The bills empower the state Department of Health to fine hospitals and nursing homes that violate staffing guidelines, with exceptions for emergencies or other extraordinary circumstances. In the case of nursing homes, the agency can evaluate worker shortages, and homes cannot be fined until after April 1.
The requirements for hospitals and nursing homes had previously been bundled into one bill dictating specific ratios, but lawmakers uncoupled them in April to allow hospitals to establish their own staffing plans rather than require set ratios.
Advocates said increased staffing levels will improve the quality of care for patients and nursing home residents. New York has more than 300,000 registered nurses, licensed practical nurses and certified nurse aides, according to data from the Bureau of Labor Statistics.
"We are doing the right thing not only for nurses across New York state but also for the patients that we care so dearly about," Assemblywoman Aileen Gunther, who sponsored the nursing home staffing bill in the lower house, said in a press conference Tuesday. Gunther represents parts of Orange and Sullivan counties.
The bill's supporters credited the pandemic for giving the legislation momentum after more than a decade of it languishing in the Legislature. Nurses said the crisis laid bare the inadequacy of current staffing levels: Covid-19 patients overwhelmed facilities, which then leaned on outside staffing agencies to fill gaps.
"Chronic understaffing at New York hospitals and nursing homes made our health care system ill-prepared for Covid-19," said Nancy Hagans, a nurse at Maimonides Medical Center and treasurer for the New York State Nurses Association, which backed both bills.
With more nurses, Hagans said, "we could've saved more lives."
The most fervent opposition to the bills came from the nursing home industry. Its representatives called its legislation "infeasible" and "simplistic," citing a lack of state funding and a shortage of workers.
About 55% of New York nursing homes would have failed to meet the requirements of the bill aimed at it last year, according to an analysis by LeadingAge New York, which represents over 400 nonprofit and public long-term-care providers. The rate was even higher among for-profit nursing homes.
The 2021-2022 state budget, approved in April, devotes $64 million to increasing nurse staffing in nursing homes.
But Stephen Hanse, president and CEO of the New York State Health Facilities Association, which represents more than 325 long-term-care facilities, said the bill could cost the nursing home industry as much as $500 million per year. LeadingAge projected the bill would saddle nursing homes with more than $260 million in additional costs each year.
Hanse said facilities are already underfunded. Providing around-the-clock care at a nursing home costs about $266 per resident per day, but the state's Medicaid program pays about $211, he said.
"Staffing is a highly complex issue that is comprised of multiple clinical variables that are unique to each nursing home and its resident population," Hanse said in a statement. "The simplistic staffing ratios in this legislation do not in and of themselves improve the quality of care."
Bronx Sen. Gustavo Rivera, who chairs the health committee and sponsored both staffing bills, said he disagrees with the industry's math.
"If we need more, we'll go and get it," he said.
