Jeanette Benigas 0:00
Hey, fixers. I'm Dr Jeanette Benigas, the owner of fix SLP, a grassroots advocacy firm here to challenge the status quo in speech language pathology by driving real change from insurance regulations to removing barriers that prevent full autonomy like the CCC, this podcast is your space to learn, engage and take action in the field of speech language pathology. We don't wait for change. We make it so let's fix SLP!
Jeanette Benigas 0:46
Hey everybody, welcome back. It's Jeanette. I have Preston with me, and we're gonna, we're gonna start this off a little differently. Probably play something that's gonna be way longer than what you end up hearing. But I guess technically, I'm a millennial, but I very strongly affiliate with the xennial Micro generation. So I have a little song here. This little song, it's from New Kids on the Block. I'm gonna take you back. We're gonna play this for a second.
Jeanette Benigas 1:14
MUSIC (lyrics: Happy birthday to you. This is your day. On this day for you, we're gonna love you in every way. This is your day. Your Day. Happy birthday to you. To you. To you. To you). Preston?
Preston Lewis 1:52
Yeah?
Jeanette Benigas 1:54
I'm a day early, and by the time our fixers hear this, it'll be a few days late. But happy birthday.
Preston Lewis 2:01
Thank you very much. I appreciate it.
Jeanette Benigas 2:02
On january 31st.
Preston Lewis 2:04
Yep, me and Timberlake exactly the same age.
Jeanette Benigas 2:07
You, Timberlake and the ASHA deadline.
Preston Lewis 2:10
Gosh, oh, it is here, isn't it? I mine went up and smoked quite some time ago, but I know for some people, they will make that payment at the very last minute. And bravo to them. I hold that money as long as you can. And for those of you that have down shifted, and we've heard a lot of folks are moving into the certificate holder only line, welcome to the line. It was a fun time for me there. And if you feel so bold in a few years, go that last mile. It's it's a good feeling.
Jeanette Benigas 2:42
We got some really exciting news last night, speaking of dropping your membership or your Cs, we had a fixer reach out to us on social media. She ended up sending me her entire story via email, but as a result of the work the Michigan team has done, you are free to practice in that state without the Cs, as long as the employer drops the requirement, which is the next big push. So clinicians have started educating employers, using our resources that are at fix slp.com, when we drop our new website in the spring, there'll be even more resources there to educate employers. But what we have there is pretty effective. And Nadine started back in November, educating her employer, which is a major hospital system in Michigan, major hospital system in Michigan, at least one of the hospitals has dropped the CCC requirement from the job description. They did do a little downgrade to CCC preferred, but that does not mean it's required. So good job Nadine. That's exactly what we need to see. We need to see these big hospital systems doing this kind of stuff, because it's just going to show the rest of the world that, no, you don't need your Cs to bill Medicare. No, you don't need your Cs to bill private insurances. Yes. Yes, there are just a small handful of private insurers that still require the Cs. However, we have been very effective at getting that changed. To our knowledge, there are only three more, and we are currently working with two of them. So hopefully in the next few months, we'll have two more big wins where we've changed more things. So keep working. You guys, keep doing, keep doing that thing. That's what we need. Educating employers is the next step
Preston Lewis 4:41
That's going to going to be part of the show today is the issues of wage theft that are out there, but we've got so many in this field that have been in stagnant pay positions for so long, and we know the reasons, but regardless, we have to be the ones that are advocating for the change, and if. We let the rehab companies and home health providers and everyone else keep squeezing us and their effort to make $1 into $1.10 we've got to squeeze back. And then they can go barking to Congress and the CMS. But this is a good opportunity. If your employer has not been paying for your Cs, you can go at them and say, Hey, you can either remove this or start paying me for it, you have options, but that starts that conversation to where you can get a leg up on talking about what you're bringing in and not just how many minutes you're billing every day. So turn that table around, make 2025 the year that you advocate either at a broader level with us, on our state teams, or just at your own employer, you can be the change, but we can't keep doing the same thing and having that rate of attrition. Jeanette, that's part of our conversation this week, isn't it?
