New Yorkers debate staffing law.

Ratios could force SNFs to curb admissions

LEGISLATION APPROVED JUNE 21 BY THE New York State Assembly establishes mandatory staffing ratios for the state's 667 nursing homes. According to the New York Association of Homes & Services for the Aging (NYAHSA), the legislation, if signed into law, would require New York's skilled nursing facilities to hire more than 55,000 additional full-time RNs, LPNs, and CNAs at a time when providers are already facing a severe staffing shortage.

This staffing crisis was the focus of a hearing held June 18 before the New York City Council's Committee on Aging. Union representatives, advocacy groups, ombudsmen, and nursing home workers urged council members to support the pending legislation.

The one dissenting voice was that of Charles Magistro, director of marketing at Providence Rest Nursing Home, a not-for-profit facility in the Bronx.

"The issue of increased personnel has to be yoked with increased reimbursement," said Magistro. "If we were to meet some of the staffing requirements that have been proposed, we would literally go out of business."

The legislation (A04171) mandates one CNA per every five residents during the day shift; one CNA per eight residents during evenings; and one CNA per 12 residents during nights. It also establishes ratios for RNs and LPNs.

Now hiring nonexistent workers

NYAHSA President Carl S. Young states that, "The staffing ratios outlined in the bill fail to address the fundamental problem--an inadequate supply of nurses and nurses' aides--and are impossible to achieve given the existing shortage. It is impossible to legislate human beings into existence."

Annie Bryant, a CNA at Regency Extended Care Center in Yonkers, N.Y., also worries about the scarcity of workers. "Because of short staffing and low wages, most nursing homes are attracting the bottom of the barrel--people who don't really care," she told the Committee on Aging.

Bryant, who has worked in nursing homes for 37 years, called for increased funding and better education to attract a higher caliber of workers.

Neva Shillingford, vice president of 1199 SEIU, New York's Health & Human Service Union, told council members that the first step in solving the staffing crisis is to enact mandatory-staffing laws. She acknowledged that, "We must also make sure that government reimbursement is sufficient so that nursing homes can implement those standards."

Without this additional funding, mandatory staffing ratios may actually hurt those they were designed to help. "In order to meet the ratio requirements," says Young, "providers would have to reduce admissions--thereby denying thousands of New Yorkers access to care."