Dive Brief:

• Hospitals and nursing homes in New York state will have to follow new staffing mandates under legislation Gov. Andrew Cuomo signed Saturday in a major win for labor unions that have advocated for such a law long before the COVID-19 pandemic.
• Hospitals will be required to form clinical staffing committees that include front-line nurses and other direct care staff when setting annual staffing standards for units, and the state health department can levy penalties against hospitals that fail to create or abide by the standards.
• The second law pertaining to nursing homes requires facilities to meet a minimum daily average of 3 1/2 hours of nursing care per resident. The two laws are set to go into effect in January 2022.

Dive Insight:

While staffing levels have always been a key concern for nursing unions, the pandemic highlighted the struggles of healthcare workers who say they sometimes take care of more patients than they can reasonably handle. Now they're using the COVID-19 crisis to advocate for change, either lobbying state legislatures or trying to negotiate new staffing rules in their employment contracts.

California is currently the only state with mandated staffing ratios on the books after landmark legislation passed there in 2004, though a number of other states have laws similar to New York's requiring nurse-led staffing committees.

California's law outlines nurse-to-patient ratios, or exactly how many patients a nurse can take care of in specified units, such as operating rooms and intensive care units.

New York's law lets hospitals form committees to set their exact standards, though at least half of the committee members must be front-line nurses or direct care staff.

"This law doesn't state that ratios must be stipulated, but inevitably that's what it means," Judy Sheridan-Gonzales, president of the New York State Nurses Association said.

The state health department will enforce the staffing plans with monetary fines for hospitals that are noncompliant, and will also establish new minimum staffing standards for ICUs and critical care units to be incorporated in each hospital's annual staffing plans.

The law also includes a provision to make each hospital's staffing data publicly available to staff and patients.

No federal staffing standards currently exist, and hospitals are generally opposed to such mandates, which they fear could hinder their operational flexibility. A spokesperson from the Greater New York Hospital Association did not respond to a request for comment.

New York was initially the hardest hit when COVID-19 arrived in the U.S., with nursing homes bearing the brunt as they dealt with an onslaught of critically ill patients.

A January report from the state's attorney general that found nursing homes with low staffing ratings had higher fatality rates lent momentum for both pieces of new legislation to pass, Sheridan-Gonzales said.