Jeanette Benigas 5:38
Yep, and one no doesn't mean no forever. It just means educate again next quarter, and educate again the quarter after that, and keep supplying examples. So if you're in Michigan, you can show that this company, this leader in Michigan, has done this, and you just keep sharing, there's another hospital system in Michigan that has been talking to me for a couple months, and I touch base with one of their clinicians after I got word on this, this one that's changed the job description, and he said it's it's still in progress. It looks like it's gonna happen. So it's very exciting. All right, Preston, let's talk. Okay, we're diving into a topic that directly affects so many healthcare workers working off the clock. This one probably could be shared with OTs, PTs, nurses, so this isn't speech specific. What we're going to talk about is pretty broad today. We call it working off the clock. Legally. It's more formally known as wage theft, overtime violations. There's names for this, and there have been legal battles that have helped shape what this looks like for us.
Preston Lewis 7:00
Jeanette went to law school this week, and she's got case precedents out there. And sure, we're, we've all felt it. I think we've all been guilty. But there are the clinicians that have to get to a point where they realize this can't be the status quo, because employers will take advantage of you. It's, it's just the way it is. And because of the reimbursements being low, they are going to squeeze us as they have Jeanette and I have talked about productivity. It was in the low 70s when I started out, and now it's not unusual to see it piped all the way up to 90 or above. And that is not sustainable, and especially when you consider the amount of documentation that goes into what we do, the amount of coordination with other healthcare professionals. It's not just all right there with the patient, one on one. And so if those minutes are not available to us, then clinicians have to say, what can I do? And if your solution to that is like Jeanette said, where you're working one to two hours off the clock every day, then that's a fraud, and you were defrauding yourself. And so we have to push back, just like we were saying earlier, and there are some lawsuits that we're going to talk to about today and some valuable lessons, but starting to set those boundaries. That's what's going to make you sustainable in this field. Otherwise, we are going to get absolutely run over.
Jeanette Benigas 8:28
So it's really just one case that we're talking about. It was kind of confusing as I was going through the case documentation. Not a ton of major news outlets picked this up. I really wish they would have but this case, this major case, was Loy versus Rehab Synergies, and we are going to use the name of that company. Sometimes we're very careful not to do that, but it is our understanding that after this lawsuit, rehab synergies went out of business. This is according to one of their former employees. So I'm pretty comfortable using the name of the company today, but also, this is all public record. We're not gonna assert anything that isn't true. We are gonna give our opinions. And with that being said, just keep in mind, I think y'all know this, but we're not lawyers, okay, take what we have to say with a grain of salt, but you can also talk to a lawyer about the things that we've said and see if it holds up. Where you live this lawsuit, Loy versus rehab synergies, started with just Loy and then became a collective lawsuit where there were multiple healthcare professionals that sued over unpaid wages and they weren't fighting for that just for themselves. What they were really doing, they were setting that case precedent, and they were fighting for every therapist, nurse, healthcare worker who has ever been told, get the work done. Figure it out. They never tell you, right? Then they're never gonna say. A clock out and keep working, because that is blatantly illegal. But they've they've got the verbiage. The most manipulative ones know how to communicate it with you without saying it. This particular case took place in Texas. Texas is a right to work state on our fixer team that comes up a lot when we're looking at laws, when we're talking about the CCC requirement, when we're exploring the makeup of the state, one of the first things Preston finds out for us is if it's a right to work state. I wanted to start off today by talking about what that means, because Texas is a right to work state. It's and it's an at will state as well. But Loy and all of these therapists won the case anyway, and I did a little research. How is that so? How could that have happened? So I wanted Preston to just take a minute since he are, He's our resident expert on all things right to work. So tell us. Tell us, yeah. Tell us what that means, Preston.
Preston Lewis 11:03
Well, there are 27 Right to Work states, I believe, the last time I checked, and it sounds so positive, it's right to work, yay. Actually, it has sort of a reverse meaning of some because basically it comes down to unionization and in a non right to work state there, and there were some issues with this for sure. I mean, it doesn't always work positive. Positively with some unions. Unions would require membership in order to work in some professions. So the pushback with that were to have right to work states where, sure, you can have a union, but if you yourself do not want to join that union, you don't have to. However, that opens up a lot more options for employers to do at will, contracts where they can dismiss you at any given time for any reason and so forth. You can leave your job at any given time for any reason. May not be the great thing to do professionally for your resume. But for those Right to Work states, they have a lot more corporate friendly laws when it comes to labor, and corporations love them. That's why you see governors in those states say we're pro business, we're open for business right to work. And companies believe that they can come in and they can pay a little bit lower wages and not have to tangle with the union, where there could be a work stoppage, there could be a collective bargaining those things are much more rare in a right to work state.
