Assembly Passes Lifesaving Legislation to Require Safe Staffing Standards in Hospitals and Nursing Homes

Speaker Carl Heastie, Health Committee Chair Richard N. Gottfried and Assemblymember Aileen Gunther today announced that the Assembly passed lifesaving legislation which will require hospitals and nursing homes to meet staffing ratios for nurses and unlicensed direct care staff.

“Nurses have always been healthcare heroes, at our loved ones bedsides. And for the last year, they have also served on the frontline of a global pandemic,” Speaker Heastie said. “These bills will ensure that our nurses, whether in hospitals or nursing homes, are working under conditions that allow them to best help their patients and save lives.”

“As a nurse myself, I know how important it is to have the right nurse to patient ratio. The fact is, patients do better when there are enough nurses at bedsides,” Assemblymember Gunther said. “This legislation will save lives, promote healthier outcomes and help our nurses who work hard every day in nursing homes and in hospitals.”

“For decades, nurses, patients and their families, and legislators have fought for passage of a safe staffing law,” said Assemblymember Gottfried.“COVID-19 has made this long-standing need even more clear and compelling, as shown in reports by Attorney General Tish James and the U.S. Public Interest Research Group.Lives are at stake.I congratulate the long-time sponsor Assemblymember Aileen Gunther, Speaker Carl Heastie, and the workers whose dedication to patient care made this possible.”

Safe staffing is proven to reduce avoidable adverse patient outcomes. A study in the Journal of American Medicine estimated that the odds of patient death increased by seven percent for each additional patient a nurse must care for at a time. Additionally, research done by the Agency for Healthcare Research and Quality found that hospitals with lower nurse staffing levels have higher rates of pneumonia, shock, cardiac arrest, urinary tract infections and upper gastrointestinal bleeds.


Legislation passed today would establish a base for nurse to patient ratios based on peer reviewed academic research and evidence based recommendations for hospitals (A.108-B, Gunther). The bill will require that each hospital establish a clinical staffing committee made up of 50 percent nurses and ancillary staff that provides direct care and 50 percent selected by hospital administration. These councils must be established by January 1, 2022, and will develop an annual clinical staffing plan that includes specific guidelines or ratios establishing how many patients are assigned to each registered nurse and the number of nurses and ancillary staff to be present on each unit and shift.

Staffing plans must be adopted and submitted to the New York State Department of Health (DOH), along with data from the previous year on the adopted staffing plan. The plans will also be posted on DOH’s website, and in a public area of the hospital. Hospital staff will have the ability to report to the committee if there are staffing patterns that do not adhere to the adopted plan and will be protected from retaliation. DOH will investigate violations and may require a corrective action plan or civil penalties. Plans must be fully implemented by January 1, 2023, and annually thereafter.

Additionally, the legislation would create an independent advisory commission representing experts in staffing standards and quality of patient care, labor organizations representing nurses, and hospital representatives. The commission will evaluate the staffing levels and other quality metrics related to nurse staffing in hospitals, and will submit a report to the speaker of the Assembly, the temporary president of the Senate and chairs of the Assembly and Senate Health Committees.

Nursing Homes

The legislation requires the commissioner of the DOH to establish minimum staffing standards for nursing homes, as well as a system of civil penalties for non-compliance (A.7119, Gunther). At minimum, nursing home staffing standards would have to include 3.5 hours of nursing care per resident per day, and at least 2.2 of those hours would need to be provided by certified nurse aides and at least 1.1 by licensed practical nurses or registered professional nurses. Nursing homes will be required to publicly disclose information regarding nurse staffing so it is visible and accessible to residents, families and staff. They would be required to be in compliance by January 1, 2022.