Failure to Care Plan for Non‑English Communication Needs
Penalty
Summary
The deficiency involves the facility’s failure to develop and implement person-centered care plans addressing communication needs in residents whose preferred language was not the dominant language used in the facility. For one resident admitted with diagnoses including diabetes mellitus, muscle weakness, and malignant neoplasm of the large intestine and rectum, the admission record and MDS identified a preferred non-dominant language and a desire for an interpreter to communicate with doctors and health care staff. During interview, this resident reported understanding only some English words, not being fluent, and needing assistance to communicate needs. Observation showed a RN Supervisor using another licensed nurse to translate in the resident’s primary language, and the resident stated he could not communicate his needs in English. Despite this, the MDS coordinator confirmed there was no person-centered care plan developed to address this resident’s communication limitations and need for services in the preferred language. The second resident was admitted with hepatic encephalopathy, dysphagia, and a cognitive communication deficit, and the MDS documented moderately impaired cognition and the need for supervision or assistance with multiple ADLs. Progress notes indicated this resident also needed and wanted an interpreter to communicate with doctors or health care staff. During interview conducted in the resident’s primary language, the resident stated he could not make himself understood and could not fluently understand the language spoken in the facility, and he was unable to explain to staff that his television did not work and that the only audible channel was not in a language he understood. The MDS coordinator acknowledged that, based on the MDS information, both residents should have had person-centered care plans reflecting their communication limitations and language needs, but no such care plans existed. This failure occurred despite facility policies on accommodation of residents’ communication needs and resident rights, which required identification of communication requirements, documentation of preferences, and inclusion of these needs and interventions in the plan of care.
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