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.
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.
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...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.
Most professionals do not punch time clocks. It is expected that hours will vary over time. PTO is allotted in a time-block at the beginning of the year. ...
In my 25 years of hospital nursing, in every facility in which I've worked, nurses were required record their time by clocking in/out. It is not uncommon that nurses are also expected to clock in/out for lunch. As for PTO, rather than being assigned as a block at the beginning of the year it was earned incrementally throughout the year based on FTE status and seniority.
I suspect that this is common at most facilities, at least for staff nurses.
@chare I don't doubt you in the least. I was speaking of the "professional day" that most professionals work.
What I am really commenting on is the fact that this practice is antiquated and reduces nurses to the status of individuals who are unbelievably micromanaged. Professionals do not clock-in and out. If they need to take a day off - they do. We are trusted.
Nurses rightly aspire to be considered professionals - and we are in responsibility, legal weight, education and licensure and more...but we are not considered so by employers who still micromanage using these practices that came about during the days of the industrial revolution and sweatshops. Nursing has moved on - but employers who inherently do not trust their employees continue these practices because (as they would say) "How would we know if someone is working and doing their job?" Well - by the documentation, the care given, the nursing process outcomes...these ideas are not unique to nursing. Professionals in other areas must demonstrate also that they have done their job - but as we all know - clocking someone in and out to the minute doesn't guarantee someone is doing their job.
Nurses in non-bedside roles do not all punch time clocks. In my experience, most nurses prefer hourly pay, but once I left the bedside I loved salary for the flexibility.
@chare I don't doubt you in the least. I was speaking of the "professional day" that most professionals work.
What I am really commenting on is the fact that this practice is antiquated and reduces nurses to the status of individuals who are unbelievably micromanaged. Professionals do not clock-in and out. If they need to take a day off - they do. We are trusted.
Nurses rightly aspire to be considered professionals - and we are in responsibility, legal weight, education and licensure and more...but we are not considered so by employers who still micromanage using these practices that came about during the days of the industrial revolution and sweatshops. Nursing has moved on - but employers who inherently do not trust their employees continue these practices because (as they would say) "How would we know if someone is working and doing their job?" Well - by the documentation, the care given, the nursing process outcomes...these ideas are not unique to nursing. Professionals in other areas must demonstrate also that they have done their job - but as we all know - clocking someone in and out to the minute doesn't guarantee someone is doing their job.
That's a tough thing to measure and I that takes some time away for patient care which doesn't help. Having said that , the best floor job I ever had was in a hospital that did just that. No one got overtime unless it was an unusual situation. It was so pleasant having the payroll people out of your life.
chare
4,374 Posts
In my 25 years of hospital nursing, in every facility in which I've worked, nurses were required record their time by clocking in/out. It is not uncommon that nurses are also expected to clock in/out for lunch. As for PTO, rather than being assigned as a block at the beginning of the year it was earned incrementally throughout the year based on FTE status and seniority.
I suspect that this is common at most facilities, at least for staff nurses.