Chronic staffing shortages plague New York nursing homes
NEW YORK, UNITED STATES — New York nursing homes are struggling with some of the lowest staffing levels in the United States, with 80% of facilities failing to meet the federally recommended minimum of 4.1 hours per resident day (HPRD) of nursing care. This benchmark, established in a landmark 2001 federal study, is considered essential for providing basic clinical care.
According to a new report by the Long Term Care Community Coalition (LTCCC), New York nursing homes averaged just 3.59 HPRD in Q2 2024, placing the state in the bottom ten nationally.
The LTCCC’s analysis, based on payroll-based journal data from the Centers for Medicare & Medicaid Services (CMS), highlights a nationwide crisis, with over 70% of U.S. nursing homes falling short of the 4.1 HPRD standard.
State law fails to enforce minimum care standards
A 2022 New York law requiring nursing homes to provide at least 3.5 HPRD of care has seen little enforcement. Over 400 facilities are currently out of compliance and subject to $2,000 daily fines. However, no penalties have been issued due to delays by the Department of Health (DOH) in finalizing enforcement actions.
DOH spokeswoman Danielle DeSouza stated that the department is working on prioritizing enforcement referrals while considering mitigating factors. She emphasized the importance of balancing accountability with fairness to facilities.
Health Commissioner James McDonald declared an acute labor shortage shortly after the law went into effect, allowing operators to apply for leniency through mid-2023 — a move that has further delayed enforcement efforts.
Top and bottom performers highlight staffing disparities
The LTCCC report identified significant disparities among nursing homes in New York. Facilities like Henry J Carter Skilled Nursing Facility in Manhattan and Queen of Peace Residence in Queens ranked among the best for nurse staffing levels.
Conversely, Haven Manor and Ocean Garden, both located in Queens, were among the worst performers. Rankings excluded outliers such as pediatric facilities or those reporting no nurse aide time
Non-nurse staffing deficits undermine oversight and care
Staffing issues extend beyond nurses. New York ranks worst nationally for administrator time per resident, a critical role responsible for overseeing operations and ensuring compliance with regulatory standards.
Additionally, 42.7% of facilities reported zero hours of medical director presence during Q2 2024, raising concerns about clinical oversight and leadership gaps.
Federal rules fall short of addressing crisis
While federal regulations mandating a minimum of 3.48 HPRD are set to roll out over the next two to five years under a Biden administration rule, advocates argue this falls short of addressing systemic understaffing issues in New York.
The use of contract staff has also declined slightly — from 12.7% to 12.2% — since the end of the public health emergency, reflecting ongoing workforce challenges that limit care quality.
Systemic crisis demands urgent action
Advocates stress that stronger enforcement and investment in workforce development are urgently needed to address chronic understaffing in New York’s nursing homes.
Richard Mollot, executive director of LTCCC, criticized operators who cut staffing as a cost-saving measure.
“You couldn’t put two people in a bed, you have to provide a certain amount of food, but in [the] absence of enforcement of minimum standards of care, you can provide as little staffing as you want,” he stated.
Without immediate action at both state and federal levels, thousands of vulnerable residents will continue to face substandard care across New York’s nursing homes.
