New York Religious Order Sues State Over Gender Identity Law in Long-Term Care Facilities

A Catholic religious order that has provided free care to the terminally ill for over a century filed a federal lawsuit on April 7, 2026, challenging a New York state law that imposes mandates related to gender identity in long-term care facilities. The plaintiffs, the Dominican Sisters of Hawthorne, allege the law violates their First Amendment rights and are seeking protection from penalties that include steep fines, loss of their operating license, and potential imprisonment. The lawsuit targets New York’s LGBTQ Long-Term Care Facility Residents’ Bill of Rights, which Governor Kathy Hochul signed into law in November 2023. The Dominican Sisters operate Rosary Hill Home, a 42-bed facility in Hawthorne, New York, that provides free palliative care to individuals with incurable cancer who cannot afford treatment elsewhere. The order, founded 125 years ago, accepts no payment from patients, their families, private insurance, or government programs like Medicare and Medicaid, relying entirely on charitable donations. This situation highlights a growing area of conflict where state regulations directly oppose the core beliefs and operational models of mission-driven organizations. For such entities, this creates not just a legal battle but a significant operational and financial risk that threatens their ability to serve their communities. According to the lawsuit, the state law requires long-term care facilities to adhere to several specific provisions. These include assigning resident rooms and granting bathroom access based on a person’s self-professed gender identity rather than their biological sex. The law also mandates the use of residents' preferred names and pronouns, requires staff to undergo biennial state-approved training on gender ideology, and compels facilities to post notices affirming their compliance with these regulations. The penalties for non-compliance are substantial. According to the state, violations can result in initial fines of $2,000, which can escalate to $5,000 for repeat offenses. The law further stipulates that “willful violations” can lead to criminal charges, carrying fines of up to $10,000 and a prison sentence of up to one year. For the Dominican Sisters, the most severe consequence would be the revocation of their license to operate Rosary Hill Home. The conflict escalated after the New York State Department of Health sent a “Dear Administrator” letter to Rosary Hill Home on March 18, 2024, according to a press release from the Catholic Benefits Association. The letter and an accompanying training curriculum outlined the state's demands, requiring the sisters to align their patient care and staff training with the state's policies on gender identity. For businesses, especially non-profits and healthcare providers, navigating this regulatory landscape is increasingly complex. When a state imposes mandates that carry criminal penalties, it moves beyond a simple compliance issue into a question of organizational survival. We advise clients that proactive financial risk management is essential to prepare for such regulatory challenges, which can manifest as crippling fines or litigation costs. Proper planning can help an organization withstand the financial pressure of defending its operational model against government overreach. In their legal filing, the sisters argue that the state’s mandates force them to violate their Catholic faith, which teaches that sex is a biological reality created by God. “New York’s gender ideology mandates not only violate our Catholic values, they threaten our existence with fines, injunctions, license revocation, and even jail time,” a representative for the order told Fox News Digital. “This is why we were forced to go to court to seek protection of our religious exercise and freedom of speech so that we can continue our ministry to the poor.” The challenged law builds on an existing framework of protections for LGBTQ+ individuals in New York. The state’s Human Rights Law already prohibits discrimination based on sexual orientation and gender identity in public accommodations, and prior court rulings have established rights for transgender individuals in healthcare settings. The 2023 law, however, codified these principles specifically for long-term care facilities and attached the severe penalties that prompted the lawsuit. The core issue for many small and mid-sized businesses is not the social debate, but the tangible cost of compliance and the severe penalties for dissent. Whether the issue is healthcare, environmental standards, or labor rules, when regulations come with the threat of imprisonment, business leaders must take notice. It's a stark reminder that regulatory compliance is a critical business function. For guidance on assessing and mitigating these risks, businesses can contact C&S Finance Group LLC at csfinancegroup.com. The case will now proceed in federal court, where it is expected to draw significant attention. Business operators, non-profit leaders, and legal experts will be watching closely to see how the judiciary balances the state’s interest in enforcing anti-discrimination laws with constitutional protections for religious freedom. The outcome could set a major precedent for other faith-based organizations in New York and may influence similar legislative efforts across the country.