Jeanette Benigas 12:33
And we want to be very, very clear, being in a right to work state has nothing to do with wage laws, with overtime pay or protections under the Fair Labor Standards Act. So even if you live in a right to work state, your employer still has to follow federal laws that includes overtime. If you're a non exempt employee, your employer has to follow that, and I will talk about being a non exempt employee later in this episode, what we're seeing is that a lot of companies try to confuse workers into thinking they have no rights because they are in a right to work state. That is simply not true. So we're going to get into how this lawsuit unfolded, sort of what it means for you and what you can do if you think your employer is stealing your wages. And that is, we're going to use that harsh terminology. We're not going to say working off the clock. That sounds like a cute little kitten. Your employers are stealing your wages. Let's call a spade a spade. That is what is happening.
Preston Lewis 13:45
Loy versus Rehab Synergies. It's the lawsuit that we're going to reference today. It's interesting, as we've talked about, this one, there was a clinician in Arkansas several years ago that had sued one of Arkansas's big rehab providers that's still in business about this same issue with not paying overtime wages and basically coming down to wage theft. He won that lawsuit. There was a settlement. And so this is a very similar kind of case as well. It's a collective action. So you've got, like we said, this probably involved P, T, O T, S, T, and they filed this under the Fair Labor Standards Act. So that's where it began, a violation of this then it leads into this lawsuit. Jeanette, you've got more details about it. Let's go.
Jeanette Benigas 14:30
So this lawsuit, I think, started around 2018 it was it went to several different levels of courts, you know, different circuits. I don't understand all that again, not a lawyer, but it was finally. It finally came to an end with a 2023 decision, which was decided by the US Court of Appeals for the Fifth Circuit. So the key issues here in the case revolved around alleged violations of the False Claims Act, or the FCA, and retaliation against the plaintiff, who was Loy, a licensed therapist who reported fraudulent billing practices. So the last suit started with Valerie, Loy, I don't know what, what type of therapist she was. I'd love to believe that she's an SLP. I should have looked it up in my mind, in my heart, she's SLP adjacent, if she's not an SLP. But she filed a claim under the Fair Labor Standards Act, or the FLSA, and she alleged that rehab synergies failed to pay proper overtime wages. So as she started into this lawsuit, she recognized that this issue affected multiple employees, so then she sought to proceed. It proceed as a collective action, so almost like a class action lawsuit, but in her state, with what she was doing, it was called a collective action, and she did that under the FLSA. So what that allows for is for employees who are similarly situated to join together in a state lawsuit. The district court approved the approach, and ultimately, 22 employees from rehab synergies participated in the trial. The jury found in favor of the employees and concluded that rehab synergies had willfully violated the FLSA by not compensating for overtime work, and I have a big question. So what happened was, as Loy moved to this class action version of what this lawsuit was going to be, an employee files the FLSA lawsuit, the court issues an official notice under the federal court letterhead to all similarly situated employees that they too can join the lawsuit by filling out a form. And in this case, I think the rehab company got off easy because apparently there were around 1000 potential employees who could have joined the suit. 50 did, and by the time of the trial, the number was down to 22 what 1000 employees should have filled out that form? You know what that smells of to me, Preston? Fear.
Preston Lewis 17:20
Yeah.
