Healthcare Compliance Perspective – Resident Sues Nursing Home:
The Compliance Officer should review the nursing home’s policies and procedures to ensure they contain 
provisions requiring interpreters/translators to be made available to residents with Limited English Proficiency (LEP). Staff should be educated about the important role communication plays in providing quality care and the affect it has on a resident’s overall well-being and outcome. An audit should be performed to review and discover any communication needs of the residents particularly those where English is not their primary language.
A deaf resident in a Louisiana nursing home recently filed a lawsuit against the nursing home claiming the facility failed to provide her with access to an American Sign Language (ASL) interpreter while she was a resident in the nursing home. The woman spent 14-days in the facility receiving physical therapy after having shoulder surgery. It was noted that the woman was the Vice President of the North Shore Louisiana Deaf Coalition.
The woman, along with her hearing impairment, is not fluent in English, and according to the lawsuit wanted a sign language interpreter to talk with her doctors and nurses. The woman’s attorney contends that “American Sign Language (ASL) is as different from English as Russian is from Chinese, and you need an interpreter who knows what they are doing to interpret medical terminology.”
Although the woman had some familiarity with both spoken and written English, she contends that she needed a sign language interpreter to help her understand the doctors and nurses and the complex medical terms being used.
In the complaint, the woman alleges that she asked a nurse in writing for a sign language interpreter the next day after her admission; but, for the first eight, she used a dry erase board to communicate and write down simple notes or tried to read people’s lips. The woman alleges that she asked for an ASL interpreter four or five times during that 8-day period.
After that period, the nursing home provided the woman with an ASL interpreter on a limited basis. However, the woman asserts that the interpreter’s presence was sufficient to provide her with the ability to communicate daily with the nursing home’s staff and other residents to the extent that a hearing person could communicate. The key phrase used by the “The Americans with Disabilities Act of 1990” (ADA) when it comes to deaf and hard of hearing individuals is “effective communication.” Whatever is necessary to ensure effective communication is required, by law, to be done. In some cases, the ADA specifies that an effective form of communication may consist simply of a written note, but if a conversation is more complicated – such as explaining a patient’s symptoms or a medical procedure – a qualified ASL interpreter may be necessary.
