October 28, 2026 – The Long Term Care Community Coalition (LTCCC) has released a new report, New York Nursing Home Care and Oversight: State Findings from The Accountability Gap, examining serious and persistent problems in nursing home care and oversight across New York State.

Building on our national study, The Accountability Gap, the report analyzes federal staffing, inspection, citation, and penalty data from 2022-2024. The findings reveal widespread understaffing, high rates of pressure ulcers, and troubling gaps in the identification of substandard care and resident harm.

Key findings include:

  • Widespread understaffing: in the fourth quarter of 2024, 95.6% of New York nursing homes with comparable data (566 of 592) staffed below the levels expected to meet residents’ basic care and clinical needs. More than three-quarters (77%) were at least 20% below expected staffing levels.
  • Few violations identified as causing harm: Of 8,350 health deficiency citations issued from 2022-2024, only 3.1% were classified as causing actual resident harm or immediate jeopardy. The remaining 96.9% were classified as “no harm.”
  • Among the nation’s lowest citation and penalty rates: In 2024, New York had the second-lowest rate of health deficiency citations per resident among the 50 states and DC. Across 2022-2024, New York had the lowest rate of federal nursing home fines per resident among the 50 states and DC.
  • High pressure ulcer rates, limited accountability: Pressure ulcer care is a key indicator of nursing home quality. New York’s reported rate of residents with unhealed pressure ulcers exceeded the national rate throughout the study period. Yet 83.2% of citations for substandard pressure ulcer care were classified as causing no resident harm. If a pressure ulcer isn’t harm, what is?
  • Limited consequences for insufficient staffing: While New York nursing homes averaged the 4th lowest rate in the nation for meeting expected staffing levels, DOH issued only 104 citations for insufficient nursing staff in 2024. Only one of those citations was classified as resulting in resident harm or immediate jeopardy.

While New York has made some improvements in inspection activity and identifying violations, these findings raise serious concerns about whether nursing homes are being held accountable when they fail to meet minimum care standards.

“Low citation counts do not erase widespread understaffing or persistent failures to provide necessary care,” said Richard Mollot, LTCCC’s executive director. “Before committing more taxpayer dollars, New York leaders must demand accountability for the money operators already receive: Does it reach resident care? Does staffing meet residents’ needs? Are violations corrected and kept corrected? Vulnerable residents, families, and taxpayers deserve more than another funding increase in exchange for another empty promise.”

Resources on the report page include:

  • New York Nursing Home Care and Oversight: The full statewide report, including findings and recommendations for improving care and accountability.
  • The Accountability Gap Close to Home: A companion brief examining staffing, care, and oversight by county, legislative district, and nursing home ownership.
  • Report Highlights: A two-page summary of key findings and recommendations.
  • Searchable Data Files: Facility-level information on staffing, citations, care indicators, and nursing home chain performance. Files are easily searchable to view findings at the county, regional, and legislative district levels.

The findings and data can help residents, families, ombudsmen, advocates, and policymakers identify concerns, ask informed questions, and advocate for better care and stronger oversight.

Nursing home residents deserve safe, dignified care, and taxpayers deserve accountability for the services they fund. LTCCC urges state leaders to strengthen oversight, ensure that violations are appropriately identified and corrected, and hold nursing home operators accountable when they fail to meet their obligations to residents.