The short answer
New York law requires nursing homes to provide an average of at least 3.5 hours of direct nursing care per resident per day, with at least 2.2 hours from certified nursing assistants and at least 1.1 hours from licensed nurses (RNs and LPNs). Federal rules also require an RN on duty at least eight hours a day, seven days a week, a licensed charge nurse on every shift, and enough staff to meet every resident's needs.
The rules
- New York minimums: 3.5 hours of care per resident per day, including 2.2 hours of CNA care and 1.1 hours of licensed nurse care.
- Federal requirements: sufficient staff with the right skills to meet each resident's needs, an RN at least eight consecutive hours a day, seven days a week, a full-time director of nursing, and a licensed charge nurse on each shift.
The minimum is a floor, not a target. A unit with many residents who need two-person transfers, feeding help or frequent turning may need far more.
How to check staffing
- Read the posted staffing. Nursing homes must post daily nurse staffing numbers at the start of each shift, in a place residents and visitors can see. Facilities must keep these postings for at least 18 months.
- Check the staffing rating for any facility in our directory. It is based on payroll data the facility reports to Medicare.
- Visit at different times, including evenings and weekends, when staffing is usually thinnest.
- Ask how many residents each CNA is assigned on days, evenings and nights.
Signs of understaffing
- Call bells ringing for a long time
- Residents left in bed, in wet briefs or in the same position for hours
- Meal trays left untouched for residents who need feeding help
- Heavy use of agency staff who do not know the residents
- Repeated falls and new pressure injuries on the unit
The rules behind this
- New York Public Health Law § 2895-b
- 10 NYCRR § 415.13
- 42 C.F.R. § 483.35 (nursing services and posted staffing data)
Related questions
This guide provides general information, not medical or legal advice. Rules change; confirm current requirements with the facility, the New York State Department of Health or a professional. Attorney Advertising.