Nurse and patient

Nurse Staffing Ratios

Unnecessary, unaffordable

The Coalition for Safe and Affordable Care is a diverse group of patient-focused nursing, health care, and other organizations that believe inflexible, government-mandated nurse staffing ratios are wrong for patients and wrong for New York.

Legislation proposed by the New York State Nurses Association and other nursing unions (A.02954/S.1032) would mandate strict nurse-to-patient ratios at every hospital and nursing home across New York State. This draconian bill would limit access to care and threaten patient safety by undermining real-time patient care decisions, robbing health care facilities of the flexibility to respond to emergencies, and compromising caregivers’ ability to deliver safe, affordable care. It would also drive up costs by over $3 billion per year.

Get involved

What's at Stake?

Rigid, government-mandated nurse staffing ratios would override the professional judgment of nurses and other health care professionals, threaten patient safety and quality of care, and drive up costs by more than $3 billion per year annually. That’s money most hospitals and nursing homes don’t have for a staffing formula they don’t need.

There is no data to suggest these arbitrary ratios will improve quality outcomes. So, what will happen?

Critical care programs will decrease, hospital departments will downsize, and some community hospitals and nursing homes will close their doors for good when they can no longer remain financially viable. Access to care for New York’s most vulnerable residents will be seriously impacted. New York’s entire health care ecosystem will suffer irreparable harm.

One-size-fits-all ratios make no sense for New York’s varied hospitals and communities.

New York has some of the best hospitals in the world, with high-quality outcomes in every category, but no two of them are alike, nor are their patients. Holding every hospital to the same staffing plan makes no sense and would disrupt the quality care currently being provided.

Health care decisions should be made by health care professionals, not by the government.

Rigid, government-mandated nurse staffing ratios would replace the judgment of professional local nurses and doctors with strict, arbitrary state standards. It is essential that these experienced professionals have flexibility when responding to diverse patient and resident needs that can evolve and change quickly.

The bill's $3 billion annual cost will divert funding away from vital services.

Hospitals and nursing homes will be forced to cut vital health care programs such as cancer screenings, opioid treatments, mental health services, domestic violence programs and pre- or post-natal care. Many rural and community hospitals and nursing homes operate on razor thin operating margins. This mandate would force facilities already struggling to remain viable to decrease services or close their doors completely.

Nurse staffing ratios would drive up costs at a time when health care funding is already at risk.

This staffing mandate, on top of the ever-present threat of Federal health care cuts, will put substantial financial burdens on New York’s providers, and ultimately drive up costs for patients.

There is no data to support government-mandated nurse staffing ratios.

No credible scientific studies or reports have found that government-mandated, one-size-fits-all nurse staffing ratios improve patient care. California’s government-mandated nurse staffing ratios show no direct correlation to improved patient safety and outcomes.

Nurse staffing ratios will dramatically increase emergency room wait times, delay lifesaving care services, and threaten quality of care.

Government-mandated nurse staffing ratios would force hospitals to send patients to hospitals farther away. Hospitals would be prevented from admitting patients if the number of nurses on duty does not comply with the mandated ratio. The law would prevent hospitals from providing urgent and critical care, even in the event of an unexpected influx of patients.

Many nurses do not support staffing ratios.

Every patient is different, and every nurse has unique expertise and experience. Flexibility is essential in responding to diverse patient and resident needs that can evolve and change quickly. Safe, high-quality care is about matching the skill set of the nurse with the unique symptoms of each patient. Mandated ratios take away the autonomy that nurses rely on.

Nurses need—and want—the ability to make their own decisions at the bedside. If this legislation passes, nurses will lose the flexibility to make real-time patient care decisions, even in life or death situations.

This is an effort by a few nurses unions that represent less than one in five nurses in New York. Issues involving unions should be addressed during the contract process at individual hospitals, rather than the government imposing a one-size-fits-all policy.

Nursing homes serve a unique and vulnerable community. A one-size-fits-all mandate would put our elderly at serious risk.