Jeanette Benigas 17:21
I'm afraid to rock the boat. I'm afraid to get written up. I'm afraid to be let go. I'm afraid, I'm afraid, I'm afraid. We've heard from a bunch of people who listen to this podcast who have said to me, I am so glad that you asked that guest in your last podcast if she lived in a rural area where there weren't more jobs, generally speaking, there are jobs everywhere. For us, we can go get another job. Stand up for yourself, and at the end of the day in this lawsuit, for those 22 people, they won, and the rehab company shut down anyway, so these people got a payout. 22 of them, well, the other 978 or I hope that math is right, didn't get a dime and lost their job anyway. Stand up for yourself. The jury determined that their employee, the employers, violated the FLSA. The violation was willful. It was in favor of the employees. And when, when this happens in these kinds of suits, you get more than your owed so the amount of overtime lost is automatically doubled as a payout, as the employees get an automatic award of their attorneys fees, litigation costs and double what they were owed automatic. That's if they didn't even fight for anything else. That's what they got. Fine fire. Me gonna join this lawsuit. There's precedent now, all over the place. We're gonna win, especially if we have our time audits and these documents, these documents where we've been written up for not being productive. Give me a break. There were two things that were alleged here. One was this wage theft, and the other one was fraudulent billing. So Loy had also alleged that rehab synergies was engaged in fraudulent billing by pressuring therapists to provide unnecessary therapy to maximize Medicare reimbursements. So she claimed that the company retaliated against her after she raised concerns with administration about these practices, and I'm just going to insert here, guys, we are seeing this more and more if you're in healthcare with PDPM and some of these other codes that are popping up. I just saw this conversation on Facebook a few days ago where people are being asked to bill for codes for therapies that they're not necessarily providing. I think this is probably being a. Applied to SLPs more than anyone. Because we all know, and maybe we don't all know, if you're a student, if you're a new clinician, if you work in the schools or in pediatrics, maybe you just don't know how billing works, largely in speech language pathology. We are not a timed code. We are a service based code. And what that means is that we can give eight minutes of therapy or 800 minutes of therapy, and the reimbursement is the same, and it is generally low for OT and PT. They are on time based codes, which means every eight minutes they can charge the code again, their reimbursements are typically higher. And then when they're racking up these time based codes, the reimbursement is much higher for the employer. So that means they could give eight minutes or 80 minutes, and the rate is going to be grossly different. And it also means at minute number nine, you get to build the code again. You don't have to go to minute 15 or 16. It is as soon as you cross into that next minute, you get to bill again. So anyway, that's how it works in healthcare. It's one of the reasons why we are so underpaid. A systemic issue for another day, has nothing to do with this lawsuit, but we know that employers are trying to find ways to make more money as reimbursement goes down, because, God forbid their bottom line take the hit. Sounds like some some other organizations we know from Preston, it does okay. Yeah. So. So
Preston Lewis 21:40
anyway, the ivory towers,
Jeanette Benigas 21:44
the case involved these claims under the False Claims Act, which prohibit submitting false claims for government reimbursement. So part of this lawsuit, Lloyd claimed retaliation under the FCA, and she argued she was terminated for refusing to participate in fraudulent billing. Here's what happened. They went through a couple trials. It made it up to this fifth circuit, and the Fifth Circuit upheld the lower court's dismissal of the FCA fraud claim. So in one of the earlier trials, the fraud claims were thrown out, and this Fifth Circuit said, Yeah, we're keeping that thrown out. This is due to insufficient evidence that specific false claims were submitted. Now this is why documentation is important. And towards the end of this episode, we are going to talk about how to document some of this. But you have to have documentation. And in my mind, as I was preparing for this episode today, I think it's really hard to prove this. It's going to be really hard to make that kind of case. But if you are smart and savvy and you know this is going on, and you can collect the evidence for some of this, I think you have a case, I think if you collect the right kind of evidence over time, and especially as it applies to more than one patient, and if you could get colleagues doing the same thing, I think the claim could be there. So anyway, they upheld the dismissal of fraud, but they ruled that Lloyd's retaliation claim was valid because she presented enough evidence to show that she engaged in protected activity and that her termination was linked to her complaints again, fraud claims were dismissed. With the retaliation claim being upheld, she could proceed. This gave her the ability to recover damages for her termination, which I think is huge, and what this really reinforces is the high burden required to prove those FCA violations. Again, it's hard to prove that, but what it does is it upholds the whistleblower protections for employees who report suspected fraud. So whistleblower means you know you're you're calling out dirty practices where you work, and the government is saying we will protect you, and this is a situation where she lost her job. But again, government says we will protect you, and they did. So all of the therapists in this case were expected to meet extremely high productivity standards. As I was reading, I could not find what that standard was, but it was high, or at least it was high to the courts when it was presented to hit those quotas, these therapists often had to work off the clock to finish documentation after hours. They would stay late, they would come in early, and they wouldn't be paid for it.
Preston Lewis 24:44
Well, I looked and guess what? Valerie Loy is a speech language pathologist.
Jeanette Benigas 24:50
We need to get her on this podcast!!! Somebody tag her!!! Have to lower that volume when I'm editing.
Preston Lewis 24:56
I looked. Texas SLP.
Jeanette Benigas 24:58
Shut up!
