Caregivers at Lower Manhattan Hospital Allege Dangerous and Illegal Patient-to-Staff Ratios
Nurses allege that the only hospital in Lower Manhattan is violating state law by maintaining dangerously low staffing levels. In an official notice filed by their union, the Communications Workers of America (CWA), with the State Department of Health (DOH), nurses argue that NewYork-Presbyterian Lower Manhattan Hospital (LMH), located at 170 William Street, has accrued more than 2,000 violations of minimum staffing levels required under the 2021 Safe Staffing law. This statute requires hospitals to empanel clinical staffing committees, evenly divided between hospital management and front-line nurses, when setting headcounts for various units such as the emergency department and intensive care. Under the law, DOH can impose penalties against hospitals that fail to create such a plan or comply with its standards.
The staffing plan formulated by LMH and filed with DOH calls for a total of 70 registered nurses to be assigned each day and evening shift across a dozen departments, with 55 nurses on the overnight shift. This plan notes that the LMH clinical staffing committee reached consensus on the required numbers of nurses and support staff in four of these 12 departments: ambulatory surgery, recovery, operating rooms, and endoscopy. For the remaining eight departments (including the emergency room, the intensive care unit, and the neonatal intensive care unit), LMH rejected the staffing levels proposed by the nursing representatives on the clinical staffing committee.
The CWA alleges that LMH has illegally disregarded the staffing levels called for by nurses across the eight departments for which management and nurse representatives could not agree.
Angela Smith Karafazli, a spokesperson for LMH responds, “we continue to actively participate in the clinical staffing committee process that was developed as part of the New York State staffing law, and believe it is the most effective and appropriate forum to collaboratively address staffing needs.”
A CWA spokesperson counters that since the Safe Staffing Quality Care Act went into effect, “nurses and other healthcare workers have mobilized to track staffing in their units themselves, to ensure clinical staffing plans are being followed. The 2,000-plus complaints are mainly instances where healthcare workers documented they were working under unsafe ratios, due to the hospital’s inability to attract and retain staff. The complaint review process necessitates clinical staffing committee members reach a consensus on a resolution plan, a written document outlining management’s actions to address staffing concerns. A resolution plan has yet to be established for any of the substantiated complaints determined by the clinical staffing committee at New York Presbyterian Lower Manhattan, and that is why CWA is now escalating concerns to the DOH.”
The complaints filed with state regulators about LMH are part of a broader push, in which the CWA has alleged more than 8,000 such violations at hospitals across the state. Approximately 25 percent of this statewide total focuses on LMH.
Beth Loudin, a nurse who works in LMH’s neonatal intensive care unit, said at a Tuesday rally outside a state legislative hearing in Manhattan, “we assist in open heart surgery on infants. This kind of specialized care requires very specialized nurses. Over the last few years, we’ve seen a decline in our staffing numbers. This is a lack of respect that violates safe standards. We have to overcome a lot to deliver quality care.”
“Last week,” she continued, “DOH finally showed up and actually started investigating all these complaints. DOH needs to stop listening to lobbyists and hospital management and start listening to the people actually doing the work, the nurses and front-line healthcare workers.”
A DOH spokesperson acknowledged that LMH is among a group of 11 hospitals that were cited for violations of the law, adding, “these hospitals were required to submit a corrective action plan. As this may be the subject of an ongoing investigation, we cannot comment further at this time.”
At Thursday’s rally, Pat Kane, the executive director of the New York State Nursing Association, said, “there is no shortage of nurses. There is a shortage of nurses that are willing to work under the conditions we are seeing in our hospitals.”
A CWA spokesperson added, “decades of underfunding and staffing shortages across New York have plunged the state’s healthcare workforce into crisis, requiring healthcare workers to push themselves past the point of exhaustion, working mandatory overtime with skeleton crews. Meanwhile, hospitals throughout the state are having to work with negative or unsustainable operating budgets, incentivizing the further reduction of healthcare workers, exacerbating short staffing, worsening quality of care and further destabilizing the workforce.”