By Garret DeReus
This article examines how healthcare facilities have a legal obligation to provide effective communication for patients with disabilities and limited English proficiency. A Louisiana court ruling highlights the importance of providing appropriate accommodations like ASL interpreters for deaf patients, while a separate inspection found similar issues with non-English speaking residents.
Understanding the ADA and Rehabilitation Act Requirements for Healthcare Facilities
In the case King v. Our Lady of the Lake Hospital, Inc., the United States District Court for the Middle District of Louisiana ruled on a motion for summary judgment in a case brought by a deaf patient. This case illustrates the legal requirements that healthcare providers must meet when treating patients with disabilities.
The Case: King v. Our Lady of the Lake Hospital
Sandra King, a deaf individual who primarily communicated through American Sign Language (ASL), brought action against Our Lady of the Lake Hospital under the Americans with Disabilities Act (ADA) and Rehabilitation Act (RA). King alleged that during three hospitalizations in 2017, the hospital failed to provide consistent ASL interpreters, forcing her to rely on lip reading and written notes to communicate with medical staff.
The Court’s Decision: Equal Opportunity to Participate in Healthcare
The United States District Court for the Middle District of Louisiana denied the hospital’s motion for summary judgment, finding genuine issues of material fact existed as to:
- Whether King received an equal opportunity to participate in her healthcare compared to non-disabled patients
- Whether she would seek treatment at the hospital again, supporting her standing to seek injunctive relief
Key Legal Principles Addressed
The court emphasized several important principles:
- The ADA and RA focus on providing an “equal opportunity to participate in or benefit from” healthcare services
- It is not enough that a patient ultimately receives correct medical treatment; they must be able to effectively communicate throughout the process
- Whether requested auxiliary aids (like ASL interpreters) are necessary is an “inherently fact-intensive inquiry”
- Deaf patients need not demonstrate substandard medical care to prove discrimination
Beyond Disability: Communication Barriers in Nursing Homes
Communication barriers aren’t limited to disability cases.
I secured and reviewed a public record documenting a September 21, 2023 inspection of Chateau Living Center in Kenner, LA, which revealed that Resident #80, a Spanish speaker, lacked proper communication accommodations. Despite the facility’s care plan specifically stating “Resident #80 would have a communication board in order to communicate more effectively,” staff members confirmed that no such tool was provided. When interviewed, a Licensed Practical Nurse admitted “Resident #80 did not have a communication board to interpret Spanish into English,” leaving the resident unable to effectively communicate with staff or visitors. This case demonstrates that healthcare providers must address communication needs for all residents, regardless of whether they have a recognized disability or simply speak a different language.
The Dangers of Ineffective Communication: Pressure Ulcers and Patient Safety
Effective communication isn’t just a legal requirement—it’s vital for patient safety. For example, pressure ulcers (also known as bedsores) represent a serious risk for hospitalized patients with limited mobility. When communication barriers exist, patients may not understand crucial prevention instructions about repositioning. They may be unable to effectively communicate pain or discomfort in early stages when intervention would be most effective. Educational materials about recognizing early signs may be inaccessible, and patients cannot adequately participate in their care plan development.
A communication gap can be particularly dangerous for patients who rely on visual communication or speak different languages, as they may miss verbal alerts or instructions that could prevent these painful and potentially life-threatening wounds from developing or worsening.
Impact on Healthcare Providers in Louisiana
These cases clarify that Louisiana hospitals, nursing homes, and other healthcare facilities must:
- Provide appropriate auxiliary aids when necessary for patients with disabilities
- Ensure deaf patients can effectively communicate medically relevant information
- Create personalized care plans for patients with limited English proficiency
- Maintain policies that protect all patients’ right to equal participation in their healthcare
As the court noted in King, a patient “has still been denied the equal opportunity to participate in healthcare services whenever he or she cannot communicate medically relevant information effectively with medical staff.”
When Healthcare Facilities Fail: Understanding Your Rights
When a healthcare facility fails to provide effective communication—whether through sign language interpreters, communication boards for non-English speakers, or other necessary accommodations—they may be violating state or federal law.
An experienced attorney can help you navigate this complex legal landscape. Through litigation, attorneys have access to powerful tools unavailable to individuals conducting private investigations, including:
- Subpoena power to compel testimony from facility staff and administration
- Ability to conduct formal depositions under oath
- Access to internal policies, training materials, and documentation through discovery
- Power to request and review communication assessments and care plans
- Ability to obtain facility inspection reports and complaint history
These legal tools can uncover systemic problems and patterns of discrimination that might otherwise remain hidden. It is reasonable to expect that a healthcare facility will respond more thoroughly to legal discovery than to informal requests.
If you believe your rights or those of a family member have been violated, consider speaking with an attorney who handles disability rights or medical malpractice cases. Many offer free consultations to evaluate your situation. Don’t assume that poor communication is simply an unavoidable part of healthcare—it could be a violation of your legal rights.