24 June 2021: New Laws Set NY Hospital and Nursing Home Staffing Levels

Two New Laws Guard Against Understaffing At NY Hospitals And Nursing Homes

This report provides some analysis for New York's new laws setting minimum staffing levels at hospitals and nursing homes.

The hospital measure signed by Cuomo takes a substantially different approach than the one that unions originally proposed, giving medical centers more flexibility. Instead of state officials setting universal requirements for all hospitals, the new law requires each hospital to set up its own committee of frontline staff and administrators to determine appropriate staffing levels for each unit.

Hospitals must submit their staffing plans to the state by July 1st and implement them by January 1st. The state Department of Health will then be responsible for ensuring that each hospital adheres to its own staffing plan.

“The Department of Health is going to police and regulate those plans to make sure they are implemented and to penalize any violations,” Cuomo said at the press conference.

While that law has the support of both labor groups and the Greater New York Hospital Association, the law governing nursing homes is less flexible and more controversial.

The nursing home law says every facility must hire enough staff to provide each patient with 3.5 hours of daily care, on average. About a third of that care must come from nurses, and aides can provide the rest. Nursing home groups argued the legislation would be too costly to implement, while consumer advocacy groups said it didn’t go far enough to ensure adequate staffing and care.

During the coronavirus pandemic, a significant difference developed between for-profit and non-profit nursing homes with respect to residents who died from COVID, which appears directly related to their staffing levels, which did not affect the number but did influence where they died. For-profit nursing homes tend to have lower levels of staffing, where one in three residents who died from COVID in these facilities were sent to hospitals. That compares with one in four residents at non-profit nursing home facilities. This outcome suggests the the level of available staff plays a role in determining where nursing home residents receive health care when their medical conditions become more serious.

The COVID death data suggests New York's new laws for nursing homes would not have affected the fatality rate from COVID in nursing homes had they been in place before the pandemic. What they seem designed to do instead is to minimize the number of nursing home residents from being transferred to hospitals because of staffing level-related considerations.