Senior Care Language Services: Language Access in Elder Care

Language access in health care settings promotes effective communication between health care providers and limited-English proficient (LEP), Deaf, and Hard of Hearing patients as 1 in 5 U.S. residents now speak a language other than English at home. This year has brought attention to serving the needs of our most vulnerable LEP populations, including seniors utilizing health care services. Senior Care Language Services are vital for organizations providing elder care services.

How important are Senior Care Language Services? 8% of Medicare beneficiaries are limited English proficient.

Non-discrimination laws and regulations mandate that programs and activities receiving federal financial assistance must provide qualified interpreters and translated materials for LEP, Deaf, and Hard-of-Hearing patients. New trends in language services have emerged due to the global coronavirus pandemic, and facilities providing aged care services may be new to utilizing remote language services, which have skyrocketed to ensure safety with necessary social distancing measures.

Today, we’ll look at the importance of language access in elder care, important changes for Medicare beneficiaries, and provide an overview of senior care language services that are appropriate to the unprecedented need for social distancing in aged care facilities such as nursing homes, assisted living facilities, and home health care. 


The Importance of Senior Care Language Services

Medical interpreters in aged care settings help at every step of the patient journey – from routine medical services to laboratory and hospital procedures. Although languages access is crucial to all LEP patient communications, here are just a few situations where senior care language services facilitate communication:

  • Taking a medical history
  • Giving a diagnosis
  • Performing medical procedures
  • Understanding treatments and prescriptions
  • Understanding discharge and follow up instructions
  • Admission to ER or urgent care
  • Initial medical consultations
  • Physical checkups
  • Surgery
  • Informed consent
  • Communicating with family non-English speaking family members


Senior Care Language Services: Key Facts about Medicare and Limited English Proficiency

  • 52% of limited-English proficient Medicare beneficiaries speak Spanish
  • 8% of Medicare beneficiaries are limited English proficient. (ACS, 2014)
  • There are about 4 million LEP Medicare beneficiaries. (ACS, 2014)
  • 80% of LEP Medicare/Medicaid beneficiaries reside in the East Coast, West Coast, and Southwest


Non-English languages most commonly spoken by Medicare beneficiaries:

1. Spanish, 52%

2. Chinese, 5%

3. Vietnamese, 4%

4. Tagalog, 4%

5. Korean, 4%

6. Russian, 3%

7. Italian, 3%

8. Cantonese, 2%

9. French Creole 2%

10. Other Languages, 2%

Source: Centers for Medicare and Medicaid Services (CMS)


States with the highest share of limited-English proficient Medicare beneficiaries:

The national average for Medicare Beneficiaries with limited English proficiency was 7.7% as of 2017. Two-thirds of LEP Medicare beneficiaries reside in California, New York, Florida, and Texas. The following 12 states reported the highest numbers of limited English proficient beneficiaries.

1. California, 30%

2. Hawaii, 19%

3. New York, 16%

4. Texas, 13%

5. New Jersey, 12%

6. Florida, 12%

7. Massachusetts, 11%

8. New Mexico, 10%

9. Rhode Island, 10%

10. Illinois, 8%

11. Nevada, 8%

12. Connecticut, 8%

Source: Centers for Medicare and Medicaid Services (CMS)


Geographic Distribution of LEP Populations in Medicare and/or Medicaid (Infographic)

Limited English Proficient Population in Medicare and/or Medical

Source: ACS PUMS, 2014  


Senior Care Language Services: Changes in Language Access Requirements for Home Health Agencies

Between 1990 and 2018, the number of Medicare home health agencies has nearly doubled. Standards of care have also increased, which include language access requirements to serve Medicare and Medicaid beneficiaries who rely on home health agencies. Minimum standards, known as CoPs, must be met by home health agencies to participate in Medicare. Failing to comply with CoPs can lead to program termination for sanctions from Medicare.

Statistic: Number of Medicare home health agencies in the U.S. from 1967 to 2018* | Statista
Source: Statista

Home Healthcare Providers must provide a “Notice of Rights” to patients and their representatives during the initial evaluation visit, and before the HHA can provide care. LEP Patients and those with disabilities must be provided notices that are understandable to them. In addition, Home Health Agencies must verbally provide these notices in the patient’s primary or preferred language. If an interpreter is needed, they must be provided at no cost to the patient.

Home Health Agencies must provide information in a way that is both timely and accessible to the patient, and must be provided instructions for how to access services. For patients with limited English proficiency, this means access to translated materials and interpreters (via Phone, Video Remote or On-site), and for deaf or hard-of-hearing patients, access to auxiliary aids, and services like qualified interpreters (via VRI or On-site).

“To address effective communication with patients who are limited English proficient (LEP) or have disabilities, we proposed a new standard at § 484.50(f), “Accessibility.” We proposed that information that is provided to patients would have to be provided to the individual in plain language, and in a manner that is both accessible and timely.”

“§ 484.50(c)(12) that patients have the right to be informed of their right to access auxiliary aids and language services, and to be provided instruction on how to access these services.”

