Failure to Honor Resident’s Right to Communication in Primary Language and Respectful Treatment
Penalty
Summary
The deficiency involves the facility’s failure to ensure a resident was treated with respect and dignity and informed of and supported in exercising her right to communication in her primary language. The resident was an older female with dementia, insomnia, anxiety disorder, hyperlipidemia, difficulty in walking, PTSD, cognitive communication deficit, bipolar disorder, and hypertensive heart disease, with a BIMS score of 15 indicating mild cognitive impairment. She required assistance with ADLs and transfers. During an observation and interview, the resident’s hands were trembling as she reported feeling labeled as “bipolar,” experiencing high anxiety throughout her body, frequent crying, and compulsive picking at the skin on her chin. She attributed her heightened anxiety in part to medication changes and confrontations between her responsible party and the facility. The resident reported that a medication aide spoke to her only in Spanish, even though her primary language was documented as English, and she felt obligated to speak Spanish to receive her medications and to show respect to the aide’s preferred language. She stated she did not know she had a right to be spoken to in her primary language and expressed that she did not want to upset anyone, so she would continue speaking Spanish to obtain her pain medications. She also stated she had previously spoken with the Administrator and DON about her concerns but could not recall when. The ADON confirmed that the resident frequently came to her to confide and had recently expressed feeling that nobody in the facility liked her. Facility staff, including the medication aide and ADON, acknowledged that residents have the right to be spoken to in their preferred language, and the facility’s written policy stated that residents must be informed of their rights and responsibilities in a language understandable to them, with accommodations for limited English proficiency and foreign languages commonly encountered in the community.
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