As the US population ages, the landscape of long-term care is shifting. According to the US Census Bureau’s American Community Survey, 25.7 million US residents over the age of five have limited English proficiency (LEP). At the same time, more than 50% of older adults born outside the US speak English less than very well. For leaders at skilled nursing facilities, assisted living communities and rehabilitation centers, these statistics are more than just numbers—they represent a challenge in providing equitable, safe and empathetic care.
In a setting where resident health depends on clear communication regarding symptoms, medication and emotional well-being, language barriers can be a critical risk factor. Providing meaningful access to information and services is not only a regulatory mandate but also a hallmark of high-quality care. By integrating professional over-the-phone interpreting (OPI) and video interpreting (VRI), facilities can bridge these gaps instantly.
The High Stakes of Language Barriers in Residential Care
The challenges of managing a long-term care facility are multifaceted, ranging from clinical outcomes to financial sustainability. Language barriers can exacerbate these challenges in two primary areas:
1. Clinical Risks and Resident Safety
Communication is the cornerstone of effective healthcare. When a resident cannot accurately describe their pain level, a reaction to a new medication or a change in their physical condition, the risk of medical errors increases. Clinical research also confirms that as cognitive impairment progresses, many residents experience a decline in secondary language fluency, often reverting to their primary native language, creating an urgent, 24/7 need for interpreters. This makes linguistic access a matter of basic clinical safety, not just a convenience.
Professional interpreters with knowledge of medical terminology are essential in these and other moments to ensure that clinical data is captured accurately. Relying on ad hoc interpreters—such as bilingual staff members who are not trained in medical interpreting or, worse, a resident’s family members—can lead to dangerous misunderstandings and omissions.
2. The Admissions and Intake Bottleneck
The first 24 hours of a resident’s stay are critical. Admissions directors need to navigate complex paperwork, medical histories and consent forms. If a resident or their family speaks English less than very well, the intake process can stall. This delay not only affects the facility’s census but also creates an immediate atmosphere of stress for the new resident. These delays during the intake process can also lead to incomplete clinical histories and medication errors, posing immediate safety risks to the resident. And in some populations, the need is even more acute. For example, about 40% of older Asian American adults newly admitted to skilled nursing facilities for dementia care between 2011 and 2022 required an interpreter, according to Trends and Healthcare Profiles of Older Asian American Adults With ADRD in U.S. Nursing Homes.
The Accentable Services Solution: On-Demand Interpreting
To address these challenges, Accentable Services provides a comprehensive suite of remote interpreting solutions designed to fit the fast-paced, 24/7 environment of long-term care.
Over-the-Phone Interpreting
Our over-the-phone interpreting services provide access to live, qualified interpreters in more than 260 languages and dialects.
- Speed: Connections are made within a few seconds for all major languages, which is vital during medical emergencies or late-night shifts.
- Convenience: There is no need for special equipment; staff can use the calling equipment they already have on-site.
- Cost-Effectiveness: At a rate of only $1.49 per minute, over-the-phone interpreting is a fraction of the cost of scheduling on-site interpreters, who often require multiple minimum-hour guarantees and travel fees.
Video Interpreting
For situations where visual cues are necessary, video interpreting services provide on-demand language access you can see.
- Visual Support: Our live video interpreters support 60+ spoken languages, as well as American Sign Language (ASL).
- Enhanced Engagement: Video interpreting is particularly effective for complex medical consultations, physical therapy sessions or family meetings where seeing the interpreter helps build trust and aids in non-verbal communication.
- Accessible Pricing: Video services are available for $1.79 per minute, providing a high-definition experience on any device with an internet connection.
Navigating the Regulatory Landscape: Section 1557 and HIPAA
Current federal law mandates language access for long-term care facilities that receive federal financial assistance through programs such as Medicaid and applicable Medicare funding streams. For compliance officers and administrators, the legal requirements for language access are a primary concern. Several key regulations govern how long-term care facilities must handle communication with individuals with limited English proficiency:
Section 1557 of the Affordable Care Act (ACA)
Section 1557 is the primary non-discrimination provision of the ACA. It prohibits discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs and activities. For facilities receiving federal financial assistance, including Medicare and Medicaid, this means providing meaningful access to LEP individuals. This includes providing qualified interpreters at no cost to the resident. Accentable Services offers professional, trained interpreters designed to help your facility meet the language access requirements mandated under Section 1557 and Title VI standards.
Title VI of the Civil Rights Act
Title VI requires that programs receiving federal funds ensure LEP individuals have meaningful access to their services. Beyond avoiding regulatory scrutiny, consistent language access is a clinical best practice that drives higher patient satisfaction scores and improves long-term health outcomes.
HIPAA and Confidentiality
Data privacy is non-negotiable in residential care. Accentable Services has designed its infrastructure to support HIPAA compliance. We implement technical and administrative safeguards for Protected Health Information (PHI) and execute Business Associate Agreements (BAAs) with qualifying healthcare accounts.
Identifying the Need: When to Call an Interpreter
Determining when an interpreter is necessary is the first step in a successful language access plan. It is often beneficial to secure an interpreter if a resident:
- Requests an interpreter directly.
- Relies on family or friends to interpret complex medical information.
- Has difficulty understanding or responding to open-ended questions in English.
- Prefers to communicate in their first language, even if they have some English proficiency.
In some cases, the resident may speak a language that is less common or an Indigenous dialect. For example, while most residents from Mexico speak Spanish, some may speak Indigenous languages such as Mixteco. Accentable Services offers interpreting in specialized dialects like Mixteco Alto and Mixteco Bajo to ensure comprehensive coverage for regional and Indigenous language speakers.
Implementation Made Easy
We understand that facility staff are often stretched thin. That is why we have designed our onboarding process to be as seamless as possible:
- Sign Up Online: Your account can be set up within minutes through our website.
- Instant Access: Once registered, you can connect to an interpreter 24/7/365.
- Training Support: We provide quick start guides and training materials for you and your staff to ensure everyone feels confident using the interpreting services right away.
A Partner in Excellence
In the demanding world of long-term care, communication should never be the barrier that stands between a resident and their health. By partnering with Accentable Services, your facility can provide professional, dignified and compliant care that truly honors the diverse lives of your residents.
Better communication leads to better outcomes. It reduces the risk of readmissions, ensures regulatory compliance and most importantly, provides peace of mind to residents and their families.
Ready to provide your facility with complete language support? Sign up online today to get instant access to live interpreters.