Legislation to Set Safe Staffing Levels in Hospitals and Nursing Homes is Supported by CELJ

June 26, 2018


The Honorable Andrew M. Cuomo

Governor of New York State

NYS State Capitol Building

Albany, NY 12224


Re:       Letter of Support – Safe Staffing Levels


Dear Governor Cuomo,


The Center for Elder Law & Justice (CELJ) is a civil legal services agency serving the eight Western New York counties. Since 1978 we have provided comprehensive free legal services to the community’s older adults, people with disabilities, and those who have lower income. Our services help maintain the essentials of life and our mission is to use the legal system to help our clients live independently and with dignity.

CELJ strongly support your efforts to address subpar staffing levels in NYS hospitals and nursing homes by introducing legislation next session that would enable the NYS Department of Health to set safe staffing levels by regulation. Staffing levels are an important indicator of quality and safety. The current federal and NYS standard of having “sufficient” staffing in our nursing homes is not enough. We believe that having minimum staffing standards in conjunction with a competency based approached is essential to ensure every nursing home resident in NYS has the opportunity to receive safe and quality care.

Even though numerous studies and reports have shown that staffing is key to the provision of safe and quality care in nursing homes, there are no minimum federal or NYS staffing level requirements.[1] (Outside of the requirement each nursing home has a Registered Nurse (RN) for at least 8 consecutive hours a day, seven days a week.)[2] The current standard is that each nursing home have “sufficient nursing staff… to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident.”[3]

Nursing homes are paid to provide safe care for every resident they admit; regardless whether the resident is there for short-term rehabilitation services, or long-term care. Unfortunately this is not always the case and nursing homes are rarely held accountable for having insufficient staff, even when it leads to avoidable injury or death.   In addition, tax-payer dollars are being wasted when Medicare & Medicaid pays for substandard care.

We believe that having minimum staffing levels, in conjunction with the current standard that nursing homes staff based on resident acuity, is key to improving the quality of care in our nursing homes. CELJ supports your efforts to introduce legislation that directs the NYS Department of Health to implement safe staffing levels at both the hospital and nursing home setting.



Lindsay Heckler, Esq., MPH

Staff Attorney


CC:      Hon. Patrick M. Gallivan;

Hon. Chris Jacobs;

Hon. Timothy M. Kennedy;

Hon. Robert G. Ortt;

Hon. Crystal D. Peoples-Stokes;

Hon. Sean Ryan;

Hon. Robin Schimminger;

Hon. Monica P. Wallace



[1] For example, see U.S. Office of the Inspector General. Adverse Events in Skilled Nursing Facilities: National Incidence Among Medicare Beneficiaries. OEI-06-11-00370. Harrington et al. The Need for Higher Minimum Staffing Standards in U.S. Nursing Homes. Health Services Insights 2016:9 13-19

[2] 42 CFR 483.35 ;and 10 NYCRR 415.13(b)

[3] Id.

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