Ҥ 484.50(f)(2) Persons with limited English proficiency through the provision of language services at no cost to the individual, including oral interpretation and written translations.


The final rule revising the conditions of participation (CoPs) that home health agencies (HHAs) must meet in order to participate in the Medicare and Medicaid programs can be found on the Federal Register website.


Senior Care Language Services: Top Considerations for Providers

Home Health Agencies New Medicare CoPs in 2018Language Access Compliance: If your organization receives payments from Medicare or Medicaid, Section 1557 of the Affordable Care Act may require you to provide language services to limited-English proficient patients. This mandates the posting of non-discrimination signage and the availability of language services in the top 15 non-English languages of your state and using qualified interpreters in health care settings.

Patient Safety and Language Access: 9% of the United States population is at risk for an adverse patient safety event as the result of a language discrepancy. Language barriers can cause miscommunication errors that result in adverse patient events and patient harm.

A report on Adverse Events in Skilled Nursing Facilities by HHS found that 22% of Medicare beneficiaries experienced adverse events during their SNF stays, and 11% percent of Medicare beneficiaries experienced temporary harm events during their SNF stays. It was also determined that 59% of the adverse events and temporary harm events were clearly or likely preventable.

Health Services Research has found the use of professional medical interpreters to positively impact patient care: “Use of professional interpreters is associated with improved clinical care more than is use of ad hoc interpreters, and professional interpreters appear to raise the quality of clinical care for LEP patients to approach or equal that for patients without language barriers.”

Language Access Results in Higher Levels of Patient Satisfaction: In a review published by,  studies found that patient satisfaction increased with hospital-trained interpreters when compared with ad hoc, and that video remote interpreting had the same satisfaction as in-person interpreting, regardless of whether the patient and the physician are in the same room.

COVID-19 Telehealth Coverage Expansion: Make sure that non-English speaking patients are included in your telehealth efforts. Under the COVID-19 telehealth coverage expansion, healthcare providers such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers, are able to offer telehealth to Medicare beneficiaries. Beneficiaries are able to receive telehealth services in any healthcare facility including a physician’s office, hospital, nursing home, or rural health clinic, as well as from their homes. Certified medical interpreters can be easily integrated to provide senior care language services into any telehealth call via video or phone.

Safety and Ease of Use in Language Access Services: Seniors in residential care facilities, especially with underlying medical conditions, are among the most vulnerable to COVID-19. Remote language services, such as telephonic interpretation and video remote interpretation, provide safe (no contact) access to remote interpreters. The ease of use also promotes staff adoption and overall efficiency.

Telelanguage provides Video Interpretation Services and Telephonic Interpretation Services to thousands of organizations nationwide. Our proprietary technology ensures that our clients have fast and reliable access to certified medical interpreters – available 24/7, 365 days a year.

In light of the COVID-19 crisis, Telelanguage offers all new accounts our language interpretation and translation services with no contract required.

  • Quick and Easy: Account set-up can be done remotely and completed in minutes. You can begin offering your communities over-the-phone, or video interpretation and translation services the same day you call – with the equipment you likely already own!
  • Free Support Materials and Staff Training: Telelanguage can also provide free customized electronic, and printed, reference material for you to distribute to your families, communities, patients, and staff. Unlimited staff training can be conducted via webinar or conference call to ensure efficient use of services.

Call 1-(877) 968-0642, or email [email protected] for more information!


How Telelanguage Can Help with Senior Care Language Services

Make sure that non-English speaking patients are included in your telehealth efforts for the COVID-19 telehealth coverage expansion. During these challenging times, health care providers have seen an increased need for remote language services. Telelanguage has added additional staff to take on the increased volume of calls. Many facilities – particularly healthcare – are forced to send staff interpreters home, requiring that they move towards a telephonic and video interpretation solution. Telelanguage’s remote implementation procedures allow activation of new accounts (or new departments within existing accounts) within minutes over the phone or via an online chat. Interpretation can begin immediately upon account activation.


Language Access and Aged Care: Organizations We Help

  • Hospitals
  • Telehealth
  • Urgent Care and Emergency Medicine
  • Health Insurance
  • Medicare Health Plans
  • Nursing Homes
  • Private Practices
  • Assisted Living Facilities
  • Memory Care
  • Nursing Homes and Skilled Care Facilities
  • Home Health Care
  • Continuing Care Retirement Communities
  • Palliative Care
  • Hospice Care
  • Geriatric Care Management Services (Public and Private)


Video Remote Interpreting

Video Remote Interpreting, or VRI, is the fastest-growing foreign language service in the country. An on-demand interpretation solution, VRI bridges the gap between telephonic interpreting and on-site interpreting and senior care language services can be easily integrated into a telehealth system. VRI provides the highest level of accuracy in telehealth interpretation with the added visual support of the interpreter, enabling healthcare providers to communicate with limited-English proficient, Deaf, and Hard-of-Hearing patients.

With easy access from any smartphone, tablet, laptop or PC, a live medical interpreter can be added to your appointment in seconds. Press one button and choose your language.

