Band-Aid Solution or Transformative Tool? Home Care Leaders Sound Off on Daily Pay.

Rising consumer demand and a lack of available, qualified home care workers will likely keep recruitment and retention in the spotlight come 2020. To mitigate those challenges, some home care providers have turned to daily pay, though the jury is still out on its ultimate impact.

In 2018, the median caregiver turnover rate jumped to 82% — a new all-time high, according to Home Care Pulse.

BrightSpring Health Services is among the list of companies that have publicly touted their success with daily pay. BrightSpring began using a daily-pay tool in late 2018 and is already seeing positive results, its executives say.


About 30% of home care industry professionals who took part in a recent Axxess survey named daily pay as the best way to address staffing shortages.

Despite ample support, not every home care industry professional agrees that daily pay is a magic bullet when it comes to attracting and keeping workers. CEOs from FirstLight Home Care, Interim HealthCare and Right at home recently weighed in on the topic during the 2019 Home Health Care News Summit in Chicago.

To get to the bottom of daily pay and its role within home care’s ongoing workforce challenges, HHCN reached out to several industry leaders for their take. Their responses are provided below, edited for length and clarity.



While daily pay, in theory, sounds like a viable solution, I believe it is still too early to say. Many providers are talking about it, but no one has really given it a fair shot over an extended period of time.

In my personal opinion, I think daily pay will make the issue of caregiver turnover and caregiver shortages worse, due to the fact that rather than developing a meaningful relationship with caregivers, the daily pay program will cause caregivers to be more transient and for caregivers to be treated more like staffing employees.

Our research has shown that the lowest-rated area of Caregiver Satisfaction is Caregiver Recognition, and with a daily pay program, I feel like the opportunity to create a more unified employee/employer relationship will be diminished.

As I’ve been traveling to industry and franchise conferences around the nation, I’m hearing more and more owners talk about trying daily pay; however, the biggest holdup at this point has been the backend payroll structure to support it. In a conversation with a Paychex representative, she indicated that after months of vetting a viable partner to handle daily pay for their organization, and at the request of one of their large customers, they’ve had a total of two people sign up for the program.

Most organizations are not equipped to handle the additional burden for an office to implement the program

— Erik Madsen, CEO of Home Care Pulse


We are piloting daily pay with several franchisees and, so far, the results have been very positive. We expect to see more of our franchisees adopt it as an option in the future.

Daily pay could be a short-term solution as an effective strategy for combating staffing shortages. I started SYNERGY HomeCare as my own home care agency before I began to franchise. Having that experience taught me that pay is not the top priority for most caregivers.

The best caregivers are those that are empathetic and caring toward others. More times than not, caregivers will place the value in what they do every day and how they are treated higher than their compensation. To be successful and provide the best care with the best caregivers, agencies need to recruit and retain the best caregivers. The key to that is treating them well and responding to their needs.

Daily pay options are tools that help do that. They afford caregivers more flexibility. So instead of having to turn to a payday loan or title-loan center to meet an unexpected cash flow shortage, a caregiver can take advantage of daily pay opportunities — or even pick up a shorter shift knowing they’ll be able to take advantage of a daily pay program.

Right now daily pay is not widely adopted in our industry, but it is growing. Our caregivers have employment opportunities inside and outside of our industry. Other industries have begun to implement daily pay benefits, so it’s important that our industry does as well.

A person can go to work in a restaurant and take tips home every night. Ride-share companies offer instant pay options as well.

There are not really any major barriers to implementing daily pay programs. The vendors we work with have developed a pretty seamless process — the only thing left for us to do is educate the caregivers on the options available to them.

— Peter Tourian, CEO of SYNERGY Homecare


Daily pay is an excellent idea to improve staffing shortages through the retention of staff, but in it of itself, it’s not the full solution. It’s one of many things that need to be done.

In order to compete with employers competing for the same labor pool, it continues to be paramount that the home care industry demonstrates as many possible benefits and advantages to potential candidates to attract and retain staff.

The competition for the labor pool continues to be challenging, and the employers that will win the battle will be those that have a strong focus on providing all the components that staff are looking for: benefits, pay rate, treatment, work environment, recognition, perks, incentives, meeting the staff’s objectives, etc. Daily pay is one of those components and has the potential to be a key differentiator.

We do not currently offer daily pay but are definitely looking to in the very near future. We do think it will be a further differentiator with competing employers. Much of the staff could really use this offering to improve their daily life and lower their stress.

A barrier we run into is identifying a daily-pay provider that is willing to work with a franchise organization. As a franchise organization, we have 105+ independently owned companies, ranging in size from small to very large.

The daily-pay provider companies typically prefer to work with just one company entity, with one payroll system, one bank, and one point of contact for thousands of staff — versus 100 or more company entities. Additionally, with our independently owned franchised businesses, owners can make many of their own choices on different aspects of their business.

— Jake Brown, president & CEO of Always Best Care


Daily pay is one of a few solutions out there to combat staffing shortages. We implemented PayActiv. PayActiv allows us to continue to differentiate ourselves from our competitors by allowing caregivers to access up to 50% of their net earned yet unpaid wages prior to payroll.

Our company also works to combat home care shortages by historically paying more than the industry, offering great benefits and providing first-class training.

We don’t use daily pay. We recently went with PayActiv, which we feel is better suited for our company. With PayActiv, our employees can choose to transfer funds to their bank account, payroll card, reloadable debit card or PayActiv Visa prepaid cards. They also offer a variety of other complementary services, including savings and budgeting tools, financial counseling, bill pay, and prescription discounts.

There really are no major barriers to implementing tools like daily pay and PayActiv. Most of these companies have made it fairly simple to implement, and they work directly with your payroll provider so there is minimal additional work by the providers. There is often no cost to enroll, no recurring costs and no cost to cancel.

— Joseph Verdirame, CFO of Alliance Homecare


I don’t believe daily pay is the single answer. Most quality caregivers are looking for long-term assignments and a career. The lesser quality, newer staff members are generally the ones more prone to look for daily pay.

We’re not using daily pay. We are trying to attract better-quality people and develop career-motivated staff.

But implementing the daily pay program is not difficult. Managing the more transient, temporary staff is very difficult, results in more workers’ compensation claims, theft claims and client complaints. The costs overall to manage more temporary caregivers versus less high-caliber staff make it cost-prohibitive.

Nick Payzant, founder and CEO of Cerna Home Care

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