Preston Lewis 24:59
Yes! And so that's the thing, is that, you know, I love it when people come to us and they say, Wow, I found fix. SLP, they're doing all these things. There are some of you out there that have fought those wars already and have been in the trenches. Know how to push back. Know that you just don't have to take the crap that is thrown on you. And so, wow, yes, let's find Valerie, and let's have her come on, if she can talk about it. Sometimes people, they've, they've left something illegal in the past, and they, you know, need to move on. And we understand that as well. But there are those of you that are just ready to turn it on its head, and wow, I'm, impressed. And also I'll say this because we all think, well, how do these companies sustain themselves? I can tell you, from my own experience, Jeanette that rehab companies I've dealt with have some of the same just rigid, pointy headed people working in middle and upper management that have been there forever, and they're just sucking, like, you know, the claws on this company and drawing some pretty good salaries and just trying to move everybody around like pieces on the chessboard. And this week, I mean, I've heard it from two or three SLPs that have said I got called by my boss because of a productivity issue where I was two minutes over, or I, you know, I had to spend 10 extra minutes with a patient, and we had a 25 minute meeting about this. How is that efficient? And the answer is, it's not so I think that there are so many people like Valerie out there. There are so many talented SLPs that know how to take their productivity and make it work for the patient. That's what it's all about. And for these companies to just treat us like these mindless automatons. Give those SLPs some autonomy and look what they can do. Let them know what you're trying to achieve financially within your company and the reimbursements that you're working with. Because so many of us have no idea what comes in and what goes out in terms of the finances for our operations. If we know it more, we can own it more, and we can make the company succeed. Not some bastard who's at mid level management, who's making $125,000 driving around the company car and just telling everybody that they were five minutes over their productivity last week. Go fly a kite. That retaliation threat that comes. You will feel it. And for a lot of people, I think Tiffany always says this, well, in her group, is that you really have to just, you know, go out and say, really, you're gonna, you're gonna get rid of me. Who's gonna treat all these patients? I can't think of, maybe, but two instances in all the years I've been in healthcare, and it wasn't an SLP, in either of those circumstances where somebody was really fired because of lack of productivity, so they are going to squawk and just bitch and moan about it, but at the end of the day, if you're not just a serial abuser who's just woefully unproductive, it is a bluff, and it is one that we have allowed to go on way too long, and that's a big reason why We're sitting with stagnant wage growth along with the reimbursements. But you know what? If we squeeze the rehab companies from this end, then they can go to the government, they can go to their lobbyists, which, believe me, they have, and they can start flexing their muscle, but as long as we're an easy mark compared to Congress, guess who they're going to pick on.
Jeanette Benigas 28:19
These were all non exempt employees, again, we'll talk about that towards the end of the pod, but they were legally entitled to overtime when you work over 40 hours per week, if you are a non exempt employee, that means you need to be paid overtime and and honest to God, let's be real. This is not just a problem at Rehab. Synergies, I've done this. Preston has done this. We have all engaged in participating in wage theft, and not as the person stealing the wages as the victim. We have all been willing victims out of fear and out of love for this job, and out of concern for what Preston just talked about, being let go or being reprimanded. So in this case, the productivity was high. It was unrealistic. People were working off the clock. People had to work outside of their expected hours, and the workers won again. The Fifth Circuit ruled in the favor of these employees because the employer was violating labor laws by not paying the extra hours worked. And this is a huge win. This is a huge win you guys, because it sends a message to other companies that they can't just force health care workers to put in extra hours for free. It is not our problem that Medicaid and Medicare reimbursements are crappy. It is not our problem that the cost of everything is going up and reimbursement is going down. Around that is not our fault. It is the burden of the company to freaking figure it out. It is not our job to uphold the profits of a higher bureaucratic organization in the name of we love our job. It's not our problem. We are professionals who dedicated six plus years of our lives to go get a master's degree to learn a highly desired skill that nobody else can do. Well, let's be honest, they're passing our jobs to OT. They're passing our jobs to ET. We just heard from someone yesterday who said she's being forced to train physical therapists on AAC because her job is figuring out a way that PT can now bill for it, and it's cutting into her productivity, and now she's getting in trouble. And you know what I told her? Girls, start that time. Audit. Start it now. Every day. Start it now. Yeah, track your time. Keep a notebook. Use an app, take screenshots of just your minutes, not patient, sensitive info. Because, believe me, I have seen this before too, where all of a sudden, some companies that are not operating above board will suddenly purge the system and say, Oh, we had to update our software, and that's been a little suspicious when that's happened before. And I'll ask about the records. Well, we've got them, but, you know, we can't put it back in the system. It's not compatible. Keep your own time, especially if you're in a crunch situation. And then Jeanette, we're going to have to know a little bit more about our own labor laws, because they're there to protect us. Yeah, where's a good place to find out about labor laws, Preston?
