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Understanding the Risks of Failing to Use Language Services in Healthcare

Published on January 25, 2017 by Graham Newnum

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Staff adoption presents an ongoing challenge for language service managers nationwide. Getting hospital staff to use an interpreter for every limited-English proficient (LEP) patient can be difficult, as can securing executive-level buy-in for a quality language services program.

Emphasizing benefits like improved HCAHPS scores and reduced readmissions may improve staff adoption, but it’s also important to talk about the potential consequences of noncompliance: hospitals today face legal liability and regulatory sanctions for failing to provide language access. Here are five reasons why using language services for every LEP patient is critical:

 1. Increased Risks of Negligence and Medical Malpractice

When a patient doesn’t understand what their healthcare provider is telling them, that patient can’t make informed decisions about their care, treatment options, or medical procedures. Doctors also risk misdiagnosing a patient if the patient is unable to accurately communicate their past medical history or their symptoms. This increases the risk of a harmful outcome, one that may cause providers to face significant liability for negligence and malpractice.

2. Increased Fines

If hospitals refuse to provide language services to those who need it, they may receive fines for national origin discrimination pursuant to Title VI of the Civil Rights Act of 1964. They may also receive fines for noncompliance with the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (the National CLAS Standards).

3. Increased Risk of Lawsuits 

Section 1557 of the Affordable Care Act empowered individual LEP patients to sue healthcare providers for failing to provide care in their language. Section 1557 allows these patients to claim national origin discrimination using a disparate impact argument – that a hospital’s failure to provide them in-language care constitutes illegal discrimination, regardless of intent. Staff adoption of language services is key to preventing these liabilities.


The Joint Commission’s accreditation factors in language services programs and processes for working with limited-English proficient patients. If your hospital fails to create and follow a language services plan, hospitals with Joint Commission accreditation may lose it, and those seeking accreditation may be denied.


The Americans with Disability Act and Rehabilitation Act of 1973 requires that a qualified American Sign Language interpreter is provided to ensure effective communication with Deaf or Hard of Hearing people. If there is not a qualified interpreter present, miscommunication may lead to mistakes in patient health and safety. This puts both the patient and the healthcare provider at risk for negligence, malpractice, and fines for noncompliance.

 Language Services Boost Hospital Performance Guide