Legislation that would mandate nurse staffing ratios for all hospitals and nursing homes in the state would cost providers $3 billion a year, according to the Greater New York Hospital Association.
Lorraine Ryan, senior vice president for legal, regulatory and professional affairs for the association, stated the figure in testimony before the City Council hospitals committee Monday afternoon. Ryan's testimony on behalf of the association was in strong opposition to forced nurse staffing ratios.
The testimony comes as the hospitals committee is considering a resolution in support of an Albany bill that would impose the ratio as 1 nurse to 4 patients.
"It would cost New York's hospitals and nursing homes a staggering $3 billion annually to comply with the nurse staffing ratios bill—money they don't have for a mandate they don't need," Ryan said in her testimony. "Many of these financially struggling institutions would be forced to reduce services, lay off staff or even close their doors for good, impacting access to care for those with the most need."
She said that mandating ratios "belies the proven ability of hospitals and unions to agree on staffing plans on their own," as was recently the case between Montefiore, Mount Sinai and New York–Presbyterian health systems and the New York State Nurses Association.
Ryan additionally noted in her testimony that California is the only state thus far to impose nurse staffing ratios on all units of hospitals, and it has not been proven that such ratios improve care across the board.
She further said the cost of forced ratios could prevent hospitals from taking steps to reduce emergency department wait times, such as hiring more primary care and specialty physicians and investing in facilities. "This is particularly problematic because hospitals are currently working to reduce avoidable ED visits as part of the state's Delivery System Reform Incentive Payment, or DSRIP, program," she said.
Fiscal implications of the bill are noted to include a possible increase in Medicaid spending to cover the cost of increased staffing. But that increase could be balanced by reduced Medicaid spending as a result of fewer negative outcomes and less staff turnover that would both reduce health care costs.
A memo in support of the bill states that safe staffing reduces adverse patient outcomes, citing research funded by the federal Agency for Healthcare Research and Quality. The data, the memo states, have shown hospitals with lower nurse staffing levels have higher rates of pneumonia, shock and cardiac arrest, among other adverse outcomes that lead to higher costs and mortality from hospital-acquired complications.
Jill Furillo, executive director of the New York State Nurses Association, testified Monday in support of the legislation.
"The Greater New York Hospital Association and other associations that don't want regulation, they're missing the point," Furillo said. "A highly regulated environment is absolutely necessary when you're talking about patients' lives."
Furillo, who previously helmed lobbying efforts that led to nurse staffing ratios in California, said hospitals actually did better financially there post-implementation.
Mitchell Katz, president and CEO of New York City Health + Hospitals, also testified before the hospitals committee Monday. Katz, who previously served as director of the Los Angeles County Health Agency, said he was not aware of any hospital closures as a result of the implementation of ratios in California.
Katz said he supports the legislation. He added that the legislation has fiscal implications for the city and affects the health system's contract with NYSNA. "I see it as something we would do together," he said.
He noted that H+H has made efforts to improve such ratios during the past year, including hiring 340 net new nurses. H+H is aiming for a ratio of 1 nurse to 6 patients in most of its medical and surgical wards.
"Mandated staffing ratios would cost $3B a year: hospital association" originally appeared in Crain's New York Business.