Preston Lewis 31:44
Start with probably some of the Fair Labor Standards Act. I know some of this is really boring stuff to read. It's made a lot easier in our lives these days. Jeanette, because of AI that's out there, explain your situation to AI, see what it says and how it applies to that law. But then, of course, do your due diligence, go in and actually read a little bit about that law. You can find some cases in your state where people have sued before. That gives you a good guideline.
Jeanette Benigas 32:11
So remember, anything that you're doing off the clock. It might sound like you could reach these productivity numbers reasonably, but it doesn't include your documentation time. A lot of us, I think, have fallen victim to that, where we are documenting and including that as part of what we bill so we can stay productive. And that's again, that's fraud. Medicare insurance companies clearly state that documentation time is not part of the billable service. And so when you're doing documentation and including that as part of what you're billing for the patient care, that's fraud. You need to be documenting after the patient and this point of service documentation baloney that they've started, you're really not supposed to be doing it. If you're the patient, do you want your health care provider sitting and staring at a screen the entire time you're being seen? No, give them their service. This doesn't include the consultations with other team members. It doesn't include phone calls prep time. It doesn't include any of that when you have back to back to back patients all day, if you're actually taking the time to do the documentation properly, to do all of these things off the clock that are supposed to be off the clock, you're not going to get paid for it. Employers are getting away with this by making it sound like it's our fault for not hitting their obnoxious productivity requirement, like you should be faster, or you should be more efficient, or you should be doing Point of Service documentation. The truth is, these quotas are designed to maximize profit at our expense. And not only are they maximizing profit at our expense, but it's not like they're bringing in new patients. So every time productivity goes up, that means we are seeing the same number of patients in a shorter amount of time. And guess what that equals for you and me? A pay cut. It's not a raise, it's a cut. So as as the cost of living goes up, as we don't get raises in the first place, now they're giving us pay cuts by increasing our productivity and expecting us to do the same amount of work we would have done. For me in 2008 I have to do the technically the same amount of work 17 or 18% faster than I did in 2008 what changed? Did the therapies get better? No, no, no, it's they change their rate to maximize profit at my expense and also at the expense of the people we serve.
Preston Lewis 34:50
Sure, so let's be realistic about what we're dealing with. I always did my level best to try to not stand out as. A sore thumb when I could, but you're going to have those days where you're just not going to play at the company way. And when they call, I think you just have to be incredulous and say, Look, I was caring for my patients today. And they're going to spout their line of bullshit. And you can sit there and let them say it, but at the end of the day, you just have to hold to your guns, folks, and say I took care of my patients, and here's what I did with my time. I'm sorry that I was 12 minutes over today, but, you know, the computer system crashed, or the PPE, you know, locker wasn't filled, or this patient had to take a break, or I had a family member come by and ask about them for, you know, when they weren't in the gym, and so I had to take 10 minutes to talk to their family member who came by. These things happen, and the more you've got better records, the more you keep a notebook about your day and what you're doing, the more you've got ground to cover, and it also rehab companies will notice when they talk to you, if you say, Well, let me pull up my notebook for the day and tell you what I was doing, if they know that you're keeping records, that is going to be a huge stop gap to keep them from doing this gaslighting and intimidation tactic that they will use on everyone, and they'll know this person is keeping tabs, and that's a good way for you to defend yourself.
Jeanette Benigas 36:17
Yeah, I wanted to pull up a comment made on Facebook, and I think this is a good place for me to plug this in. So this last week, we talked to someone who is working in healthcare, who is working for a very unethical company. So you can always go back and listen to that. We'll link it up in the show notes. We made a post about advocating for yourself, and in that post, we talked about doing these time audits. And somebody said under this post, one of the challenges for any helping field is the weak relationship of quality of care and the funding income or compensation associated with it to clarify an exceptional, well prepared SLP does not generally bring in more money for a school district or clinic compared to an average SLP who wings therapy sessions. The business end looks at quantity of therapy and generally disregards the quality of therapy. School districts look at accurate forms and paperwork, not effective therapy practices. There are no incentives for the leaders and decision makers to improve our workload because it does not coincide with increased revenue or budgets. Now do I disagree with that? No, she's right. But here's what I said to it. It doesn't mean we have to accept and participate in that working off the clock is wage theft. My comment now is whether you're effective or not, if you're working off the clock, you are the victim of wage theft. So I said that, and so this person responded and said, I wholeheartedly agree. I'm just saying employers may respond by writing up or terminating employment for those who don't meet productivity requirements. And I said, and we've already covered this today in this episode, very, very few people are let go for productivity, and that's the point of this post. Keeping good documentation is how we protect ourselves. I then said, and who really cares if you get written up? It's a scare tactic. We have to start standing up to this behavior. It's the entire point of this post. Somebody else jumped in and said, What about when you get written up and then it affects your raises? Yes, people do worry about it. There are real world consequences. And I knew you'd have something to say to that person, so I'll give you the floor.
