2024 NYSNA Staffing Report
Unsafe staffing levels in New York’s hospitals undermine the quality of care patients receive. All New Yorkers — from patients, community members, healthcare workers and their unions to legislators and regulators — have a stake in ensuring that the laws and regulations meant to protect patient safety are working well.
New York took a major step forward to address patient safety and the nurse staffing crisis when legislators passed a safe staffing law in 2021. The Clinical Staffing Committees and Disclosure of Nursing Quality Indicators law directed all hospitals to set minimum safe staffing standards and established a universal 1:2 nurse-to-patient staffing ratio for critical care patients.
Nearly three years after the law was enacted and two years after it became enforceable, New York is at a critical point. The law established an independent advisory commission, which was tasked with releasing a report on the law’s impact in October 2024 and making recommendations to the legislature in 2025. The Commission has yet to release a report due to the lack of data available to evaluate staffing law progress.
To fill the gap in evaluating the safe staffing law, New York State Nurses Association (NYSNA) members and staff took the work of gathering staffing data into their own hands, conducting staffing surveys at more than 60 facilities across the state. NYSNA members working in intensive care units (ICUs) and caring for critical patients conducted staffing reports for 532 shifts from 32 critical care units from 20 hospitals across the state. The data from these staffing surveys was compiled to create this report on the current state of the staffing crisis and how well the staffing law is working to address that crisis.
Key findings include:
- As of November 2024, only 33% of hospitals are publicly posting staffing plans in all hospital units. Sixty-two percent are posting the plans but only on some units.
- As of November 2024, only 55% of hospitals are publicly posting actual staffing levels on all units.
- From Jan. 1 to Oct. 31, 2024, 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.
Limited data, along with interviews with frontline nurses and case studies, show that understaffing in New York’s hospitals is still widespread and negatively impacts patient care, and there is much room for improvement in New York’s clinical staffing committee law. Hospital administrators continue to hire and schedule too few nurses to meet safe staffing standards, and many employers do not comply with procedural elements of the law meant to improve collaboration and transparency. Without strong implementation and enforcement of the law, it is difficult to measure its impact on hospital safety. However, we do know that the law has yet to deliver the kind of transparency and accountability that would ensure that all New York hospitals meet safe staffing standards.
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.
Most New Yorkers will require hospital care at some point in their lives, and a person’s access to quality healthcare should not depend on their ZIP code. All hospitals in New York should be held to safe staffing standards to improve quality care.