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Health & Medicine

New York Lawmakers Mandate Minimum Staffing For Nursing Homes And Hospitals

SEIU 1199 United Health Care Workers East

The New York State legislature approved measures that will require that hospitals and nursing homes meet minimum staffing levels of nurses and other health care staff.

Measures mandating minimum staffing at health care facilities have been around for several years, but the spotlight on stressed and understaffed hospitals and nursing homes during the COVID-19 pandemic finally prompted the bill’s passage. 

Senate sponsor and Health Committee Chair Gustavo Rivera, spoke before the vote.

This is an historic moment,” said Rivera, who said in the decade he’s held office, he’s had more meetings on the topic than any other issue. 

The measures provide different approaches to hospitals and nursing homes.

The state Health Commissioner would establish minimum staffing levels for nursing homes, and would impose civil penalties if the homes fail to meet the minimum standards. Each resident would receive an average of three and half hours of care a day from, with at least one hour from registered or licensed practical nurses, and two hours from certified nursing assistants. The new rules would take effect in January.

The measure comes after a provision in the state budget that requires nursing homes to spend 70% of their revenue on direct patient care, and 40% on direct care providers.

The bill that regulates hospital workers sets up clinical staffing committees in hospitals to determine staffing guidelines and decide the proper ratio between patients and staff. The panels will include hospital administrators, as well as registered nurses, licensed practical nurses, and other staff that provides direct patient care.

The legislation is backed by health care unions including the New York State Nurses Association, and the health care worker union 1199 SEIU.

Nurses’ union treasurer Nancy Hagans says the measures are a “good start.”

Finally, we could have a strong law and tools we need to advocate for our patients,” Hagans said.

Rudy Sokna  an RN and SEIU union member who works in a nursing home,  says even before the pandemic, it was under staffed. And he says the pressure mounted when Covid struck. He says he never had enough time to talk to family members who wanted to know how their loved ones were faring, when many were ill and dying.

It’s like seeing your own family members dying in front of you,” said Sokna, who said he was often the only one there with the residents in their final hours. “I felt helpless.”

The measure is backed by the state’s major hospital lobbying groups. The Greater New York Hospital Association, and the Health Care Association of New York. HANYS’ President Bea Grouse says the addition of the staffing committees gives hospitals “flexibility” in making staffing choices. 

But some nursing home owners say it could be difficult for them to meet the new standards. Michael Balboni, is executive director of the Greater New York Health Care Facilities Association (GNYHCFA), a non-profit trade  association representing downstate nursing homes. He says nursing homes have struggled for decades to find enough trained staff, and he says the state has not done enough to help recruit and retain nursing home staff.

We haven’t done anything to develop the work force,” Balboni said. “And this has been an issue way before the pandemic.”

And he says many nurses, after a long and difficult year, are leaving the profession.

Balboni says state lawmakers cut Medicaid reimbursement rates that pay the costs of caring for many of the residents. At the same time, costs rose for PPE and other equipment needed to meet COVID-19 protocols.

The virus took a tremendous toll on nursing home residents and staff. 15,000 residents died of the disease in the homes and other long term care facilities. Governor Cuomo and his staff’s handling of  the death numbers are the subject of a federal investigation, and a January report by the State Attorney General, Tish James, was critical of many nursing home practices. 

Balboni says that some nursing homes might have to close if they have to meet the new standards, and he says the approach should be collaborative to find a solution, not punitive.

We should learn the lessons from this horrible time, and we should institutionalize the things that worked, and jettison the things that didn’t,” Balboni said. “This legislation is driven by the union, and it’s been very successful, but it’s not necessarily going to affect outcomes.” 

Senate sponsor Rivera says he believes the nursing homes will be able to cope with the new staffing standards and survive.

The bills now go to the governor’s desk to sign or veto. A spokesman for Cuomo, was non committal, saying the safe staffing measures are “under review.”