Preston Lewis 38:55
Raises? What the hell is a raise?
Jeanette Benigas 38:57
Exactly.
Preston Lewis 38:59
And one of the things also, companies have very clever ways they do write ups, and I'm doing the air quotes here. As I say that I think, for the company that I work for, for many years, it was an in service. So they're they're careful, because they know that some things can be seen as retaliatory. So pay attention to those labels sometimes. And ask, is this, is this going in my HR file? Is this going to be brought up in my annual review? There were no annual reviews where I worked because there were no raises. So that's one way they got around that. But you know, it's Know your worth, and if you're not, if you're in a job where they're not giving you any raises, then really, what are you scared of anyway? You probably should be out there looking for other opportunities.
Jeanette Benigas 39:42
So I said to this person, all of this needs to be documented. Companies do this, but the law says they can't. So it's exactly what you said, Preston, pay attention to what they're doing, and if they're writing you up for not meeting productivity, you can request that your documentation, if it's going in your HR file that. Your documentation of how your time was spent be stapled to that write up. And obviously you'll get a copy too. So keep it again. Keep a folder. Keep a folder of all of this, because this is all a case that you are building to protect yourself. So I said it all needs to be documented. Companies do this. They actually can't so and this is this is what we want you to hear. Change isn't easy. Standing up for yourself is not easy, and sometimes it comes with risk. Clinicians can choose to stand up for themselves and take action, or roll over and continue to take it. That's the point of all of this. That is the point of fixed SLP, to gain our autonomy back, to stand up for our profession and to bring in the value that we deserve. And the more we sit down and shut up and roll over and take it, the more these companies are going to do this to us.
Preston Lewis 41:06
And I'll say one thing that some people will say, and it's full of the best of intentions, where the comment is, well, I just don't want to be, you know, terminated, or I don't want to be reprimanded, because I feel like it's, it's just, ultimately, it's going to hurt my patients that I'm serving, and I just, I care so much about them, and that is, that is something that's meant with the best of intentions. It's a noble statement, but you are worth nothing to your patients if you burn out and you're quitting in nine months time or two years time because you're in an unsustainable and toxic relationship with your rehab company. Rehab company. So you owe it to your patients and to the future patients that are going to come in that building to make that position better, not just for yourself, but perhaps for someone else when they take that position. So that advocacy for yourself actually does your patients a service versus you staying in a toxic relationship and not being the best clinician that you can be.
Jeanette Benigas 42:05
I think we could keep talking about this for another 45 minutes, very easily. We have a lot of strong opinions on this, but I do have to leave for a doctor's appointment, technically in like five minutes, but I can stretch it 10. So we're gonna wrap this up. So I want to just really bring this all together and talk about what this lawsuit means for healthcare workers. First, it means we can fight back. This wasn't just one person. It was a group of people who came together and said, Enough is enough, and because of that, they won. So think about that. We're all in this together. It doesn't matter if you're in a right to work state, you can fight back. You have the legal avenue to do it. And what we're going to do. Preston, hopefully you can send me some information on that case in Arkansas. At some point soon, I will get some of these cases linked up at fix slp.com, so you can look at some of this case precedent and see how it might apply to you and your state. The second thing it does is that it reinforces that productivity quotas do not override labor laws. If meeting your employer's expectations means that you are working unpaid hours, it's illegal. Period, full stop. Call a spade a spade. And third, this is a wake up call to anyone who just accepts wage theft as just part of the job. Well, it's, you know, like that person. This is the helping profession. I don't care what the effort is. I deserve to be paid, and I don't have to tolerate it, and neither should you. So I think most people don't realize they're being short changed. You know, we don't talk about these things in our field. It's time to start. You are being short changed. I am being short changed. Your employer is not following the law. So if you're listening to this, start tracking your hours. Get paid for what you do. So in these last few minutes, how can you protect yourself? What can you do? You need to keep track of retaliation. So Loy showed that her termination was linked to her complaints about fraudulent billing practices. I read how they figured that out is because she had documentation, I believe, of when she was bringing this