If this legislation is enacted, nursing homes may be unable to accept new patients or residents, leading to patient backups in hospitals and unsafe living situations in the community. Nurse staffing ratios would come at an unmanageable fiscal cost for these facilities, effectively hurting the elderly population of New York State.

Team-based care would suffer.

Rigid, government-mandated nurse staffing ratios would deny hospitals the workforce flexibility they need and crowd out other essential members of the health care team, including staff physicians, licensed practical nurses, physical therapists, dieticians, clinical pharmacists, lab technicians, social workers, and others.

Lack of Evidence

There's a reason 49 states don't have hospital-wide nurse staffing ratios, and why the voters of Massachusetts so soundly rejected them last year. Albany should support New York's hospitals and nursing homes by letting them make their own patient care decisions, not harm them by imposing unnecessary and unaffordable mandates.

No credible study has found a direct link between fixed nurse staffing ratios and improved patient outcomes. California remains the only state to mandate nurse staffing ratios in every unit of every hospital—at enormous cost to the institutions—and the patient care improvements that were promised simply haven't happened.

The Coalition for Safe and Affordable Care is a diverse group of organizations with the shared belief that nurse staffing ratios are unnecessary and unaffordable for New York's hospitals and nursing homes.

  • Business Council of New York State
  • Coalition of New York State Public Health Plans
  • Continuing Care Leadership Coalition
  • Greater New York Hospital Association
  • Healthcare Association of New York State
  • Iroquois Healthcare Alliance
  • LeadingAge New York
  • New York Organization of Nurse Executives and Leaders
  • New York State Coalition of Managed Long Term Care/PACE Plans
  • New York State Health Facilities Association
  • NYS Council of Deans of Baccalaureate and Higher Degree in Nursing Programs
  • Organization of Nurse Leaders, Massachusetts
  • Organization of Nurse Leaders, New Jersey
  • Pandion Healthcare: Education & Advocacy
  • Partnership for New York City
  • Pennsylvania Organization of Nurse Leaders
  • Southern New York Association
  • Suburban Hospital Alliance of New York State
  • Westchester County Association
  • Western New York Healthcare Association
Nurse and patient

Nurse Staffing Ratios

Unnecessary, unaffordable

The Coalition for Safe and Affordable Care is a diverse group of patient-focused nursing, health care, and other organizations that believe inflexible, government-mandated nurse staffing ratios are wrong for patients and wrong for New York.

Legislation proposed by the New York State Nurses Association and other nursing unions (A.02954/S.1032) would mandate strict nurse-to-patient ratios at every hospital and nursing home across New York State. This draconian bill would limit access to care and threaten patient safety by undermining real-time patient care decisions, robbing health care facilities of the flexibility to respond to emergencies, and compromising caregivers’ ability to deliver safe, affordable care. It would also drive up costs by over $3 billion per year.

Get involved

What's at Stake?

Rigid, government-mandated nurse staffing ratios would override the professional judgment of nurses and other health care professionals, threaten patient safety and quality of care, and drive up costs by more than $3 billion per year annually. That’s money most hospitals and nursing homes don’t have for a staffing formula they don’t need.

There is no data to suggest these arbitrary ratios will improve quality outcomes. So, what will happen?

Critical care programs will decrease, hospital departments will downsize, and some community hospitals and nursing homes will close their doors for good when they can no longer remain financially viable. Access to care for New York’s most vulnerable residents will be seriously impacted. New York’s entire health care ecosystem will suffer irreparable harm.

One-size-fits-all ratios make no sense for New York’s varied hospitals and communities.

New York has some of the best hospitals in the world, with high-quality outcomes in every category, but no two of them are alike, nor are their patients. Holding every hospital to the same staffing plan makes no sense and would disrupt the quality care currently being provided.

Health care decisions should be made by health care professionals, not by the government.

Rigid, government-mandated nurse staffing ratios would replace the judgment of professional local nurses and doctors with strict, arbitrary state standards. It is essential that these experienced professionals have flexibility when responding to diverse patient and resident needs that can evolve and change quickly.

The bill's $3 billion annual cost will divert funding away from vital services.

