Governor Andrew Cuomo signed two landmark pieces of health care legislation Friday that will create minimum standards for staffing levels in hospitals and nursing homes. Health care unions have been seeking similar regulations for years, arguing that patient care suffers when nurses are stretched too thin.

“Congratulations to everyone who worked so hard to make this a reality,” Cuomo said during a press conference Wednesday to celebrate the signing. “I know it was hard, but New York is better for it.”

Evidence backs the claims that staffing levels are linked to the quality of care, but proposed regulations repeatedly stalled in the past amid opposition from hospital and nursing home groups. The issue gained a new sense of urgency during the COVID-19 pandemic as reports of understaffed intensive care units and nursing homes reached the public. The state legislature initially passed the measures in early May.

“COVID-19 laid bare the fact that New York's hospitals have been severely understaffed for quite some time,” George Gresham, president of 1199SEIU, said in a statement on the legislation last Friday. “As we continue to battle this ongoing pandemic, and future health crises, it is imperative that facilities have the staffing levels needed to ensure quality care.”

To get the legislation passed, state lawmakers created separate bills for hospitals and nursing homes. The hospital measure signed by Cuomo takes a substantially different approach than the one that unions originally proposed, giving medical centers more flexibility. Instead of state officials setting universal requirements for all hospitals, the new law requires each hospital to set up its own committee of frontline staff and administrators to determine appropriate staffing levels for each unit.

Hospitals must submit their staffing plans to the state by July 1st and implement them by January 1st. The state Department of Health will then be responsible for ensuring that each hospital adheres to its own staffing plan.

“The Department of Health is going to police and regulate those plans to make sure they are implemented and to penalize any violations,” Cuomo said at the press conference.

While that law has the support of both labor groups and the Greater New York Hospital Association, the law governing nursing homes is less flexible and more controversial.

The nursing home law says every facility must hire enough staff to provide each patient with 3.5 hours of daily care, on average. About a third of that care must come from nurses, and aides can provide the rest. Nursing home groups argued the legislation would be too costly to implement, while consumer advocacy groups said it didn’t go far enough to ensure adequate staffing and care.

During Wednesday’s presser, Cuomo focused his remarks on the hospital law. But health care unions are unequivocally celebrating both measures.

“These new laws have the potential to significantly improve the quality of care, to prevent the serious complications that result from understaffing, and to begin to address the gross inequities that exist in our healthcare system,” Judy Sheridan-Gonzalez, president of the New York State Nurses Association, said in a statement Friday. “NYSNA is excited to begin the work of organizing—in real-time—to make the promise of these new laws a reality.”