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Interpreters for Hospital Family Meetings

A family meeting is where a care team and the people closest to a patient talk about prognosis, treatment limits, discharge or the end of life, and decide things that cannot be undone. When the family does not speak English, the interpreter carries all of it. Here is who has to provide that interpreter, what the meeting asks of one, and how to run it.

If the hospital receives federal funds, the hospital provides the interpreter — for the family too

The Section 1557 rule applies to any recipient of federal financial assistance (45 CFR 92.4). Under 45 CFR 92.201 such a covered entity must take reasonable steps to give meaningful access to each person with limited English proficiency, and it names companions expressly. A companion is a family member, friend or associate whom the hospital should be communicating with alongside the patient — which describes the people at a family meeting. The language help must be free of charge, accurate and timely, and must protect the person's privacy and independent decision-making. When interpretation is needed, it must come from a qualified interpreter, and the hospital may not require anyone to bring or pay for their own.

So if you are a relative and the meeting is with a hospital or health system that takes federal money, ask the nurse, the social worker or the patient relations office for an interpreter for the meeting, and expect one. You should not be paying us for it. If the family includes people who speak different languages, say so: each language needs its own interpreter.

Who books us, then. Hospitals, palliative care and social work teams whose usual service is phone-only, when a long multi-person meeting needs an interpreter in the room or on video, or when the language is one their vendor cannot cover on the day. Hospices, nursing facilities and home health agencies holding a care conference at the facility or in the home. And families, for the conversations that are not part of a hospital's program — with an elder law attorney, a private care manager or a funeral home.

Why a relative should not interpret

The rule is specific. A covered entity must not rely on an accompanying adult who is not a qualified interpreter, except as a stopgap in an emergency, or when the patient asks for it in private, with a qualified interpreter present and the companion absent, and the request and the agreement are documented. It must not rely on a minor child except as an emergency stopgap (45 CFR 92.201(e)).

The reasons are sharper in a family meeting than anywhere else in the hospital. The bilingual daughter is not a neutral channel: she is often a decision-maker herself, she is grieving, and she may decide on her own that her father should not hear the word "dying." Families sometimes ask the team to withhold a prognosis from the patient; whether and how to do that is a conversation for the team and the family through an interpreter, not a decision for whichever relative is translating. And a relative who interprets cannot also take part in the meeting as a relative, which is the reason they came.

What a family meeting asks of an interpreter

Most of it is consecutive interpreting among many people: a physician, a nurse, a social worker or chaplain, and several relatives who talk over one another, sometimes in two languages and sometimes with one relative abroad on a phone. The vocabulary is clinical and decisive — code status, do-not-resuscitate and do-not-intubate orders, intubation, dialysis, a feeding tube, comfort care, hospice, a skilled nursing facility, a health care proxy — and several of those terms have no settled equivalent in the family's language. The interpreter renders what the clinician says and tells the clinician when a term needs explaining; the explanation itself has to come from the clinician.

The rule's own definition of a qualified interpreter asks for rendering without changes, omissions or additions, preserving the tone, sentiment and emotional level of what was said (45 CFR 92.4). In this meeting that means saying "he is dying" when the doctor says it, and rendering a relative's anger at the team as anger. Euphemism is the most common failure, from the clinician and the interpreter alike: "we will keep him comfortable" can be heard as a promise of recovery.

Running the meeting through an interpreter

• Brief the interpreter for five minutes first: the purpose of the meeting, who will be there, what the patient already knows, and the decisions on the table. The interpreter does not decide what is disclosed; they need to know so nothing surprises them mid-sentence.
• Seat the interpreter where every relative can hear, not between the physician and the family. On video, make sure the camera shows the room, not only the speaker.
• One speaker at a time. When three relatives talk at once, the interpreter will ask them to take turns; agree on that at the start.
• Name things plainly and explain each decision the first time: what resuscitation involves, what hospice means in the United States, what happens on discharge.
• Pause for questions and ask the family to say back what they understood and what they have decided, through the interpreter.
• Use a speakerphone only as a last resort. The rule sets standards for remote interpreting — clear audio, and for video a picture large enough to show faces (45 CFR 92.201(f)–(g)); a phone in the middle of a conference table rarely meets them for eight people.

