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

The Buffalo News - - CITY&REGION - By Lou Michel

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, DForest­burgh, 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, DBronx, 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.

“Noth­ing is writ­ten in stone. We’re look­ing at a min­i­mal amount of staf f in or­der to pro­vide high qual­ity care.”

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