By Long Island Senior Advisor Care Team · September 18, 2026
The federal minimum staffing standard for nursing homes was repealed effective February 2, 2026. New York's own 3.5-hour rule survived it, and the state started issuing penalties the same month. Here is how to check a Nassau or Suffolk home.
Two staffing rules, and only one of them is still standing
If you have been reading about nursing home staffing over the last two years, you have probably been reading about the wrong rule.
The federal one is gone. The Centers for Medicare and Medicaid Services finalized a national minimum staffing standard for nursing homes in 2024. A federal court in Texas vacated it. Congress then went further: the budget reconciliation law signed on July 4, 2025 barred any implementation or enforcement of that standard until September 30, 2034. CMS published an interim final rule on December 3, 2025 formally repealing it, and that repeal took effect February 2, 2026. There is, at the moment, no federal minimum number of staffing hours a nursing home must provide.
New York's rule is a different animal, and it is untouched. Public Health Law § 2895-b, with its implementing regulation at 10 NYCRR § 415.13, is state law passed by the New York Legislature and effective since 2022. A federal repeal does not reach it. New York is one of a small number of states that wrote its own staffing floor into statute, which means that for a family touring a nursing home in Mineola or Bay Shore this fall, the applicable standard is a state one that most national coverage has stopped mentioning.
That gap matters, because the state also started enforcing it in February 2026 -- the same month the federal rule died.
What New York actually requires: 3.5 hours, split three ways
The number to know is 3.5 hours of care per resident per day. That is the total daily nursing care each resident must receive, delivered by certified nurse aides, licensed practical nurses and registered nurses combined.
Inside that 3.5 hours are two sub-minimums. At least 2.2 hours must come from a certified nurse aide. At least 1.1 hours must come from a licensed nurse -- an LPN or an RN. A home cannot satisfy the standard by loading everything onto aides, and it cannot satisfy it with nurses alone.
Here is the part families routinely misread. This is an average, calculated per resident per day across a facility, not a staffing ratio you can observe from the hallway. Walking in on a Tuesday afternoon and counting aides tells you very little about whether a home meets 3.5. A home can meet the standard on paper and still be thin on a Sunday night, because the arithmetic runs across all residents and all shifts.
So the standard is worth knowing as a benchmark you ask about, not a thing you can eyeball on a tour.
The state checks it with the federal data CMS still collects
New York does not run its own staffing count. Compliance with § 2895-b is determined quarterly, using the most recent available data from the federal Payroll Based Journal -- the CMS system through which every nursing home submits verifiable, payroll-linked staffing hours four times a year.
This is the quiet reason the federal repeal changed less than the headlines suggested. Repealing the staffing standard did not repeal the staffing reporting. Payroll Based Journal submission is a separate requirement and it continues. Homes still report their hours, CMS still publishes them, and the staffing component of the federal five-star rating on Care Compare is still calculated from them.
For a Long Island family, that is the practical takeaway: the measuring apparatus is fully intact even though the federal yardstick is gone. New York simply kept using the same data to enforce its own number.
It also means the information you need is public, current within a quarter or so, and free.
The penalty list is public, and no Long Island home is on it
A facility that violates § 2895-b and 10 NYCRR § 415.13 is liable for civil penalties of up to $2,000 per day, under Public Health Law §§ 12, 206(4) and 2895-b(2)(b). The statute also requires the Commissioner to post assessed penalties, and the mitigating factors considered, on the Department of Health website at least thirty days before acting against a facility.
That posting exists. It lives on the New York State Department of Health's Nursing Home Minimum Staffing and Direct Resident Care page, and it is worth ten minutes of any family's time. The Department issued its first round of civil penalty notices in February 2026, covering compliance quarters running from April 1, 2022 through the fourth quarter of 2023.
The list posted as of June 30, 2026 names twenty-five facilities statewide. Not one of them is in Nassau or Suffolk County. The counties represented are Kings, Queens, Bronx and Westchester downstate, and a scatter of upstate counties -- Albany, Broome, Chautauqua, Columbia, Delaware, Dutchess, Herkimer, Monroe, Montgomery, Oneida, Ontario, Rensselaer, Steuben and Tompkins.
Two caveats, and the Department states the first one itself: the absence of a facility from a posting does not mean penalties will not later be assessed against it. The list is explicitly non-final and continuously updated. The second caveat is about time. The published penalties cover 2022 and 2023 compliance. A home's behavior three or four years ago is history, not a current quality signal, and a home that has since changed hands is effectively a different operation. Use the list to rule things in, never to rule a home out on its silence.
Why a home can miss 3.5 hours and still pay nothing
The penalty is not automatic. The Commissioner is required to weigh mitigating factors, and there are three.
