Staffing Ratios—Sample Letter
Dear [name of legislator]
I write to you today as a trustee of ___________ Hospital to express my strong opposition to Assembly Bill 6571 and Senate Bill 3691, which would impose one-size-fits-all nurse staffing ratios on hospitals and nursing homes across New York State.
This legislation would not only impose the largest-ever unfunded health care mandate in New York State, approximately $3 billion annually, it would require more than 20,000 new nurses in hospitals alone, assuming these nurses could be found.
Moreover, mandating statewide staffing ratios is the wrong approach to determine staffing levels. This legislation does not account for the unique patient population at each facility and the specific needs of individual patients. I strongly believe that minimum staffing ratios will obstruct our ability to ensure quality of care and fulfill our mission of service to the community.
Providing quality care at my hospital is a top priority. The latest peer-reviewed studies find no direct link between mandated nurse staffing ratios and improved patient outcomes as outcomes are improved primarily by implementing evidence-based practices to standardize care. Hospitals continue to aggressively put into practice a variety of patient care improvement strategies, including the substantial work of the New York State Partnership for Patients initiative to improve quality and patient safety.
Staffing at my facility is determined by many complex factors that appropriately vary across facilities. It starts with the condition of the patient and their needs. It also includes the experience, education, and preparation of the staff; the use of technology; the physical layout of the hospital or nursing home; and the number and competencies of clinical and non-clinical staff that collaborate with nurses. Nurses have different skill and experience levels and the responsibilities of nurses will justifiably differ between novices and experienced nurses.
The appropriate level of staffing changes day to day, unit by unit. This complexity cannot and should not be reduced to simple numbers—greater flexibility is needed. These bills would inappropriately rely on a formula—rather than on the judgment and experience of health care professionals and providers—to deliver quality care.
Hospitals and nursing homes in New York State are undergoing significant transformation and struggle under the cumulative impact of more than $27 billion in recent and anticipated state and federal cuts.
Mandating minimum staffing ratios runs counter to efforts to change health care delivery from inpatient to outpatient and community settings, and are an outdated concept.
Instead, I urge you to support measures that focus on population health, invest the necessary resources to stabilize and transform the health care delivery system, and provide regulatory and mandate relief.
I respectfully but urgently ask you to oppose legislation that mandates minimum staffing ratios.