New York nursing homes will have to begin complying with new minimum staffing requirements this month after being granted a temporary reprieve by Gov. Kathy Hochul.

The governor had issued multiple executive orders delaying the rules, which were supposed to take effect in January, citing a health care workforce shortage. But after facing pressure from state Attorney General Letitia James and labor organizers, she quietly allowed the last order to expire on Thursday without renewing it.

The new rules will require nursing homes to hire enough staff to provide an average of 3.5 hours of daily clinical care to each resident. These long-term care facilities will also have to spend at least 70% of revenue on direct patient care and at least 40% of revenue on the staff needed to provide that care. Nursing home profits will be capped at 5%.

Nursing home lobbyists still claim that many operators will struggle to recruit the staff necessary to comply with the new staffing standards. But advocates for nursing home residents and the 1199 SEIU labor union held a press conference Friday afternoon to celebrate the rules taking effect.

“These are our most fragile citizens, and we need to make sure they are being taken care of,” said Beth Finkel, the New York State director for AARP. “In times of crisis, you don’t lower the standards. You raise the standards because otherwise the quality of care will plummet.”

Advocates and labor leaders said at the press conference that the next step is for the state to ensure that non-compliant nursing homes face consequences. Nursing homes with profit margins greater than 5% this year are supposed to send any excess revenue to the state by next November. The money will be put into a fund that will be redistributed to long-term care facilities based on their performance.

Proposed penalties for homes that don’t comply with the daily staffing hours are still being finalized.

Only about 63% of 611 nursing homes across New York state were in compliance with the 3.5 hour staffing requirement in the third quarter of 2021, according to a recent report from the consulting firm Clifton Larson Allen. The report determined that it would cost $324.5 million annually for all of the state’s operators to come into compliance with the new requirements.

If the 1% increase to the Medicaid rate that Hochul has proposed is included in the final state budget, which is officially delayed, that would result in about $140 million additional dollars a year for nursing homes, according to Stephen Hanse, president and CEO of the New York State Health Facilities Association, which represents nursing homes. His organization commissioned the report from CLA.

But Hanse said staffing up at nursing homes will require more than just additional funds.

“The original executive order [from Hochul] spoke about a health care workforce crisis,” Hanse said. “And here we are on April 1st. The health care workforce crisis has not subsided and has not been resolved.”

Asked to respond to claims that the workers needed to fill the gaps are simply not available, advocates at Friday’s press conference said that nursing homes should begin by working harder to retain the staff they have.

“If employers actually invest and do everything they can to retain those workers, they won’t lose them,” said Milly Silva, executive vice president of 1199 SEIU. “They need to confront issues around wages, issues around benefits and issues around working conditions.”

While nursing homes continue to push back on these mandates, consumer advocates said their next move will be to fight to raise minimum staffing standards even higher.