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April 27, 2021

HANYS’ new white paper sounds alarm on discharge delays affecting patients with complex care needs

Healthcare association seeks to convene stakeholders, lead efforts to identify systemic and practical solutions to ensure patients do not live in hospitals

Rensselaer, NY – The Healthcare Association of New York State today released a new white paper, The complex case discharge delay problem.

Complex case discharge delays, also known as bed blocking or bed delays, are a longstanding and growing challenge throughout New York, the United States and the world. These delays happen for many reasons but are most commonly attributed to difficulty finding safe post-discharge care and navigating lengthy administrative or legal processes. Individuals experiencing behavioral health, intellectual or developmental disabilities and/or co-occurring conditions are most profoundly impacted.

A lack of coordinated care options has created an environment where hundreds of New Yorkers with complex care needs unnecessarily languish in emergency departments and hospital beds annually, often for months to years. Hospitals are serving as long-term housing rather than a way station for those who, once their acute care needs are met, are better served in a non-hospital setting.

HANYS’ new white paper explores:

  • an introduction to complex case discharge delays;
  • unintended consequences on patients, care delivery (such as bed shortages, safety and staff well-being) and associated costs;
  • existing gaps in the care continuum, system design flaws and administrative obstacles;
  • examples of work attempting to address this challenge; and
  • HANYS’ suggested actions to help in the short term, while building long-term solutions.

“Addressing complex case discharge delays is one of our key priorities. These delays hurt patients who need long-term services, not a busy, acute care environment. Lawmakers, regulators and caregivers need to come together now and begin to solve this longstanding issue,” said Bea Grause, RN, JD, president, HANYS. “Patients should never have to ‘live’ in hospitals and emergency departments. HANYS has taken the lead and developed an initial roadmap for stakeholders to begin working on this problem. The time to act is now.”

Healthcare organizations have expressed their support for the work HANYS is doing in this area.

“The white paper lays out all the reasons the current state is untenable,” said Andrea Smyth, executive director, New York State Coalition for Children’s Behavioral Health. “We appreciate HANYS’ prioritization of this issue and look forward to continuing our partnership with them as we work toward the identification and implementation of concrete solutions.”

“The County Mental Health Commissioners appreciate this much-needed effort by HANYS to bring awareness to the barriers that continue to exist in treating individuals with co-occurring complex needs, and we are proud to work alongside them and our state partners to identify solutions that create a “No Wrong Door” approach and obtain long lasting recovery and overall life success,” said Katherine Alonge-Coons, LCSW-R, chair, New York State Conference of Local Mental Hygiene Directors.

HANYS seeks to continue to convene stakeholders and offer expertise in setting policy while strengthening relationships and establishing best practices across the field to achieve better patient outcomes. The association thanks its complex case discharge delays workgroup members for their guidance in developing this white paper.


The Healthcare Association of New York State is New York’s statewide hospital and continuing care association, representing nonprofit and public hospitals, nursing homes, home care agencies and other healthcare organizations. HANYS is a nonprofit organization whose mission is to advance the health of individuals and communities by providing leadership, representation and service to healthcare providers and systems across the entire continuum of care.