Nursing: Government-mandated Staffing Ratios Are the Wrong Approach

State legislation can be devastating to nurses, patients and healthcare systems

By Travis Heider

Travis Heider, President & CEO of Pandion Healthcare: Education & Advocacy, a nonprofit organization that represents 17 hospitals in Rochester and the Finger Lakes.
Travis Heider, President & CEO of Pandion Healthcare: Education & Advocacy, a nonprofit organization that represents 17 hospitals in Rochester and the Finger Lakes.

Nurses are the backbone of hospitals and nursing homes. They have direct contact with patients — implementing doctor’s orders, dispensing medication, using medical equipment and ensuring that patients receive the best possible care. For 15 consecutive years, nursing has been ranked as the No. 1 most-trusted profession, receiving the highest rankings for ethical standards and honesty. Unfortunately, legislation has been reintroduced in the state government that would completely undermine nurses and take away local control over staffing in hospitals and nursing homes.

The legislation, which would impose government-mandated nurse staffing ratios at all New York hospitals and nursing homes (S.1032/A.2954), has been pushed for many years by a New York City-based labor union that represents a very small percentage of nurses. Pandion Healthcare: Education & Advocacy, which represents 17 hospitals in Rochester and the Finger Lakes, is strongly opposed to government-mandated staffing ratios because they’re rigid, unfunded mandates that would be devastating to nurses, patients, and our healthcare system as a whole.

It doesn’t make sense for politicians to dictate the same staffing ratios in every hospital and nursing home — regardless of their size or location — especially in a state as diverse as New York. This legislation would not distinguish between a rural facility in Upstate New York or an urban facility in a city of 8.6 million people. All hospitals and nursing homes would be subject to the same staffing ratios at the same time — with no exceptions. This rigid, one-size-fits all approach would be devastating to our local healthcare system, especially to rural hospitals and nursing homes.

There is no scientific evidence that government-mandated staffing ratios would improve the quality of care that patients receive. Instead, it takes a team of experienced healthcare professionals who have the knowledge and the flexibility to respond to their patients’ needs. Government-mandated ratios would have the unintended consequence of eliminating jobs for other healthcare professionals who assist nurses in patient care, including technicians, respiratory therapists, physical therapists, occupational therapists, and other members of the healthcare team.

Voters in Massachusetts rejected a similar ballot initiative Nov. 6. An independent study by two research groups determined that government-mandated staffing ratios would have cost Massachusetts hospitals $1.3 billion the first year and $1 billion each year after that, with an additional $100 million in state spending. The Massachusetts legislature would have been forced to significantly raise taxes to comply with the mandate. New York has almost three times the population of Massachusetts. The cost to our healthcare system would be astronomical.

Government-mandated ratios would significantly increase costs for healthcare providers that are already facing significant financial challenges. New York’s hospitals have the second-lowest operating margins in the nation, and some smaller, rural hospitals are struggling to keep their doors open. Many nonprofit nursing homes are in a similar situation. Fortunately, Gov. Cuomo recognized the difficulties that healthcare providers face and directed the NYS Department of Health to study the cost of staffing ratios in his FY 2020 executive budget.

Even if the government-mandated staffing ratios were implemented in New York, hospitals and nursing homes would be unable to meet the requirements due to the nursing shortage. There simply aren’t enough nurses. According to a Workforce Development Study conducted by the University at Albany, certified nursing aids (CNAs) are the most difficult specialty to recruit and retain at long-term care facilities. If facilities are forced to limit the number of patients they can receive due to staffing ratios, patients will be forced to stay in the hospital longer, decreasing the number of beds that are available for others. It’s common sense that the state can’t pass legislation that’s impossible to comply with.

Hospitals are the economic drivers of their communities. In Rochester, the top two employers are UR Medicine/The University of Rochester and Rochester Regional Health. Imposing government-mandated staffing ratios would have a devastating impact on the local economy. We’re fortunate to have two excellent healthcare systems in Rochester and the Finger Lakes — why would we put it all at risk?

Pandion Healthcare: Education & Advocacy strongly urges state legislators to oppose this legislation. We don’t need another unfunded mandate that would increase costs for both patients and providers, and we don’t need politicians in Albany telling nurses how to do their jobs.

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