Report Finds Widespread Understaffing in Hospitals and Lack of Compliance with Safe Staffing Laws
New York’s Staffing Law at a Critical Point with Commission Missing Report Deadline and Legislature to Evaluate Law in 2025
The New York State Nurses Association (NYSNA) released a report examining the impact of New York’s safe staffing laws that passed in 2021. The report is the first attempt to measure the impact the law has had on staffing levels in New York’s hospitals. Unsafe staffing levels in New York’s hospitals undermine the quality of care patients receive.
The state staffing law created an independent advisory commission tasked with releasing a report in October 2024 to assess the law’s effectiveness and make recommendations to the New York Legislature. The Commission has yet to release a report due to the lack of data available to evaluate staffing law progress.
The NYSNA report attempts to fill this gap by analyzing data gathered through polls, direct member reporting, and case studies from the experience of frontline registered nurses. It also examines the roots of the nurse staffing crisis, implementation of the law, and offers recommendations to improve staffing conditions in all hospitals around the state.
New data analysis from the report finds that a majority of hospitals fail to publicly post all staffing plans and actual daily staffing levels in all units of the hospital, as the law requires. It also finds that surveyed hospitals failed to staff ICU and critical care patients at the 1:2 nurse-to-patient ratio mandated by the staffing law more than 50% of the time.
NYSNA President Nancy Hagans, RN, BSN, CCRN, said: “Safe staffing continues to be New York nurses’ top priority, because we know that upholding these safety standards will keep our patients safe and improve hospital care everywhere. New York needs a strong staffing law that works for nurses and patients and holds hospitals accountable. We will continue advocating to increase implementation and enforcement of the staffing law, as well as other policies that help recruit, retain and train enough nurses for quality patient care.”
The report includes detailed case studies of how the law is working—or not working—to increase transparency, improve staffing levels and hold hospitals accountable at Albany Medical Center, Vassar Brothers Medical Center and NewYork-Presbyterian Hospital. Albany Medical Center is a prime example of how the clinical staffing law is failing patients, nurses and communities.
NYSNA nurse leader and staffing committee member at Albany Med, Jaimie Alaxanian, RN, said: “I take care of patients after they’ve had surgery, and my floor is staffed to the bare minimum. I’m on the hospital clinical staffing committee, and we’ve worked with administrators and submitted a plan to the DOH that outlines that the nurse-to-patient ratio on my unit shouldn’t exceed one nurse to five patients. The CEO keeps talking about this plan being such an accomplishment, but it’s not being implemented.”
Where the DOH has investigated staffing complaints, cited the hospital for deficiencies, and ordered a corrective action plan, nurses have seen improvements in staffing. Unfortunately, since the law became enforceable in January 2023, there have been very few success stories.
NYSNA Treasurer and Vassar Brothers Medical Center nurse Margaret Franks, RN, BSN, was instrumental in tracking staffing levels for one year. She said: “When the DOH finally met with the staffing committee after their investigation, the nurses and techs were so happy that someone was finally acknowledging what we were going through. Instantly, we started seeing change. But it required speaking up and having the DOH hold the hospital accountable.“
NYSNA Executive Director Pat Kane, RN, who was instrumental in advocating for the staffing laws that passed in 2021, said: “Nurses are the patient advocates, but we cannot do it alone. Nurses and patients deserve to see more success stories and more hospitals meet safe staffing standards. This report shines a light on the ongoing staffing crisis and gives policymakers a roadmap to improving staffing in New York’s hospitals.”
NYSNA urges regulators and policymakers to strengthen the current law and follow our other recommendations for addressing the nurse staffing crisis. NYSNA recommends:
- The DOH must increase transparency so that the public can see actual staffing levels in New York’s hospitals.
- The DOH must enforce safe staffing standards as the law requires.
- Expand nurse recruitment and retention.
- Restore quality training and orientation programs.
- Respect nurses by improving working conditions, including health and safety protections, pay and benefits.
Visit nysna.org for more information.
