Lack of Translated Discharge Instructions from Hospital Sparks Lawsuit from Patient

Bronze statue of Lady Justice.

A few months ago, Song Xie sued a hospital system in Texas saying that the hospital discriminated against him as a foreign-born, limited English proficient (LEP) person when it failed to supply him with translated discharge instructions.

In 2015, Song Xie was discharged from the hospital with post-discharge instructions written in English — a language neither he nor his son could read. Days later, Song Xie suffered a stroke and found himself readmitted into the same hospital.

A ruling by the U.S. Department of Health and Human Services on Section 1557 of the Affordable Care Act (ACA) requires healthcare providers to offer translations of key documents in the patient’s native language and access to qualified interpreters free of charge. Providers had until October 2016 to comply with key provisions of the ruling.

Xie’s case seems to be the first to address language access under Section 1557. Healthcare facilities should be watching this case closely to ensure their own language access plans are up to snuff.

Healthcare providers, especially, need to pay attention

Before you say, “This will never happen to me,” know that lawsuits like Mr. Xie’s are just the beginning. If you don’t fully comply with Section 1557, or employ a “wait and see” approach, you could be facing penalties.

According to Jaklyn Wrigley, an associate at Fisher & Phillips, Gulfport, “Aside from individual (or class-based) lawsuits, the government can also compel compliance. The penalty for non-compliance can be as insignificant as mandated implementation of a language access plan (i.e., the plan that speaks to an organization’s language access capabilities), or as serious as a total loss of federal funding.”

If monetary reasons aren’t enough to implement or tighten your language access plan, here are some other incentives:

  • LEP individuals make up a very large percentage (we’re talking in the millions) of the U.S. population.
  • Studies (like this one) show a strong correlation between quality and speed of care and the strength of a healthcare system’s language access plan.
  • Section 1557 and the implementation of its requirements is relatively new. Meaning, while healthcare providers may have complied with regulations thus far, the spirit of the law may yet be embedded in the culture fostered by healthcare staff.

Related: Speaking of Your Health: Communication and The Affordable Care Act

Healthcare providers need to be proactive

If you’re worried you’re not in full compliance with the law when it comes to meaningful language access for your LEP patients, it’s never too late to get back on track. Ensuring your LEP patients have access to all their healthcare information before there’s a problem takes careful planning, but it will be well worth the effort in the end. Here are a few things healthcare facilities and systems can do to make sure they’re compliant with Section 1557 and promote language inclusivity:

  • First, make sure you know your language demographics and are tracking them. This includes the number of interpreter requests made each month.
  • Then, take a quick look at your language access plan and evaluate it for gaps in coverage and confusing workflows.
  • Double-check that both over-the-phone interpreting (OPI) and translation services are easy to access by staff members.
  • Create an internal engagement campaign to make sure your staff knows about this lawsuit, knows what to do when they encounter an LEP patient, and encourages them to embrace accessibility and inclusion.
  • Build in period reviews and audits of your plan. As mentioned, Section 1557 is only a few years old, so best practices may shift as times goes on.

Want more on Section 1557 and language access? Download our Guide to Section 1557 for more information about the ruling, including the updates that went into effect in late 2020.

Take me to the Guide

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