In Part 1 of our F699 Trauma-Informed Care deep dive, we unpacked the foundational elements of trauma-informed care and why it’s more than just a buzzword in today’s regulatory landscape. Now, let’s take it a step further. Part 2 shifts our focus to cultural competency—an essential, and often underemphasized, component of trauma-informed care.
The Centers for Medicare & Medicaid Services (CMS) doesn’t just want facilities to recognize trauma – the Agency expects us to understand how cultural identity shapes a resident’s experience of trauma, healing, and trust. That means moving beyond generic care plans and into the realm of personalized, culturally responsive practices. If your team isn’t trained to recognize the nuances of cultural background, language, religion, and lived experience, you’re not just missing the mark—you’re missing the regulation. Let’s break down what surveyors are looking for and how to embed cultural competency into your care delivery in a way that’s both compliant and compassionate.
More Background on Cultural Competency
Per Appendix PP of the State Operations Manual, cultural competence refers to an individual’s ability to effectively interact with others who are of a different culture than their own. When applied to the healthcare setting, this refers to the behaviors and attitudes that staff hold which allow them to effectively communicate with residents/ representatives from various cultural backgrounds to plan for care which is culturally appropriate. This includes recognizing cultural and other needs/ preferences of the resident population such as:
- Language
- Cultural preference
- Religious preference
- Sexual orientation
- Gender identity
- Racial and ethnic diversity
- Food preparation and choices
- Clothing preferences
- Cultural etiquette
- Other cultural aspects, including communications, beliefs, values and customs
As you’d expect, any and all of these can influence the way we provide care and services – whether it’s offering a vaccination, recognizing dietary needs or staffing to provide same-sex caregivers. Administration should foster an environment where every resident feels respected, valued, and empowered to make choices about their care.
Link to the Facility Assessment
The Facility Assessment should include data about the facility’s residents, including information related to the areas indicated earlier. The Facility Assessment should not only capture demographic and cultural data about residents but also serve as a blueprint for staff education. This means identifying gaps in staff knowledge or skills related to cultural differences and implementing targeted training. Staff should be able to articulate how cultural factors influence care planning, daily routines, and resident choices, and demonstrate respect for residents’ identities and preferences.
Ftag of the Week: F838
View our revised Ftag of the Week for F838 here.
Communication is Key to Cultural Competence
Effective communication is foundational to cultural competency. CMS guidance highlights the need for staff to communicate in ways that residents can understand, including using preferred languages, interpreters, and accessible devices. Training should cover both verbal and nonverbal communication, active listening, and the use of technology (such as TTY/TTD or video conferencing) to support residents with different needs. Facilities should also ensure that written and oral notices are provided in languages and formats accessible to all residents.
In our next post, we’ll discuss trauma-informed care and discuss care planning related to these areas in more detail.