Booking a family meeting

In person is $110 an hour per interpreter with a two-hour minimum: a family meeting of an hour and a half is billed at the two-hour minimum, $220, plus travel at $0.70 per mile from the interpreter's location — a 30-mile round trip to a hospice patient's home adds $21. By video, it is $80 an hour with a one-hour minimum; book two hours, $160, if the meeting may run long, because time is billed from the scheduled start. A family that speaks an indigenous language with a regional lingua franca as its second language may need relay through two interpreters; say so and we will tell you before booking whether we can staff it.

Send with the request: the language and any dialect, how many relatives and whether any will join remotely, whether the patient will be present, the hospital and unit or the address, and any document the interpreter will be asked to read aloud — an advance directive, a discharge plan, a POLST or similar form. Reading a document aloud in another language is sight translation; a written translation of the discharge summary or the medical record is a separate service, quoted per page.

By video, by phone or in person

Virtual interpreting runs on Zoom, Google Meet or Microsoft Teams, or over the telephone. It is quicker to arrange, costs less and carries no travel charge, and it suits appointments, calls and most meetings.

In person is what venues with their own rules tend to expect, and the right choice when documents are being signed or several people are speaking at once. Tell us the platform, or the city and the venue, when you send the request.

Languages

The standard-availability languages are: Spanish, Portuguese, French, Mandarin, Cantonese, Arabic, Russian, Korean, Vietnamese, Haitian Creole, Polish, Italian, German, Japanese, Hindi, Urdu, Persian, Turkish, Ukrainian, Tagalog, Bengali, Punjabi, Gujarati, Tamil, Armenian, Greek, Hebrew, Romanian, Serbian, Bosnian, Somali and Nepali. Every other language we offer carries the 25–30% limited-availability rate. If a language is not on that list it is not because we cannot do it — it is because the pool of qualified interpreters in the United States is small enough that we will not promise a date without checking.

Each language has its own page on what to watch for — dialects, names, dates, who the speakers usually are: see interpreters by language.

What it costs

Rates are per interpreter, per hour, and billed from the scheduled start time rather than from when everyone actually arrives.

• Virtual — $80 per hour, one-hour minimum. Zoom, Google Meet, Teams or telephone.
• In person — $110 per hour, two-hour minimum.
• Limited-availability languages — add 25–30%. Which languages those are is listed below rather than left vague.
• Travel for in-person work — $0.70 per mile from the interpreter's location.

How the travel charge works out

Travel is charged at $0.70 per mile from the interpreter's location, which means you can work it out rather than wait for a quote: a 20-mile round trip is $14, a 60-mile round trip is $42, a 150-mile round trip is $105. There is no separate call-out fee on top.

We will not pretend to know in advance where the interpreter will be coming from — that depends on the language, the date and the venue. What we do is confirm the interpreter and the exact travel figure before you book, so it is never a surprise on the invoice. Virtual assignments carry no travel charge at all, which is one reason most of what we do is virtual.

How booking an interpreter works

• You send the request with the form below: the language, the setting, the format, the date and how long it should last.
• We confirm before you commit: the interpreter, the exact price and the travel figure if there is one. We reply the same business day, and no payment is taken at this stage.
• You confirm, and the interpreter is booked for your date.

What to have ready

The more of this comes in the first message, the fewer exchanges before you have a price:

• The language, the date, the start time and how long it should run.
• Virtual or in person: the platform, or the city and the venue.
• The setting and the subject matter.
• How many people need interpreting for.
• Any credential the venue requires of the interpreter.

Request an interpreter

Tell us the date, the language and the setting and we will come back with the interpreter, the exact price and the travel figure if there is one — before you commit to anything.

Sources

What this page says about the rules was checked against these official sources on October 21, 2026. Rules change; the source is always the authority.

• 45 CFR 92.201 — Meaningful access for individuals with limited English proficiency (Section 1557 rule, eCFR current text; 89 FR 37692, May 6, 2024)
• 45 CFR 92.4 — Definitions: covered entity, companion, qualified interpreter (eCFR current text)

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