Interpreters and Language Rights in Senior Care in California

California Health and Safety Code section 1259 says that when language or communication barriers exist between patients and staff of a general acute care hospital, arrangements shall be made for interpreters or bilingual staff. Under the section, each hospital must:

• Adopt, and review every year, a policy for providing language assistance, including the use of an interpreter whenever a language barrier exists, unless the patient, after being told an interpreter is available, chooses to have a family member or friend interpret.
• Aim to have interpreters available on site or by telephone 24 hours a day, to the extent possible.
• Post notices in the emergency room, admitting area, entrance and outpatient areas saying that interpreters are available on request and how to complain about interpreter services.
• Record the patient's primary language and dialect, for example on the chart or bracelet.
• Review the forms and papers given to patients at admission to decide which to translate.

The section defines a language barrier for spoken language by reference to groups that make up at least 5 percent of the hospital's service area or patient population, so the languages covered differ from one hospital to another. If your parent's language is less common, ask anyway: the hospital's own policy may cover phone or video interpreters for more languages.

A hospital stay is often when a family first starts looking at care homes. California Health and Safety Code section 1262.5 requires hospitals to inform the patient and the family caregiver of the care needed after discharge, including about medications. That information must be given in a culturally competent manner and in a language the patient and caregiver can understand, with a chance for the caregiver to ask questions.

Ask for an interpreter at the discharge meeting, not only for the doctor's rounds. Ask for the written instructions and medication list in your parent's language where the hospital has them. Our guide to hospital discharge to assisted living covers the rest of that process.

For Medi-Cal, the California Department of Health Care Services' 2026 member handbook template for managed care plans says the plan provides oral interpretation and sign language from a qualified interpreter, 24 hours a day, at no cost to the member. It says members do not have to use a family member or friend as an interpreter, and that the plan discourages using minors as interpreters except in an emergency. The template also lists written translations and other formats, such as large print and braille. Each plan prints its own phone numbers in its handbook.

Medicare's "Your rights" page says people with Medicare have the right to Medicare information and health care services in a language they understand, and to plan information in another language by contacting their plan. Medicare.gov also says anyone can call 1-800-MEDICARE (1-800-633-4227) and ask for an interpreter, 24 hours a day, 7 days a week, except some federal holidays.

At the federal level, the U.S. Department of Health and Human Services Office for Civil Rights says two laws, Title VI of the Civil Rights Act of 1964 and Section 1557 of the Affordable Care Act, require programs that receive its funding to provide language assistance services free of charge. Its examples include visiting a doctor, picking up a prescription and visiting a family member in a nursing home. That page was last reviewed in July 2025.

Assisted living communities and board and care homes are licensed in California as residential care facilities for the elderly (RCFEs). They are not hospitals, and section 1259 does not apply to them. Their Title 22 rules say:

We found no rule requiring an RCFE to provide an interpreter for daily care or to translate the admission agreement. Some homes will, and some have staff who speak your parent's language. Our guide to finding a care home in your parent's language lists the questions to ask on a tour. For the agreement itself, see the RCFE admission agreement, and ask an elder law attorney if your family needs help understanding it before signing.

A few habits make it easier to get help in your parent's language:

1. 1

   Say the language and dialect

   Tell the hospital, doctor's office or plan the exact language and dialect when you book or arrive, and ask that it be recorded.

2. 2

   Ask before the conversation starts

   Ask for an interpreter before rounds, the discharge meeting or a care home assessment, not halfway through.

3. 3

   Decide who interprets

   Your parent may choose a relative, but with Medi-Cal plans and hospital policies, a qualified interpreter is the default offer.

4. 4

   Ask for papers in the language

   Ask for translated forms, instructions and medication lists, and keep copies.

5. 5

   Complain if it does not happen

   Hospital notices must say how to complain about interpreter services. Medi-Cal plans list a member services number in the handbook.

Hamssa Benrekia speaks English, Arabic and Spanish, and she can talk with your parent in their own language on care home tours. She is not a medical interpreter, and she cannot promise that any home has staff who speak a given language. She helps families in the South Bay and Harbor area of Los Angeles County, including families leaving the hospital through hospital discharge placement, find licensed board and care homes and assisted living. To talk it through, contact Hamssa. More topics are in the California Assisted Living Placement Guide.