NY Agency Regulations
NY has two separate incentives regarding reducing agency use:
1. Exclusion of Funds
A NY nursing facility is required to spend a minimum of 70% of revenue on resident care, with at least 40% of revenue on resident-facing staffing. If less than that is spent, the difference must be paid to the state.
However, if agency use in a facility is at 8% or less, only Medicaid funds will be included in the calculation of “revenue”. This is for 2025 and on; in 2024, the threshold is 9%.
2. Reduction in Fines
The second incentive involves a reduction of fines from “excess revenue” i.e. not conforming to the 70/40 rule.
This is only applicable to facilities that have 50% or less agency use for their CNA, LPN and RN staff.
This reduction in fines is earned by reducing agency use from one year to the next. This is calculated by the quarterly average agency use of the current year compared to the quarterly average agency use of the previous year.
The table below shows the rate by which fines will be reduced:
Below is the link to the text of the regulations: