New York’s Public Health and Health Planning Council Takes Action on Nurse Aide Training and Nursing Home Oversight

The New York State Public Health and Health Planning Council (PHHPC) is an advisory and decision-making body that plays an important role in protecting the health, safety, and well-being of New Yorkers. PHHPC adopts and amends health care facility, home care agency, and other important regulations, and makes decisions on the establishment and transfer of certain health care facilities, home care agencies and hospice programs.

For nursing home residents, PHHPC’s work is particularly important because ownership, financial arrangements, facility management, and resident rights and care regulation directly affect resident care and safety. PHHPC holds public meetings throughout the year. At its September 17 meeting, PHHPC addressed two important issues that directly impact resident care and safety: proposed changes to the nurse aide (CNA) training requirements and recommendations to strengthen the state’s review of nursing home ownership, finances and management.[1]

PHHPC Rejects Proposed Reduction in CNA Training Hours

Prior to finalizing a proposed regulation (proposal) the Department of Health (DOH) provides information to PHHPC and publishes the proposal in the state register whereby the public can submit comments. After the public comment period, DOH returns to PHHPC for approval which is a two-step process: Committee on Codes, followed by full PHHPC vote.  

On June 17 the DOH proposed reducing the minimum training requirement for CNAs from 100 hours to 75 hours, which is the federal minimum. The public comment period ended on Aug 17. The Center for Elder Law & Justice (CELJ) and others, including the Long Term Care Community Coalition (LTCCC), submitted comments opposing the proposal.[2] As explained in CELJ’s comments, the 75-hour federal minimum was established over 30 years ago, and research recommends increasing this minimum to 120 hours and states requiring more than the federal minimum training hours achieved better resident outcomes. In addition, DOH failed to show that reducing training hours would meaningfully increase recruitment or retention of CNAs.

At the September 17 meeting, PHHPC members raised concerns about resident safety and workforce readiness. PHHPC also heard firsthand testimony from a CNA who explained the existing 100-hour requirement was not excessive. She also warned that reducing training could leave new CNAs less prepared and residents more vulnerable. While the Codes Committee voted to advance the proposal to the Council, the Council rejected it with nine members voting no. DOH was directed to return with additional evidence if it wishes to pursue reducing CNA minimum training hours to 75 in the future.

PHHPC Advances Recommendations to Strengthen Nursing Home Oversight

PHHPC endorsed recommendations developed by its Nursing Home Certificate of Need (CON) Ad Hoc Committee (the Committee). The CON is part of the state’s process for reviewing the establishment and change of ownership of nursing homes. The Committee met four times to examine challenges in the state’s review of nursing home applications. The Committee paid particular attention to the qualifications, finances and management structures of the operators.[3]

The Committee’s recommendations are organized around 3 pillars:[4]

1. Operator Qualifications and Experience:

Adoption of a 5-year Minimum Leadership Experience Threshold with limited flexibility. Encourage DOH to continue to leverage its existing authority under Public Health Law 2803-x Independent Quality Monitor. 

2. Financial Sustainability and Resource Adequacy

Require an independent third-party auditing firm to certify financial projections for three-year models and budgets. Require independent, professional appraisals to verify fair market rent and property values, going beyond the existing requirement for two letters from local real estate agents.

Limit related-party rent to a maximum of 1.1 times required debt payments, unless a bona fide lender requires otherwise.

3. Related Party and Administrative Oversight

Require any entity or individual exercising management control or operational influence via a consulting agreement undergo the same Character and Competence review as the operator applicant. Encourage operators to adopt strategic proactive management and retain any consultants within a timeframe that allows for notice periods to DOH in accordance with Public Health Law 2803-x. Require every natural person owner sign and notarize a certification, under penalty of perjury, affirming they will exercise independent judgment and ultimate authority over fiscal and operational decisions.

The Committee also recommended DOH consult with the Office of the Attorney General Medicaid Fraud Control Unit.

There was a fourth area of focus, conditional approvals, that was tabled for future discussion.

PHHPC’s work demonstrates why public participation and oversight matter when decisions can directly affect the health, safety, and quality of care of nursing home residents. To follow upcoming PHHPC meetings, review meeting materials, and learn how to participate in the public process visit the PHHPC website. Staying informed and engaged helps ensure that the voices of residents, families, advocates, and the public remain part of decisions affecting long-term care in New York.

[1] https://www.health.ny.gov/facilities/public_health_and_health_planning_council/meetings/2026-09-17/

[2] CELJ’s comments are available here; LTCCC’s action alert and comments are available here

[3] Meeting materials available: September 18, 2025, November 3, 2025, January 7, 2026, and June 8, 2026

[4] The Final Report and Recommendations Letter is available here, starting on pdf page 68 of 387.