Home Health & Hospice Week

Professional interpreters should be first choice.

Just how far do you need to go to make sure your non-English-speaking patients are receiving quality translation of the patient rights and other information you’re giving them? It may be farther than you think.

The Centers for Medicare & Medicaid Services clarifies in the Conditions of Participation final rule that home health agencies don’t have to have a written patient rights notice in every single language (see story, p. 123). But they do have to make sure the notice is “understandable” to patients, and that will mean an oral interpretation if a written one isn’t available.

“The use of technology, remote interpretation services, and patient-selected interpreters should accommodate most situations, alleviating potential concerns regarding an ‘unforeseen inability’ to communicate with patients in advance of furnishing services,” CMS says in the rule published in the Jan. 13 Federal Register.

While patient-selected interpreters (usually family or caregivers) may fill in the gap, providers should strive to use professional interpreters when possible, CMS says. “The most reliable way to assure that communication is effective is to use the services of a professional interpreter who possesses appropriate training and certifications to perform his or her job duties as an interpreter,” the agency says in the final rule.

“A patient should be informed of the availability of professional interpretation services, regardless of whether the patient offers to provide an interpreter,” CMS instructs. If the patient still wants to use her own selected interpreter, it’s her right to do so.

Exception: Very rarely, it may be impossible to locate a professional interpreter, even using a communication device such as the telephone, CMS allows. Then, “the HHA may use a patient-selected interpreter, such as the patient’s representative,” without offering professional services, the agency also says.

“The use of minors to serve as interpreters should be a last resort and only used in emergency circumstances,” CMS adds.

Document this: HHAs “may wish” to document the refusal of a professional interpreter, but they don’t have to, CMS permits. “Title VI of the Civil Rights Act does not require documentation, and we do not intend to require anything above and beyond what is currently required in Title VI. HHAs have the flexibility to document more information, but it is not a regulatory requirement.”

Smart agencies will err on the side of caution and document the choice to avoid survey trouble down the road, experts suggest.