Payroll challenges faced by home-based health care providers

Home health care providers are hit with several new regulations over the past few years, increasing operational challenges. And with more regulations on the books, some providers are finding themselves on the hook for not being compliant with the latest payroll practices.
Since 2015, the Department of Labor has mandated that in-home care workers are eligible for overtime and minimum wage protections, bringing forth a wave of compliance issues coupled with rising wages around the country.

Complexity in tracking
Adding to the complexity of paying care staff is the nature of in-home care as it expects workers to drive from place to place, provide care at a client or patient’s home, and keep track of their specific work hours, travel time, and distance, break times and work.
It is a problematic situation where employees are hard to manage and to know what they are doing. The employer now has a responsibility to ensure they’re tracking time, meals, and when caregivers are not working when they are supposed to be working. This stuff is difficult to do remotely. It’s very, very challenging for the industry as a whole.

Challenges in compliance
Even with some great news for providers dealing with rising wage pressures, those working in multiple jurisdictions are still facing tough times.

For instance, If you’re operating in California and you’re across multiple cities, the minimum wage changes depending on what city the individual caregiver is working in. The caregiver will move around depending on where the client is—that might be in San Francisco then to San Jose. It’s challenging to keep up with all of it and understand the regulations across multiple jurisdictions.

As such, pay-per-visit models in home health and home care are quickly becoming a thing of the past. Instead, providers looking to comply with new standards entirely are looking at adapting salary-plus models, which consists of a base salary and bonuses for productivity, which adds to the complexity.

Understanding Live-in care
Another major complication is the live-in caregiver, as some states have seen some disagreements in how to pay for care shifts that are 24 hours or longer.

In California, for example, caregivers must be paid for all hours. In New York, a judge ruled in a lawsuit that caregivers should also be paid for all 24 hours of an overnight, or live-in shift, including back pay. However, since then, the state’s Department of Labor put forth an emergency rule to keep the “13-hour rule” in place, which mandates caregivers are paid for 13 hours of care and not the hours they spend sleeping and eating.
Other states may see similar issues arise in the future.

The solution: flexible home care billing and payroll management
The future is now in-home care as technology is transforming the functions of agencies worldwide. Stamping out all the inefficiencies through a modern software means most key challenges met head-on.
The outcome is that well-run home care agencies can organize and deliver high-quality client care. At ONE BCG, we’ve watched as technology has improved agency operations in diverse, complementary ways.

Smart technology can prevent employee churn by relieving caregivers of burdensome manual tasks that can lead to burnout and eventual departure. Flexible, intuitive software enables agencies to shift in any new direction desired, embrace emerging styles of care, and deploy modern tools such as remote patient monitoring and payroll management.

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