NY Lawmakers Expected to Set New Staffing Requirements at Nursing Homes

Nursing homes in New York would be required to have enough staff for each resident to receive at least three and a half hours of direct care each day under legislation expected to be approved by the state Legislature in the next few weeks.

The bill was approved Monday by the Senate Health Committee, and the same is expected Tuesday in the Assembly Health Committee. Final passage is scheduled for next week.

“We’re trying to make sure that folks, whether they’re in hospitals or nursing homes, that they’re taken care of, and that they’re appropriately staffed,” said Sen. Gustavo Rivera, D-Bronx, who sponsors the bill and chairs the Senate Health Committee.

The bill would require about two-thirds of the mandated 3.5 hours of care to be provided by a certified nurse aide, while about an hour would have to involve a licensed nurse. It would take effect next January to give those facilities time to adjust.

Nursing homes found to have violated the law would be hit with a civil penalty by the state Department of Health, according to the legislation.

It’s not a new idea. Some Democrats have been pushing for higher required staffing levels at nursing homes and hospitals for years. Assm. Aileen Gunther, a Democrat and a nurse who sponsors the legislation in the Assembly, is one of them.

But the legislation has picked up steam in recent months because of the COVID-19 pandemic. Since last March, 13,851 nursing home residents have been killed by the virus, according to the latest data from the state.

The New York Attorney General’s Office, in a report released in late January, pointed to staffing levels as a potential contributing factor to the high number of deaths. 

“The pandemic has laid bare the risks to vulnerable nursing home residents that are inherent in a low staffing business model,” the report said.

Past proposals have suggested the establishment of minimum staffing ratios, rather than the time-based model included in the latest iteration of the bill. Rivera said the new version is what they came up with after speaking with stakeholders, including nursing home operators.

But some lawmakers still have concerns about the legislation, even if they agree with its intent.

Sen. Patrick Gallivan, the top-ranking Republican on the Senate Health Committee, said Monday that he was concerned about the financial impact the legislation could have on some nursing homes, particularly nonprofit entities with limited revenue options.

“My concern would be their ability to still be around after absorbing these costs without any additional revenues,” Gallivan said.

“We did have bad actors, there's no question about that. But like so many things, the majority of nursing homes across the state plug along and try to do the right thing.”

The New York State Health Facilities Association, a group representing more than 300 long-term care facilities, shared the same concern, and said the size of the state’s workforce may also present a challenge to the mandate.

“Many nursing homes would welcome the opportunity to increase staff, however, the workers are not there and the State refuses to fund any efforts to recruit and retain workers into fulfilling careers in long-term care,” said Stephen Hanse, president of the group.

Lawmakers appropriated $64 million in this year’s state budget to be used for staffing at nursing homes, Rivera said, but that’s still about half the projected cost of the legislation.

There is some flexibility for the requirement, according to the bill. If there’s a shortage in the labor supply in a given area, a nursing home may not be penalized for failing to meet the minimum staffing requirements.

The Assembly could bring the bill to the floor for a vote as early as this week, while the Senate is expected to approve it sometime next week.

Lawmakers, in early April, also approved legislation that requires nursing homes to spend at least 70% of their revenue on direct care for residents.