NY lawmakers require minimum staff levels for nursing homes, hospitals

ALBANY — The State Legislature on Tuesday overwhelmingly passed bills that would mandate minimum staffing levels for hospitals and nursing homes to improve care and help avoid a repeat of the critical shortages seen during the COVID-19 pandemic.

"Unfortunately, it took a pandemic to realize we need safe staffing standards in our acute care facilities," said the bills’ co-sponsor, Assemb. Aileen Gunther (D-Forestburgh). "I think in the end, with better quality of care, it’s proven there is less cost and less burnout" for nurses and nurses’ aides. "There are a lot of positives to this."

The Senate gave final legislative approval to the bills, which have been debated in various forms in Albany for nearly 20 years. Now the bills can go to Gov. Andrew M. Cuomo for his signature or veto. If Cuomo signs them, the minimum standards would begin in January.

"This is a historic moment," said Senate Health Committee chairman Gustavo Rivera (D-Bronx). "This will actually have a positive impact on patients." He said the measures will hold administrators of hospitals and nursing homes accountable to hire enough staff to adequately care for hospital and nursing home residents.

Rivera said nursing homes would be required to devote at least 3.5 hours of medical care to each resident every day on average. That would include a minimum of 1.1 hours by licensed nurses and the rest from nurses’ aides.

Unlike the strict mandates in the nursing home bill which are enforceable by civil penalties, the hospital bill requires that labor-management committees be created at each hospital to agree on minimum staffing standards.

Until this year, the measures were contained in a single bill, setting equal minimum standards for hospitals and nursing homes.

Sen. Phil Boyle (R-Bay Shore) suggested that hospitals avoided mandated minimums because they have more political pull with Cuomo than nursing homes. But Rivera said Cuomo didn’t influence the bills.

The greater New York Hospital Association, a major lobbying force in Albany and with Cuomo, had opposed a mandated minimum staffing level. The GNYHA said it supports the bill now that it no longer has that provision.

"GNYHA will do everything possible to help hospitals successfully implement this bill, once signed by the Governor," the association stated.

Gunther, a nurse who worked in a hospital during the height of the pandemic, said the bills are expected to lead to more state funding to help hospitals and nursing homes hire more staff and to recruit more people into nursing. The state budget adopted in April included $64 million to hire more nursing home nurses, but Gunther said that is only intended to cover a quarter of 2022.

Assemb. Ed Ra (R-Franklin Square) said the cost could be $260 million for all of 2022. Gunther didn’t dispute that estimate.

The hospital bill received broad support among legislators. But the nursing home measure drew concern.

The minimum standards would come at a time when most nursing homes are severely understaffed and operating at deficits exacerbated by costs incurred during the pandemic, which left more than 15,000 residents dead from COVID-19. Nursing home operators said the state’s funding for salaries has been too low to attract workers for the difficult jobs.

"We in the industry support these staffing levels," said Michael Balboni, executive director of the Greater New York Health Care Facilities Association. "But we always have the problem of how do you find folks to do this? And how do we pay for it, especially in light of the state cutting state aid?"

"This is the worst time in the world to impose huge, unknown expensive mandates," said Assemb. Andrew Goodell (R-Chautauqua). "This will only exacerbate the financial hardships facing our nursing homes today."

Gunther said minimum staff standards are needed immediately.

"This is a start, not a finish," Gunther said. "We are talking about money, but I am talking about lives and quality of life. … The level of care means quality of life for many people we call part of the greatest generation and they deserve appropriate care."

By Michael Gormley

michael.gormley@newsday.com@GormleyAlbany

Michael Gormley has worked for Newsday since 2013, covering state government, politics and issues. He has covered Albany since 2001.