  • Fast connections to medically certified interpreters
  • Low per-minute rate. No minimums.
  • No special hardware needed.
  • Remote interpreting solutions for spoken languages and American Sign Language.
  • Easy access from any iOS/Android device (smartphone/tablet), laptop, or PC.
  • Available 24/7, 365 days a year.

VRI promotes the highest level of accuracy in interpreting, second only to on-site interpreting. Telelanguage provides HIPAA, HITECH, and ADA compliant VRI services that can be accessed in seconds, available 24/7, 365 days a year – with assembly from any office or field site.

DOWNLOAD the Free Whitepaper to Help Your Organization Harness the Power of Video Remote Interpretation!


Telephonic Interpretation

Telephonic interpretationTelephonic Interpretation Services | Telelanguage is an on-demand, remote interpreting service that offers a fast response when urgent or unexpected language barriers come up. Telephone interpreting bridges the language gap in areas where on-site interpreters cannot, such as an emergency situation that requires a fast response, or when social distancing measures are necessary for patient safety. Over-the-phone interpreting allows health care professionals to connect with patients in over 300 languages. Telelanguage’s filter-based qualification interpreter connect feature allows providers to connect with a certified medical interpreter best qualified for the situation – in as little as 3-4 seconds.

  • Low per-minute rate
  • Fastest connection times in the industry
  • Multiple location and real-time transferring
  • 24x7x365 customer service support

Telelanguage offers Free Service Trial Programs where you can test our services before entering into an agreement, and no contract language services to support organizations during the COVID-19 health crisis.

*All interpreter support materials such as language posters, dialing instructions, tips on effective communication with LEP including dual handset phones are all provided for Free.


Translation Services

Translation services require not only target language/English proficiency, but also a high level of detail and comprehension to topic-specific terminology.

At Telelanguage, our translators are subject-matter experts who have been through specialized training to meet the unique set of skills, knowledge, and experience to ensure proficiency in medical, education, and social services content, formatting, etc. Telelanguage only uses translators that have native fluency in both the Target Language and English, and have at least 2 years experience in written translation.


Healthcare Language Services to Fit Your Needs

Language Access in Healthcare: Health Care Interpretation Services eBook | Telelanguage

Download Your Free Copy!

When language barriers arise in health care settings, you need a language services provider that can respond quickly to the unique needs of your organization. Telelanguage Healthcare Interpretation and Translation Services provide the solutions you need to improve language access at every step of the patient journey. Certified Medical interpreters are available 24/7/365 days a year.


  • Telephonic Interpretation
  • Video Remote Interpretation
  • On-Site Interpretation
  • Document Translation of vital forms, and notifications


Telelanguage helps healthcare organizations increase overall patient satisfaction and experience, comply with government regulations and standards, and increase the quality of care for LEP patients… all while reducing interpretation costs to our clients.

Learn More About Language Access in Healthcare. Download the Free eBook!


Confidentiality and Compliance

Telelanguage healthcare interpreters are superior-trained, tested, and certified. This process includes an understanding of medical terminology and procedure to provide the highest quality language interpretation for your patients – every time!

Confidentiality and security of patient information are critical to language access in health care. Telelanguage provides 100% HIPAA compliant services, providing meaningful language access and compliance to meet the requirements of:

  • Affordable Care Act, Section 1557 (ACA)
  • Health Insurance Portability and Accountability Act (HIPAA)
  • Title VI of the Civil Rights Act of 1964 (Title VI)
  • Americans with Disabilities Act (ADA)
  • Centers for Medicare & Medicaid Services (CMS)
  • Fraud, Waste and Abuse (FWA)
  • Protected Health Information (PHI)
  • The Joint Commission


Why Health Care Organizations are Switching to Telelanguage

  • Medically trained and certified interpreters
  • HIPAA Compliant Services
  • Lower Cost
  • Free Service Trial Programs
  • Best-in-Industry Call Volume Discount Plans
  • Proprietary Technology
  • Quick interpreter connect to over 300 languages


Getting Started with Telelanguage is Easy

Since 1991, Telelanguage has helped thousands of healthcare organizations to improve language access programs through superior language interpretation and translation services. At Telelanguage, more than 70% of our clients are healthcare entities. We work with health care organizations to provide senior care language services that improve your language access program while reducing your interpretation costs, and increasing patient satisfaction. Every organization has unique needs. That’s why we tailor our service to your exact requirements. We are committed to providing the best medically trained health care interpreters to improve language access programs across the country.

As a trusted provider of medical interpretation and translation services, we believe that all health care organizations should have affordable access to the best-qualified language support. We support over 350 languages, 24x7x365 utilizing 6,000+ U.S.-based interpreters. Telelanguage currently supports over 8,000 accounts around the world – in all industries. Services include over-the-phone, video remote interpretation, as well as document translations, on-site interpretation, interpreter management and scheduling, reporting, invoicing, language assessment evaluations, and much more.


COVID-19 Language Support: Learn More about No Contract Language Services


Certified healthcare interpreters ready to speak in over 300 languages!

Call Telelanguage today at (888) 654-3540

Certified medical interpreters available telephonically, face-to-face, or via video remote!