Skilled nursing providers and inpatient rehab facilities offer clashing views on Medicare payments

The House of Representatives has passed the “Working Families Flexibility Act.” The bill, H.R. 1406, would allow employers to offer paid time off in place of overtime pay, and has put healthcare providers at odds with workers’ unions.

Supporters of the bill, including the American Hospital Association and the American Society for Healthcare Human Resource Administration, say the measure would give healthcare workers greater control over their time, allowing for enhanced work-life balance. They say it would also reduce administrative burdens and would not compromise patient care.

Advocates also say it’s a question of fairness: Public sector employees have been given the option of overtime pay or paid time off since 1985, so private sector workers should have the same choice, they say.

Opponents of the bill include the Service Employees’ International Union, which represents many nursing home employees and is the largest healthcare workers’ union in the country. The union says the public sector law was created as a way to allow government organizations to save money, and was not primarily a workers’ rights measure. Employers with an eye on the bottom line may coerce workers into taking time off rather than opting for overtime pay, and the bill does not guarantee that workers will be granted time off as requested, these critics say.  

“The bill permits the employer to deny the request entirely if the employee’s use of comp time would ‘unduly disrupt’ operations or to grant leave on a day other than the day requested by the employee,” according to an SEIU statement. “This means that H.R. 1406 provides no guarantee that workers can use their earned time when a child falls ill, to attend a parent-teacher conference, or to help an aging parent settle in to a nursing home.”

The bill passed the House last Thursday by a vote of 223-204, which broke along party lines. But it’s not expected to pass in the Democratic-controlled Senate.