The first is extraordinary circumstances that could not have been prevented through effective implementation of the facility's required pandemic emergency plan, where the home also complied with disaster and emergency preparedness rules. The second is an acute labor supply shortage, during which the facility kept residents safe and made documented attempts to hire -- job fairs, new agency contracts, advertising, education partnerships, base salary or benefit increases, cash bonuses, relocation assistance, shift differentials, transportation assistance, upskilling. The third is a verifiable union dispute involving nursing staff, where the home submitted a plan for maintaining resident care through the strike.
The labor shortage factor is the one that moves. The Department revised the methodology it uses to designate acute labor shortage areas on February 9, 2026, and said it would contact facilities that might newly qualify for mitigation under the revised criteria.
None of this is a reason to dismiss a home. A genuine regional labor shortage is a real legal defense and a real operating condition. But when an administrator tells you staffing has been difficult, you now know that sentence has a specific regulatory meaning in New York, and you can ask the follow-up: which of those recruitment steps has this building actually taken, and what did they produce?
The other New York rule nobody mentions on a tour
Staffing hours are only half of what New York regulates. Public Health Law § 2828, implemented at 10 NYCRR § 415.34, requires every nursing home in the state to spend at least 70 percent of revenue on direct resident care, and at least 40 percent of revenue on resident-facing staffing.
There is a carve-out worth understanding: a home may deduct from the resident-facing staffing requirement at least 15 percent of what it spends on contracted agency RNs, LPNs and CNAs. A facility that runs heavily on agency staff is treated differently under the spending formula than one that employs its own people.
A home that falls short pays the state the difference between what it spent and what it was required to spend, and those recouped funds go into the Nursing Home Quality Pool under Public Health Law § 2808(2-c)(d).
For a family, the number itself is less useful than what it points at. Heavy agency reliance is not illegal and sometimes it is unavoidable, but it changes daily life in a building: a resident with dementia does better with aides who know her, and a rotating agency roster is the single most common thing adult children complain about once a parent has moved in. Ask what share of aide shifts were covered by agency staff last month. Any administrator can answer that.
How to check a specific Nassau or Suffolk home
Four steps, in this order, before anyone signs anything.
Start with NYS Health Profiles. The Department of Health publishes a profile for every nursing home in the state, searchable by county, at profiles.health.ny.gov. Choose Nassau or Suffolk, open the home you are considering, and read two tabs: the staffing data, and the inspections tab showing complaints, survey citations and enforcement actions. Read the deficiency narratives rather than counting citations -- a missing signature and an injured resident appear in the same document, formatted identically. Repetition across consecutive surveys is the signal.
Then check Care Compare. The federal staffing rating is still published and still built from Payroll Based Journal data. Look specifically at the weekend staffing figure, which CMS reports separately. Weekend coverage is where thin homes show up first, and it is the shift your parent is most likely to be alone.
Then ask the administrator directly. Ask for the building's most recent quarterly hours per resident per day, and how it compares to 3.5 total, 2.2 aide and 1.1 licensed nurse. Ask whether the home has been assessed any penalty under Public Health Law § 2895-b, or has been notified of one. Ask what its aide turnover was last year. These are not hostile questions and a well-run Long Island home will have the numbers ready.
Then call the ombudsman. Long Island runs two separate programs, one per county: Suffolk at 631-470-6755 and Nassau at 516-466-9718. The ombudsman is free, independent of the facility, and can tell you what complaints look like in a specific building. They can also attend a care conference with you -- though only with the resident's consent, or that of their legal representative, which surprises adult children who assume family can authorize it. Our guide to the ombudsman and filing complaints covers when to use them versus the state complaint line.
What the numbers do not tell you
A staffing figure is a floor, not a verdict. It tells you whether a building clears a legal minimum. It does not tell you whether the aide assigned to your mother is kind, whether the food is edible, or whether anyone answers a call bell at two in the morning. Visit at an inconvenient hour -- a weekend evening is the honest test.
It is also worth being clear about what this rule does not cover. The 3.5-hour standard applies to nursing homes, licensed under 10 NYCRR Part 415. It does not apply to assisted living. New York regulates assisted living through an entirely separate layered structure: a base Adult Care Facility license under 18 NYCRR Parts 487, 488 and 490, then optional Assisted Living Residence certification under 10 NYCRR Part 1001, then optional EALR or SNALR certification on top. Assisted living communities in New York receive no CMS star rating at all, which is why the license verification step matters even more there. If memory care is what you are actually looking for, the certification to ask for by name is SNALR.
And be careful with cost figures. There is no published nursing home cost median for Long Island, Nassau County or Suffolk County anywhere -- CareScout, the most widely cited source, publishes New York state medians only. Those are $15,528 a month for a semi-private nursing home room and $16,729 a month for a private room in the 2025 survey. Any site quoting you a precise Long Island nursing home number is estimating and not saying so. Our cost page sets out what is actually published and what is not.
If you are working through a nursing home decision now, the nursing homes overview and the county pages for Nassau and Suffolk are the place to start. The Nassau County Office for the Aging is at 516-227-8900 and Suffolk's is at 631-853-8200; both serve as NY Connects access points and can screen for the Medicaid programs that may pay for some of this.