Hospitals and nursing homes will be forced to cut vital health care programs such as cancer screenings, opioid treatments, mental health services, domestic violence programs and pre- or post-natal care. Many rural and community hospitals and nursing homes operate on razor thin operating margins. This mandate would force facilities already struggling to remain viable to decrease services or close their doors completely.

Nurse staffing ratios would drive up costs at a time when health care funding is already at risk.

This staffing mandate, on top of the ever-present threat of Federal health care cuts, will put substantial financial burdens on New York’s providers, and ultimately drive up costs for patients.

There is no data to support government-mandated nurse staffing ratios.

No credible scientific studies or reports have found that government-mandated, one-size-fits-all nurse staffing ratios improve patient care. California’s government-mandated nurse staffing ratios show no direct correlation to improved patient safety and outcomes.

Nurse staffing ratios will dramatically increase emergency room wait times, delay lifesaving care services, and threaten quality of care.

Government-mandated nurse staffing ratios would force hospitals to send patients to hospitals farther away. Hospitals would be prevented from admitting patients if the number of nurses on duty does not comply with the mandated ratio. The law would prevent hospitals from providing urgent and critical care, even in the event of an unexpected influx of patients.

Many nurses do not support staffing ratios.

Every patient is different, and every nurse has unique expertise and experience. Flexibility is essential in responding to diverse patient and resident needs that can evolve and change quickly. Safe, high-quality care is about matching the skill set of the nurse with the unique symptoms of each patient. Mandated ratios take away the autonomy that nurses rely on.

Nurses need—and want—the ability to make their own decisions at the bedside. If this legislation passes, nurses will lose the flexibility to make real-time patient care decisions, even in life or death situations.

This is an effort by a few nurses unions that represent less than one in five nurses in New York. Issues involving unions should be addressed during the contract process at individual hospitals, rather than the government imposing a one-size-fits-all policy.

Nursing homes serve a unique and vulnerable community. A one-size-fits-all mandate would put our elderly at serious risk.

If this legislation is enacted, nursing homes may be unable to accept new patients or residents, leading to patient backups in hospitals and unsafe living situations in the community. Nurse staffing ratios would come at an unmanageable fiscal cost for these facilities, effectively hurting the elderly population of New York State.

Team-based care would suffer.

Rigid, government-mandated nurse staffing ratios would deny hospitals the workforce flexibility they need and crowd out other essential members of the health care team, including staff physicians, licensed practical nurses, physical therapists, dieticians, clinical pharmacists, lab technicians, social workers, and others.

Lack of Evidence

There's a reason 49 states don't have hospital-wide nurse staffing ratios, and why the voters of Massachusetts so soundly rejected them last year. Albany should support New York's hospitals and nursing homes by letting them make their own patient care decisions, not harm them by imposing unnecessary and unaffordable mandates.

No credible study has found a direct link between fixed nurse staffing ratios and improved patient outcomes. California remains the only state to mandate nurse staffing ratios in every unit of every hospital—at enormous cost to the institutions—and the patient care improvements that were promised simply haven't happened.

The Coalition for Safe and Affordable Care is a diverse group of organizations with the shared belief that nurse staffing ratios are unnecessary and unaffordable for New York's hospitals and nursing homes.

  • Business Council of New York State
  • Coalition of New York State Public Health Plans
  • Continuing Care Leadership Coalition
  • Greater New York Hospital Association
  • Healthcare Association of New York State
  • Iroquois Healthcare Alliance
  • LeadingAge New York
  • New York Organization of Nurse Executives and Leaders
  • New York State Coalition of Managed Long Term Care/PACE Plans
  • New York State Health Facilities Association
  • NYS Council of Deans of Baccalaureate and Higher Degree in Nursing Programs
  • Organization of Nurse Leaders, Massachusetts
  • Organization of Nurse Leaders, New Jersey
  • Pandion Healthcare: Education & Advocacy
  • Partnership for New York City
  • Pennsylvania Organization of Nurse Leaders
  • Southern New York Association
  • Suburban Hospital Alliance of New York State
  • Westchester County Association
  • Western New York Healthcare Association