New York nursing homes reported staffing below the 3.50 HPRD standard on more than half of facility-days in 2025.

Data sources and scope

Primary legal reference: N.Y. Public Health Law § 2895-b. This analysis uses CMS Payroll-Based Journal (PBJ) daily nurse staffing for calendar year 2025: four quarterly CSV releases (CY2025Q1–Q4). Each record is one nursing home on one work date with role-level hours and census.

Facilities are limited to New York State CCNs present in PBJ during 2025. The unit of analysis is the facility-day (one home, one calendar day, census > 0).

Staffing metric (HPRD)

Primary NY-mapped HPRD (§ 2895-b default): (RN + LPN + CNA + Med Aide + NA trainee) ÷ MDS census. Excludes RN DON, RN admin, and LPN admin from the default total and from the default licensed-nurse floor.

Daily vs. quarterly: Daily analysis compares each facility-day’s reported NY-mapped direct-care HPRD with the 3.50 standard. Quarterly statutory-style analysis applies the full mapped standard — 3.50 total, 2.20 CNA-side, and 1.10 licensed nurse — at the facility-quarter level. Daily counts describe reported staffing levels; quarterly rollups are descriptive statutory-style mappings, not NY DOH enforcement determinations.

Primary daily metric: reported NY-mapped direct-care HPRD strictly below 3.50. Hero KPIs, weekend breakdown, and the facility directory use this reference. Other daily charts include inline PBJ Standard controls.

NY statutory role floors (quarterly): CNA-side HPRD = CNA + Med Aide + NA trainee ÷ census (floor 2.20). Licensed-nurse HPRD = RN + LPN only ÷ census (floor 1.10). Counts appear in the facility table quarterly columns. A comparison toggle shows the broader eight-role PBJ total; an embedded include-DON sensitivity adds RN DON to both the 3.50 total and the 1.10 licensed-nurse floor (still excluding admin).

Threshold and “below standard”

Scenario default threshold: 3.50 HPRD (3.50 total component). A facility-day counts as below when HPRD is strictly less than the threshold (days exactly at the threshold count as compliant).

Note: MACPAC lists 3.56 HPRD for New York total nursing, including 0.06 HPRD of a registered professional nurse to serve as the DON on a full-time basis.

PBJ Standard controls live inside each daily scenario chart (threshold and staff mix). Weekend breakdown and the facility directory use the NY 3.50 direct-care reference.

Ownership, geography, and charts

Ownership and county are assigned from CMS Provider Info snapshots aligned to each PBJ quarter where available.

NYC = Kings (Brooklyn), Queens, Bronx, New York (Manhattan), Richmond (Staten Island).

Weekend views combine Saturday and Sunday facility-days before aggregating.

Grouped ownership bars and the slice table follow the inline PBJ Standard controls on those charts.

Day-of-week chart

One bar per weekday (Mon–Sun) for NY statewide facility-days with census > 0. Below standard at threshold T: share of that weekday’s facility-days with the active metric strictly below T. Values come from precomputed day-of-week curves and update with scenario controls.

County map and top-county bars

County map uses approximate county centroids (not facility address geocoding). Bubble area scales with facility-day volume; fill color encodes % below standard at the active threshold (green / amber / red tiers in legend). The horizontal county chart lists the top 10 counties by volume; bar fill uses a blue scale by % below (see chart note).

Facility table

Each row is one nursing home (CCN) with 2025 facility-day count, mean HPRD, and a precomputed below-standard curve for thresholds 2.50–5.50 HPRD. Sorting and filters run in your browser; changing scenario controls swaps the curve for each home—no live download on each click.

Provider-day bands

For each home, compute the share of its 2025 facility-days (census > 0) with total nursing HPRD strictly below the active threshold. Sort homes into bands: 100% of days below, 90–99%, 75–89%, and so on. Bars show the percent of nursing homes in each band (596 in this report). Same facility curves as the table; recomputed when scenario controls change.

Quarterly statutory-style mapping

New York determines staffing compliance quarterly. PBJ320 summarizes each facility-quarter (sum of mapped role hours ÷ sum of census-days) against all three NY floors: 3.50 total, 2.20 CNA-side, and 1.10 licensed nurse. Provider table quarterly columns show quarters below ÷ quarters analyzed (e.g. 2/3, not 2/4). These calculations are descriptive and are not NY DOH enforcement determinations.

NY role floors (quarterly mapping)

For each facility-quarter with census-days > 0, three HPRD measures are computed from summed PBJ role hours:

NY-mapped total HPRD

RN + LPN + CNA + Med Aide + NA trainee ÷ census-days. Floor 3.50.

CNA-side HPRD

CNA + Med Aide + NA trainee ÷ census-days. Floor 2.20 (NY statute).

Licensed-nurse HPRD

RN + LPN only ÷ census-days. Floor 1.10 (NY statute mapping).

Met all three — the facility-quarter meets all mapped floors (AND). Missing any floor — below on total, CNA-side, or licensed nurse. Counts appear in the facility table.

Limitations

1. Based on facilities' self-reported PBJ daily data, not NY DOH enforcement records or penalty assessments.
2. This report does not evaluate whether NY minimum staffing policy is sufficient, effective, or well designed—only how often PBJ-reported days fall below mapped thresholds.
3. Default NY-mapped HPRD excludes RN DON, RN admin, and LPN admin; the comparison toggle shows the broader eight-role PBJ total.
4. Days with zero census excluded. Days at exactly the threshold count as compliant (strictly below only).
5. Ownership and county from CMS Provider Info, quarter-aligned snapshots. NYC = five boroughs.

Primary sources

• CMS PBJ Daily Nurse Staffing
• N.Y. PHL § 2895-b
• NY DOH — minimum staffing summary
• MACPAC State Staffing Policies

How to replicate this analysis

This report uses public CMS data. Findings can be replicated using methodology below.

1. PBJ daily staffing — Download quarterly CMS PBJ nurse staffing files for your state and year from data.cms.gov (e.g. CY2025Q1–Q4).
2. Provider Info — Download ownership and county from the Provider Data Catalog; join to PBJ by CCN.
3. Facility-days — One row per home per calendar day (census > 0). Sum hours by role; divide by census for HPRD; flag days strictly below your threshold.
4. Aggregates — Statewide and slice-level shares below standard by day of week, ownership, county, and other cuts used in the charts.
5. NY role floors — Compute CNA-side and licensed-nurse (RN+LPN) HPRD on the default NY-mapped roles. For quarterly statutory-style rollups, aggregate role hours and census-days by facility-quarter, then flag whether each facility-quarter meets all three mapped floors.

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