and organizations to understand and integrate these factors into the delivery and structure of their services.
Some common strategies for improving resident/provider interaction and providing culturally competent care include:
- The provision of interpreter services
- The recruitment and retention of staff with similar backgrounds to the residents
- The provision of training to increase cultural awareness, knowledge, and skills
- The use of community health workers
- The incorporation of culture-specific attitudes and values into health promotion tools
- The inclusion of family and community members in healthcare decision making
- The provision of linguistic competency
The goal of culturally competent healthcare services is to provide the highest quality of care to every resident, regardless of race, ethnicity, cultural background, English proficiency, or literacy.
