Failure to Provide Preferred Communication Methods for Deaf Residents
Penalty
Summary
The facility failed to ensure the rights of two residents who were Deaf to choose activities and health care services consistent with their interests, assessments, and care plans, and to participate in social and community activities. Both residents were not provided with their preferred method of communication, which was American Sign Language (ASL), and instead were limited to using whiteboards and written communication. Staff interviews revealed a lack of knowledge and training on how to use available technology, such as tablets with video relay interpreting services, and there was no consistent provision of in-person or video ASL interpretation for daily communication, medical care, or participation in activities. One resident, who was cognitively intact but non-speaking and Deaf, reported feeling isolated and unable to communicate needs, socialize, or participate in meaningful activities. The resident's care plan and speech therapy recommendations specified the use of live ASL interpreting services via tablet, but this was not implemented. Staff relied on whiteboards, which the resident was not comfortable using due to limited English proficiency, and staff were unaware of or unable to use the tablet for interpretation. The resident experienced psychosocial harm, including feelings of isolation, inability to communicate about medication changes, and lack of participation in activities due to the absence of interpreters. The second resident, who was also Deaf with highly impaired vision and moderate cognitive impairment, was similarly not provided with their preferred communication method. Although care plans and therapy notes recommended live ASL interpretation and the use of tablets, these were not made available to the resident on a regular basis. Staff and family interviews confirmed that the resident could not effectively communicate needs or participate in care discussions, and staff often resorted to writing, which was ineffective due to the resident's vision and handwriting difficulties. The lack of appropriate communication support resulted in the residents' inability to express preferences, participate in activities, and communicate with staff and peers.
Removal Plan
- Facility provided Residents #50 and #162 tablets programmed with the video relay interpreting service that were always accessible to the resident.
- Education was provided to the staff and residents on the use of the tablets.
- Tablets were to be kept in the resident's rooms.
- Facility provided in-service education to staff with plans for ongoing education of staff not currently on the schedule, prior to the start of their next shift.