Home Health & Hospice

Be Careful When Translating Patient Rights

Homecare Insider, August 17, 2009

A Beacon Institute member encountered a surveyor’s wrath over the agency’s patient rights’ statement.
Where does it say that our agency’s statement of rights must match the Conditions of Participation word-for-word?  We translated the regulations into patient-friendly language and our surveyor says we are not in compliance with the Conditions.  She is not happy and we may be getting a citation.

The Conditions of Participation require the agency to present the patient with a written statement of rights.  There is no requirement that it must match word-for-word with the regulations, but the statement must include all the rights.  When an agency translates difficult-to-understand regulations into other terms, it’s not hard for things to go astray, kind of like traveling in a foreign country.  There’s a risk of losing something in translation.  One might think she is ordering steak and vegetables, only to get a chicken, cheese, and tomato salad instead.

Some examples of things agencies tend to miss when converting the rights to patient-friendly documents include the patient’s right to respect of property and the right of the patient’s family or guardian to exercise the rights when the patient is judged incompetent.  It’s also not easy to translate some of the concepts.  How do you translate “incompetent” into patient-friendly language when the regulations do not define the term?

To avoid a citation, this agency must go word-by-word through the Conditions and highlight the corresponding language in its rights statement to show that the agency did not miss any concepts in its translation.  There’s a very good chance the surveyor will debate some of the language so a discussion may be necessary.

Avoid a surveyor’s challenges with this approach.  First, include the regulatory language and then add the translations.  Example:  The wording on the agency’s statement of rights reads, “The home health agency must maintain documentation showing that it complied with the requirements of this section [the regulatory language].”  That means, the nurse or therapist will ask you to sign a form to confirm that we have followed the government’s regulations about your rights” [the patient-friendly language].”  This approach helps ensure that the agency’s statement of rights will include all the regulatory language the surveyor looks for, in terms that patients can understand.

Two educational DVDs can help an agency demonstrate compliance with the patient rights’ requirements.  Find out about the one for leadership and clinical staff at —  and the one for home health aides.