Landmark Legal Decision in New York Sets Stage for Imposing Fines on Understaffed Nursing Homes

A recent legal development in New York marks a significant step towards the enforcement of minimum staffing requirements for nursing homes in the state. The move paves the way for the imposition of fines, reaching up to $2,000 per day, against nursing homes found to be understaffed.

The lawsuit, brought forth by LeadingAge and that challenged the New York state’s 2021 nursing home staffing law, was dismissed by Justice James Gilpatric. 

The staffing law, approved during former Gov. Andrew Cuomo’s tenure, mandates every facility to maintain daily staffing hours equivalent to 3.5 hours of care per resident per day by a certified nurse aide, licensed practical nurse, or registered nurse. Additionally, nursing homes are required to allocate at least 70% of revenue to direct resident care and a minimum of 40% of revenue to resident-facing staffing.


After years of delays, state health officials have declared that initial penalties are now imminent. The law, enacted to enhance resident care in the pandemic-burdened industry, is set to be rigorously enforced.

The fines for violations, including requested reductions, are actively being assessed and will be referred for enforcement beginning this week, according to a statement by officials to USA TODAY Network.

James Clyne Jr., president and CEO of LeadingAge New York, told USA TODAY Network that the organization will be filing an appeal.


The dismissal of the lawsuit on December 28 aligns with the state’s commitment to enforcing the staffing law. The judge rejected arguments presented by LeadingAge, emphasizing that the lawsuit was an ill-advised attempt to legislate through the courts, disregarding the separation of powers outlined in the New York Constitution.

Furthermore, the judge dismissed claims that the state staffing law conflicted with federal labor laws and Medicaid reimbursement issues. He asserted that state officials possess broad authority to enact laws aimed at safeguarding citizens’ health, including those pertaining to nursing homes.

Potential fines for nursing homes will hinge on their ability to demonstrate efforts to bolster staffing, state officials said.

LeadingAge argued that these potential fines are unreasonable given the prevailing labor market conditions, asserting that about 75% of facilities have been unable to meet staffing requirements.

Advocacy groups also said that about 400 facilities could not meet the staffing minimum requirements, citing in part flaws in those standards and national labor shortages.

“They admit that there are not enough health care workers; so why are (they) fining people?” Clyne said.

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