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Dear Friend of Heritage,

We reach out to you today to again share updates in how recent staffing mandates and budget concerns in New York State continue to impact nursing homes and those we serve.

The Background

As you know, a recent state New York State mandate regarding staffing was to go into effect on Jan. 1, 2022, requiring that nursing homes provide a quarterly average of 3.5 hours per resident per day of overall nursing services (which is comprised of registered nurses, licensed practical nurses, and aides). However, the Governor had, through Executive Order, delayed penalties for failure to meet the standards due to the current workforce shortage that is being felt throughout the healthcare system in the state.

On March 31, the Governor issued an updated Executive Order which continued a “statewide disaster emergency due to healthcare staffing shortages” in light of “severe understaffing in hospitals and other healthcare facilities” that is “expected to continue to affect the ability to provide critical care and to adequately serve vulnerable populations.” The order did not, however, continue the delay of penalties on nursing homes for failure to meet staffing mandates. As a result, the mandate took effect on April 1st, 2022. It is perplexing that the current health care staffing crisis is being recognized throughout the health care system, except in nursing homes.

What is Heritage doing to handle the situations presented by this mandate?

We want to assure you that, at Heritage, staffing has always been the top priority to us. We would like nothing more than to have enough staff to meet or exceed the mandates outlined in law. Our nurses and aides are fundamental to the high-quality care we are committed to providing. Unfortunately, there is a very serious workforce shortage right now, and despite ongoing efforts over the years, it has become harder and harder to recruit and retain staff. An analysis of the federal data discovered that 80.4% of nursing homes in the state would not be in compliance with this new mandate. Unfortunately, staffing shortages have grown since the time that data was collected, suggesting that even fewer will be able to comply today. Estimates indicate that 12,000 nurses and aides are needed, with over 9,000 needed immediately, to comply with the mandate.

There are other factors that contribute to this workforce shortage, and the pandemic has taken a particular toll on the healthcare workforce. But the state’s severely outdated Medicaid rate makes it particularly difficult for us to compete with other settings for the staff we need. Medicaid pays for nearly three quarters of all nursing homes resident days in the state, and is among the worst in the nation when payment is compared to costs. We are at the mercy of the state’s Medicaid rates, and it is not realistic to expect that private pay residents should shoulder the entire Medicaid shortfall.

Unfortunately, the consequence of failing to meet the staffing mandate is significant financial penalties, which will actually make it harder for us to pay higher wages and recruit people to work in our nursing homes. We felt it important that you understand that the promise of this mandate is a false one. Until we can recruit more staff, we cannot be in compliance, despite the state’s decision to begin penalizing homes that cannot meet the requirement.

What does this mean for you and your loved one?

We are committed to providing high-quality care. We will continue to work to recruit more staff, and we will work to ensure that the staff we have—who have been working so hard, particularly over the last two years, stay with us. We may need to make some hard decisions. We may need to stop taking new admissions. Our decisions will be guided by our mission to provide quality care and meet the requirements of the state mandate.

What can you do to help?

1. First and foremost, please understand that we have been working tirelessly to recruit and retain workers, well before this mandate.

2. You can help us find good people! If you know people that you think may want to work with us, send them our way or have them apply directly on our Careers Page.

3. Make your voice heard. You can also contact your state legislators and Governor Hochul to let them know that nursing homes are in desperate need of state funding to recruit and retain more workers. You can find information on how to contact your representative on our Advocacy Page. Every voice matters.

Again, we share this information so you can understand our commitment to increasing our staff, since quality care is our shared priority. We will keep you informed regarding our progress as it relates to meeting this mandate, and we are happy to answer any questions you might have. Please contact Sallie Williams, Vice President of Advancement at for more information or to share your concerns.

Thank you for your continued prayers and support for Heritage and the seniors we serve.