Proposed Staffing Law Not Conducive To Good Health Care
Hospitals in the Greater Rochester – Finger Lakes region have long been committed to quality, patient-centered healthcare. A multitude of factors go into a comprehensive approach that leverages state of the art processes, systems and appropriate staffing to meet the unique needs of patients.
Unfortunately, legislation proposed in the New York State Legislature would impose arbitrary statewide staffing ratios in hospitals and nursing homes that would not improve the quality of care. Instead, it would prevent experienced healthcare professionals from making appropriate staffing decisions to meet patient needs and add $3 billion to the cost of healthcare in New York.
Rochester Regional Healthcare Association, which represents sixteen hospitals and health systems across eight counties in Rochester, the Finger Lakes and the Southern Tier, strongly believes that staffing decisions must remain within local hospitals and nursing homes, and we’ve encouraged our delegation to reject this legislation.
Nursing is the largest healthcare profession in the United States, with more than 3.1 million registered nurses nationwide. Nurses comprise the single largest component of hospital staff, are the primary providers of hospital patient care, and deliver most of the nation’s long-term care. There are more than four times as many registered nurses in the United States as physicians.
Hospitals and nursing homes already develop staffing plans tailored to individual patient care needs. These staffing plans are determined by many factors, including the experience of the staff, the use of technology, the physical layout of the hospital or the nursing home, and the number of clinical and non-clinical staff collaborating with nurses to provide care.
This bill imposes a one-size-fits-all mandate, when one size does not fit all. No two hospitals or nursing homes are the same. Flexibility is crucial to respond to diverse patient needs that can change rapidly. Every patient is different, every nurse is different, and every day is different – therefore, there’s no “magic number” that works in every situation.
In fact, this legislation could have several adverse, unintended consequences if enacted. If hospitals are required to have a certain number of nurses on staff, other healthcare positions could be eliminated and nurses would have to perform jobs well outside of their current responsibilities – including transporting patients and answering phones – instead of caring for patients.
There’s also a nationwide nursing shortage, due in part to a shortage of nursing instructors. The New York State Department of Labor projects that the need for postsecondary nursing educators in the Finger Lakes region will jump by 34.2 percent by 2024. Without enough registered nurses to fill positions, healthcare facilities would be held to an impossible standard if this bill became law.
California is the only state with mandated hospital-wide ratios. Research has found no direct link between a set, mandated statewide staffing ratio and improved patient outcomes. Instead, Rochester hospitals are pursuing patient care improvement strategies through two initiatives – the New York State Partnership for Patients (NYSPFP) and the Hospital Improvement Innovation Network (HIIN). Both initiatives have shown that focusing on education and evidence-based practices improves patient outcomes, not an arbitrary statewide mandate.
A variety of laws and regulations already ensure accountability to consumers and regulators. Hospitals must comply with a wide array of state and federal requirements under the oversight of the New York State Department of Health (DOH), the Centers for Medicare and Medicaid Services (CMS) and other accrediting organizations. In addition, New York State has enacted several laws related to safe patient handling, including laws to ensure that nurses work no more than their regularly scheduled hours and laws that require the disclosure of staffing plans upon request.
The fiscal implications of this legislation cannot be stressed enough. It would cost New York’s hospitals and nursing homes $3 billion annually and become the largest-ever unfunded healthcare mandate in New York State. This couldn’t come at a worse time - New York’s hospitals already have the second lowest operating margins in the nation and the future of the Affordable Care Act remains uncertain.
In addition to the Rochester Regional Healthcare Association, government-mandated staffing ratios are opposed by the Healthcare Association of New York State (HANYS), New York Organization of Nurse Executives & Leaders (NYONEL), Greater New York Hospital Association (GNYHA), Iroquois Healthcare Association (IHA), Suburban Hospital Alliance (SHA), Western New York Healthcare Association (WNYHA) and the Healthcare Trustees of New York State (HTNYS).
There are many other ways that the Legislature could support nurses and other healthcare workers. New York could increase the proportion of nurses educated at the baccalaureate level (A.1842/S.3520 sponsored by Assembly Majority Leader Joe Morelle), provide state funding for scholarships and loan forgiveness programs, ensure that registered nurses can work to the full extent of their education, increase the use of evidence-based protocols and reduce unnecessary documentation to free up time for patient care.
Rochester Regional Healthcare Association values the judgement and experience of our Rochester area nurses and healthcare professionals who work hard every day to deliver the best care possible. Local decision-making is critical and should not be curtailed by an arbitrary statewide mandate.
Submitted by: Travis Heider, President and CEO of Rochester Regional Healthcare Association
Rochester Regional Healthcare Association is a not-for-profit 501(c)3 association whose membership is comprised of sixteen hospitals and their related health systems in the eight counties of Monroe, Livingston, Ontario, Wayne, Seneca, Yates, Steuben, and Chemung.