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State to study adopting minimum staffing levels for nursing homes, hospitals

Buffalo News - 4/12/2019

April 12-- Apr. 12--The New York State Health Department this year will study whether nursing homes and hospitals should be required to meet minimum staffing levels.

Lawmakers did not pass a proposed "safe staffing" bill that would have set minimum staffing ratios -- a move that unions support but that the industry opposes as being too costly -- but instead ordered the study in a bill that was approved as part of the state budget.

Lawmakers directed the Health Department to examine staffing ratios and how they would affect staff and the quality of care for patients, along with the costs for such a measure. The study is set to begin May 1, and the Health Department is required to report back to the Legislature by Dec. 31, making it unlikely any action on staffing ratios would occur this year.

At present, nursing homes are required only to have "sufficient" staffing levels, with no specified ratios.

Sponsors of the safe staffing bills in the Assembly and Senate say they remain committed to coming up with solutions to concerns over patient and staff safety and maintaining stability for health care facilities.

The proposed ratios are not locked in, according to Assemblywoman Aileen M. Gunther, D-Forestburgh, who is sponsoring the bill in the Assembly.

The proposed bills in both chambers are identical in the minimum time nursing homes' staff would be required to spend, on average, each day with each resident: 2.8 hours by certified nursing assistants; 1.3 hours by licensed practical nurses or registered nurses; and 0.75 hours by registered nurses.

The Buffalo News reported in December that only 49 of the 619 nursing homes in New York State -- or 8 percent -- now meet the proposed requirements, according to data from the federal Centers for Medicare and Medicaid Services.

Ken Traub, an advocate for nursing home residents in Rochester, took issue with The News' calculations, which looked at what would be required of the total nursing staff. But he agreed that only about 8 percent of the nursing homes would comply with proposed staffing requirements for certified nursing assistants.

Trade groups representing nursing home operators and hospitals say the safe staffing bill would cost the industry an extra $1 billion annually and that it would come out of taxpayers' pockets through increased Medicaid payments.

"Nothing is written in stone," said Gunther, a registered nurse, of the hourly ratios in the bills. "We're looking at a minimal amount of staff in order to provide high quality care."

Sen. Gustavo Rivera, D-Bronx, the chairman of the Senate Health Committee and sponsor of the Senate bill, said the purpose of the study is to examine ratios that "work towards staffing levels that ensure a safe environment for patients and workers while securing the viability of health care providers."

The study will include input from the trade groups, health care workers and patient and community health advocates.

State Health Department spokesman Jeffrey Hammond said the department is in the process of "developing an implementation strategy that will include stakeholders."

Helen Schaub, an official with Local 1199, Service Employees International Union, which represents 40,000 nursing home workers in the state, said she expects the study will create a ratio model that will include costs and look at different methods to improve quality of care.

Of hourly ratio levels, Schaub said, "It's all going to be subject to debate and what the study says."

The union, which supports ratios, has contributed millions of dollars to politicians statewide.

Proposed safe staffing legislation dates back about a decade in Albany. In the last year, it has gained momentum, with Democrats' now controlling both the Assembly and Senate and Gov. Andrew M. Cuomo, a Democrat, also expressing support.

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