New York — Active State Enforcement

589 nursing homes. $2,000/day penalties for understaffing.

New York has some of the strictest nursing home staffing laws in the country — 3.5 HPRD minimum with penalties up to $2,000 per day for non-compliance. Yet 48% of facilities still fall below industry benchmarks. The state also has the highest contract staffing rate among major states at 9.02%, creating significant opportunity for staffing agencies.

589

Facilities Tracked

48%

Below 0.55 RN HPRD

$2K/day

State Penalty

9.02%

Avg Contract Staffing

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Source: CMS Payroll-Based Journal (PBJ) · SeniorIndex analysis

Regulatory Context

New York enforces staffing with real financial consequences

New York Public Health Law § 2895-b requires every nursing home to provide a minimum of 3.5 HPRD, including at least 2.2 hours from CNAs and 1.1 hours from licensed nurses. Compliance is measured quarterly using CMS Payroll-Based Journal data. The state has cited over 400 of its ~600 facilities for understaffing.

State Law

3.5 HPRD minimum

NY Public Health Law § 2895-b: 2.2 HPRD from CNAs + 1.1 HPRD from licensed nurses. Measured quarterly via PBJ data.

Source: NY Public Health Law § 2895-b; 10 NYCRR 415.13

Active Penalties

$2,000/day per non-compliant day

The NY Department of Health can impose penalties up to $2,000 per day for each day in a quarter that a facility fails to meet staffing standards. Governor Hochul declared a labor shortage allowing facilities to petition for reduced fines.

Highest Contract Rate

9.02% contract staffing

New York’s strict laws and enforcement create the highest contract nursing utilization among major states. Facilities rely on agency staff to avoid daily penalties — creating sustained demand.

County Intelligence — Q3 2025

Top 15 New York counties by facility count

NYC boroughs dominate. Queens and Bronx have the highest concentration of facilities below benchmarks. Notably, zero-RN days are near zero statewide — the 8-hour RN requirement is well-enforced.

County	Facilities	Avg HPRD	RN HPRD	Below 3.48	Below 0.55 RN	Zero-RN Days	Stability Score
Queens	54	3.44	0.755	31 (57%)	15 (27%)	0.0	82.5
Bronx	42	3.23	0.646	31 (73%)	23 (54%)	0.0	81.2
Westchester	42	4.16	1.190	18 (42%)	10 (23%)	0.0	83.2
Suffolk	41	3.84	0.808	17 (41%)	12 (29%)	0.0	82.5
Kings	40	3.56	0.713	20 (50%)	14 (35%)	0.0	82.6
Nassau	36	3.72	0.803	41%	38%	0.0	83.7
Erie	34	3.81	0.624	29%	44%	0.0	81.8
Monroe	32	3.93	0.487	21%	68%	0.4	80.9
Oneida	17	3.52	0.419	47%	94%	0.0	81.5
New York	17	3.84	0.999	47%	11%	0.0	82.0
Onondaga	14	4.17	0.926	21%	64%	0.1	80.6
Dutchess	12	3.19	0.431	66%	91%	0.3	81.9
Albany	11	4.37	0.714	27%	54%	0.0	80.3
Niagara	10	3.38	0.526	50%	70%	0.0	81.7
Richmond	10	3.47	0.755	50%	40%	0.0	84.1

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Full New York Market Intelligence

All 589 facilities · County rankings · Top 25 acquisition targets · Penalty exposure analysis

Source: CMS Payroll-Based Journal (PBJ) · CMS Provider Data · SeniorIndex analysis of Q3 2025 data · State law: NY Public Health Law § 2895-b

Who Uses This Data

New York intelligence for every buyer

Staffing Agencies

9% contract rate — highest among major states

NY’s strict penalties force facilities to use agency staff rather than risk $2K/day fines. Consistent, regulation-driven demand that won’t dry up.

PE Firms & REITs

Penalty exposure is a hidden acquisition cost

48% of NY facilities are below benchmarks — and the state is actively fining. Any acquisition target needs staffing data before you can model post-close costs.

Operators

Quarterly compliance measured by PBJ

The state uses federal PBJ data to measure compliance quarterly. Our reports show where you stand before the state tells you — and what it will cost if you don’t fix it.