Comptroller Stringer to New York State: Pass Safe Staffing for Quality Care Act to Save Lives and Cut Costs

(New York, NY) — Today, New York City Comptroller Scott M. Stringer sent a letter to Governor Andrew Cuomo, State Senate Majority Leader Andrea Stewart-Cousins, and State Assembly Speaker Carl Heastie urging the passage of the Safe Staffing for Quality Care Act to save lives, improve patient outcomes, and provide critical support to the overburdened healthcare workers who have brought New York City through the COVID-19 pandemic. Comptroller Stringer underscores that this bill would not only ensure hospitals and nursing homes are equipped with the staff they need to safely care for their patients, but the clear improvements in patient outcomes associated with safe staffing standards would result in reduced healthcare costs and higher reimbursement.

The full letter is available below and here.

Dear Governor Cuomo, Majority Leader Stewart-Cousins, and Speaker Heastie,

I am writing to express my strong support for the Safe Staffing for Quality Care Act (A108/S1168), a necessary and urgent reform that would save lives, improve patient outcomes, and provide critical support to the overburdened healthcare workers who have brough New York City through the COVID-19 pandemic. All New Yorkers deserve quality healthcare and the Safe Staffing for Quality Act will ensure hospitals and nursing homes are equipped with the staff they need to safely care for their patients. By establishing strong staffing standards, we can ensure that no nurse or caregiver is ever forced to stretch their focus across large pools of patients instead of offering the careful, attentive, and individualized care that is associated with better outcomes. I believe implementing the safe staffing requirements set out by the bill will result in significant savings to hospitals and nursing homes by averting costly patient complications and associated readmissions, increasing federal reimbursements, and reducing turnover of nurses and caregivers. I urge the New York State Assembly and Senate to pass this bill this year.

COVID-19 has reinforced how much society relies on the provision of quality healthcare that can protect our families against illness and disease. Every day of the year, through pandemics or disasters, our nurses and caregivers dispense expert care that ensures all patients are looked after. The minimum staffing standards proposed by the Safe Staffing for Quality Care Act would mandate that hospitals and nursing homes employ enough nurses to properly and responsibly care for their patients. Under the bill’s provision, nurses would care for no more than 4 patients each in adult medical or surgical units. Currently, staffing levels far exceed that standard. Even prior to COVID-19, nurses within New York City have been forced to juggling care responsibilities across an average of 6.9 patients while on duty. The proposed bill would drastically cut that ratio, especially in specialty units within hospitals where patients require additional attention and treatment.

A series of peer-revied studies definitively establish the clear  benefit of low staffing ratios. According to a study released this month by researchers at the University of Pennsylvania, each patient reduction in a nurse’s workload patient per nurse is associated 13 percent reduction in deaths for elderly patients and a 9 percent decrease in the length of hospital stays for general medical patients. Professor Aiken’s research indicates that had all New York State hospitals abided by the staffing ratio’s proposed in the legislation, more than 4,370 deaths could have been averted among elderly Medicare patients during a two year timeframe. These results have been replicated across scores of studies all arriving that the same conclusion. Increasing staffing reduces deaths and improve patient outcomes. Even adding one additional nurse per patient is associated with a 16 percent decrease in deaths resulting from treatable complications. Just a five percent increase in nursing staff can potentially reduce adverse medical events by more than 15 percent.

These research findings have been tragically reenforced by the lived experiences of nurses and caregivers during the COVID-19 pandemic. A damning report by New York Attorney General Tish James has found that the rate of COVID-19 deaths within nursing homes was directly correlated with staffing levels. As many as 3,300 lives may have been saved just be requiring understaffed nursing homes to had met the staffing standards of ‘five star’ rated nursing homes. Even prior to the tragic events of the COVID-19 pandemic, low levels of staffing have been associated with allegations of abuse and neglect among patients.

Crucially, evidence suggests that increasing staffing will not just save lives, it will save costs. The clear improvements in patient outcomes associated with safe staffing standards are associated with reduced healthcare costs and higher reimbursements. Safe staffing improves metrics that are rewarded by Medicare’s Value Based Purchasing programs such as hospital readmissions and patient outcomes. Californian hospitals have thrived after a similar implementation of safe staffing requirements in 2004. Safe staffing also reduced the stresses and opportunities for burnout that contribute to costly rates of nurse turnover.

The COVID-19 pandemic has reinforced the impetrative of following the science and listening to frontline health care workers – both are unequivocal that fair staffing ratios will provide a better healthcare experience for New Yorkers. Our nurses and caregivers desperately want to deliver the high quality healthcare every New Yorker deserves when they enter a hospital or nursing homes. Safe staffing legislation will allow these professions to better serve our families and neighbors in their time of need. I urge you to pass this bill this session.

Sincerely,

Scott Stringer

New York City Comptroller

###