Home Health Nurses Beware: Docking PTO for Missing Productivity Targets is Legal


  • Home Health Columnist / Guide
    Specializes in Vents, Telemetry, Home Care, Home infusion. Has 46 years experience.

I've worked in home health agencies since 1985 from start-ups to a multi-state agency. Since 2015, heavy focus is on productivity as underpins agency financial health.  In the Philly area,  weekly full-time employees productivity = 30 points.  At my last position,  Managers reviewed biweekly each staffers productivity, documented to Finance Director any justification for not meeting goal (FMLA,  vacation, PTO, court,  patient census down, etc).  Productivity  if less than 27 points without good reason, staff could use PTO to make up pay, rarely used.  Every month, productivity reviewed with staffer, counseled if issue.  Since agency had scheduling department, expectation that staff would call in to get another assignment or reschedule visit date.

20 years ago, I was temporarily reassigned to central Philadelphia office: arrived 9AM given 6 patients names, called to setup visit times:3 refused, 3 no answers after multiple calls. 11AM given 6 more names, only 1 client permitted visit --left office 12:30 PM for 1 1/2hr drive. Saw client, called in field-able to pick up just 1 more client.  So can see this being an issue when not case managing who's clients know you and want visits. Patient visit refusal was up mid 2018, last year FT work, worsen post Covid era from my friends still in home care.


Philadelphia Inquirer 3/16/22

Docking PTO for missing productivity targets is legal under labor law, court says in Bayada case

After home health-care workers sued in central Pennsylvania, the appeals court said subtracting paid time off is not equivalent to reducing a worker's salary.



...Each worker had a predetermined number of "productivity points" they were required to meet each week, which were awarded for completing specific work tasks, the court opinion said. One point was roughly equal to 1.33 hours of work — a routine patient visit, for example, earned one point. Employees earned additional pay if they exceeded the minimum points required for their salary level, but Bayada would subtract from their PTO allowance if they came up short on productivity points.....

The health-care workers had argued that PTO was part of their salary, and taking it away for failing to meet productivity minimums was a violation of the federal Fair Labor Standards Act (FLSA).

This case marked the first time this appeals court had considered that argument, and it sided with the employer.

The FLSA doesn't define salary, the judges wrote, but "there nevertheless appears to be a clear distinction between salary and fringe benefits like PTO. Even if time off has monetary value and employees are able to someday convert unused PTO to cash, it's still not part of a worker's salary, the opinion said.

Bayada, based in Moorestown, Burlington County, provides home health-care services in 23 states and employs about 28,000 people.