By Jon Harris News Business Reporter
Long-awaited laws requiring minimum staffing and investment in New York nursing homes went into effect on Friday, a move applauded by unions but criticized by facility operators who hoped for another postponement amid a climate of difficult hiring.
The mandates, passed last year by the state legislature and signed by the then government. Andrew Cuomo, in a bid to address nursing home understaffing, was originally due to come into effect on January 1, but was delayed by three months due to staffing issues exacerbated by the Omicron surge.
Trade associations representing the state’s nursing homes say many of its members will still not be able to meet the ratios.
“More than 80% of New York State’s nursing homes cannot meet these requirements,” LeadingAge New York President and CEO James W. Clyne Jr. said in a statement. .
“By enacting an unenforceable law, the governor and legislature made a false promise to our nursing home residents,” he said. “This mandate will only drain care homes of the very resources they need to recruit and retain more staff, forcing them to pay heavy penalties due to conditions beyond their control.”
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A day before the state legislature passed a long-debated law requiring staffing levels in nursing homes, “horrendous” staffing levels were reported at a Buffalo facility.
The staff law requires the state’s more than 600 nursing homes to provide 3.5 hours of nursing care per resident per day. Of these 3.5 hours, no less than 2.2 hours of care must be provided by a licensed practical nurse or licensed practical nurse and at least 1.1 hours of care must be provided by a registered nurse or licensed practical nurse.
To meet those staffing needs, LeadingAge, a nursing home trade association, said more than 12,000 new nurses and aides are needed statewide.
Another state law passed last year requires nursing homes to spend at least 70% of their revenue on direct resident care, of which 40% must be spent on “resident-facing staff.”
Health Department spokesman Jeffrey Hammond said that when Governor Kathy Hochul issued executive orders that delayed enforcement of staffing requirements until March 31, it was “understanding that the delay would be temporary “.
One-star rated facilities have been cited for failing to test workers for Covid-19, failing to ensure workers wash their hands properly, failing to report possible cases of abuse and more.
On Friday, the main union, 1199SEIU United Healthcare Workers East, and consumer advocates welcomed Hochul’s decision to enforce staffing rules.
Milly Silva, the union’s executive vice-president, said hiring problems won’t improve until care homes invest in carers, which will help recruit and retain staff.
“If employers really invest and agree that they will do everything they can to retain these hired workers, they won’t lose them,” she said. “That means you have to deal with wage issues, benefits issues, working conditions issues and what it means to have a safe working environment for carers.”
New York is one of several states that has implemented minimum staffing standards, said David Grabowski, professor of health policy at Harvard Medical School. Depending on how staffing standards are designed and applied, he said, researchers have found that they help increase staffing and the overall quality of care for residents.
The concern remains, however, the cost – and the challenge – of trying to attract more workers in a tight labor market.
“Since the start of the pandemic, nursing homes have lost the largest share of workers despite the largest relative wage increase,” Grabowski said. “Thus, it will take higher wages and better working conditions to attract more staff to the job market. The idea that New York nursing homes can meet staffing standards at existing wages is wacky at best.”
The Healthcare Association of New York State, which represents nursing homes, hospitals and other healthcare organizations, planned to speak to the Department of Health on Friday to understand the mechanics of the app’s operation, said said President Bea Grause.
“At this time, nursing homes must appropriately document their efforts to comply with the law,” the health ministry said in a statement. “The mitigating factors may be taken into account by the department when assessing penalties for non-compliance at a later date.”
Regarding the staffing law, Helen Schaub, director of policy and legislation at 1199SEIU, said nursing homes will be required to report their staffing daily through the federal payroll-based journal. The state, Schaub said, can then download the data on a quarterly basis and use it to impose fines on homes that don’t meet the minimum headcount.
To meet staffing standards, Grause predicts that some nursing homes will reduce new admissions, which could tighten the supply of available beds.
What Grause and Clyne of LeadingAge hope to see is an increase in New York’s Medicaid rates for nursing homes, which would help operators afford the salaries needed to compete for a limited pool of applicants.
LeadingAge points out that New York’s Medicaid program covers nearly 75% of nursing home care days. The problem, they say, is that fares have been stagnant for a long time, while costs have risen rapidly.
As things stood, one house budgets agreed with Hochul’s proposal to plan for a 1% increase in Medicaid rates. LeadingAge and HANYS demand more.