Failure to Provide and Implement Communication Devices and Translation Services for Non-English-Speaking Resident
Penalty
Summary
Surveyors identified a deficiency in the facility’s failure to provide an effective communication device for a resident with a known language barrier and severe cognitive impairment. The resident had diagnoses including hemiplegia and hemiparesis following a cerebral infarction affecting the left non-dominant side, and epilepsy. The most recent quarterly MDS showed a BIMS score of 2/15, indicating severely impaired cognition, and documented that the resident’s preferred language was a non-English dialect and that an interpreter was needed. The comprehensive care plan for communication, initiated/revised on 8/22/25, specified that staff who spoke the same dialect could translate, that the family was available by phone to translate, and that the resident had a communication board in the room. However, during an observation on 1/5/26, the CNA assigned to the resident could not locate a communication device and confirmed there was no communication board in the room. Interviews and record review further showed that the facility did not effectively implement its own translation services policy. A family representative reported arriving at the hospital for an appointment with the resident and being told the facility had cancelled the appointment, then going to the facility and speaking with the resident, who spoke minimal English. Staff interviews revealed that the MD did not speak the resident’s language and communicated only by speaking slowly and observing the resident, without using any translation device or service, and that the facility did not provide such services. An LPN/charge nurse stated there was no translation or ancillary communication device in the facility. Later, in the presence of the DON, the LPN produced binders with words and images that she stated she found under the bedside table, and the surveyor noted staff were not aware of this communication device and it could not be located prior to the surveyor’s inquiry. The facility’s written policy, revised 1/2020, stated that the facility maintained a contracted relationship with a translation service and that family and friends should not be relied upon for interpretation unless explicitly requested by the resident and with written consent, but no further information was provided to demonstrate implementation of this policy.
We Help Long-Term Care Teams Stay Survey-Ready
We process and analyze inspection reports and plan of correction using AI to extract insights and trends so providers can improve care quality and stay ahead of compliance risks.