to administration, the conversation very shortly after, she was terminated. Yes, right to work state, but I'm calling you out. I'm blowing the whistle, and now I'm being let go. So she had documented reports where she raised concerns about the pressure to provide unnecessary therapy for the purpose of inflating Medicare billing. Allegedly, the company discouraged her from questioning billing practices she had that documented again. The timing of her termination was very close to when she was calling that out. She claimed her supervisors pressured employees to hit these quotas, these productivity standards, regardless of clinical necessity, everything. Was documented in terms of the False Claims Act, she couldn't provide proof that fraudulent therapy had been provided. It's hard, it's hard for that one, but here's what you can do again, keep track of your time. Document everything that you do every get. A notebook. Down the left side of the notebook, put your time 8:00 to 8:10 - talked to the DOR, 8:10 to 8:15 - look for Betty Sue, 8:15, to 8:20 - just like that all day, every day. Keep track. And if you are clocking out, which you shouldn't be keep track of that too. I clocked out at 8:32 and here's me still working for the next hour, doing all of these things that should have been on the clock. Naturally, a lot of this stuff happens verbally. So if there is a conversation with your DOR, or your administrator or whoever, where they're giving you directives or you're being verbally reprimanded, summarize it and email it to the person you interacted with so you can say something like, Hey, Mark, I'm emailing to summarize our conversation from noon today, to ensure I understand completely the company policy is 80% productivity and when I find myself in unbillable situations, you said I am free to figure it out as I see fit, to get all of my work done within the expected time frame. Did I understand that correctly? Send it off. Blind carbon copy your personal email in there. Don't store any evidence on your work computer or your work email. So if you're doing this, make sure that what you send, you either print it out or you've Blind Carbon copied it or forwarded it to your own email. Don't keep a folder on your computer if they respond and make sure you print it out, get it to your own personal files, because if you are terminated, you will lose access to the computer system. Immediately. Your access is going to be revoked. So all of your evidence is on their computer that you now can't access. So make sure you have it and with these time audits, spiral bound notebook, something like that, where you can't add pages in, where you can't rip them out, put the date at the top, sign it at the bottom, because that helps make stronger evidence. You can't be accused of sticking something in at a at a later date because you were prepping for this suit, if you're dating it and signing it in that kind of notebook, you can't be accused of doing something like that. Preston has already said, know your rights. Know what your state says. If you're non exempt, and you work over 40 hours, you have to be over time, which is 1.5 times your hourly rate, and speak up. So really briefly, what is non exempt? I took some notes for myself. If you are paid hourly, you are almost always non exempt and legally entitled to overtime. If you are salaried, you might still be non exempt. It depends on your job duties and your salary, your salary level, the people who are exempt from over time fall into this set of criteria. They have to be earning at least $684 per week, which is 35,568 if they're if they're learning earning less than that, they're not exempt. So they have to have that. They have to be perform performing executive administration or professional duties, as defined by the FLSA, and they have to have independent decision making authority. And a lot of times, our employers are classifying us as exempt when really we should be entitled to overtime. So the bottom line here 40 hour work week not getting paid time and a half you're owed back pay check and see Are you exempt or non exempt? Talk to a lawyer if you suspect this is happening, talk to a lawyer. Find out what kind of stuff you have to start pulling together. Speak up. Your co workers are dealing with the same thing. Do a collective action. This can make a difference. Preston, I did a lot of talking. You did. You talked a lot in the last one. You got anything else to say before we go?
Preston Lewis 49:35
Yes, I think we need to put a link when we drop this pod for the lawsuit that we've mentioned. So everyone can reference that.
Jeanette Benigas 49:44
Valerie Loy. We need a chat with that original fixer. I mean, this thing was, this thing was finished before Fix SLP started. This was OG fixer, so proud of her. Okay, I've got to go. I have to get my brain checked. Guys, thanks for joining us for another week on the podcast. Like, share, subscribe, do all the things we so appreciate you. We'll see you next week. Thanks for fixing it!
Preston Lewis 50:17
My video is frozen. I've got this huge thunderstorm here right now too.
Jeanette Benigas 50:21
Yeah, and Preston, I'm going to take a screenshot of...
Preston Lewis 50:24
Oh God, don't. This is an awful photo.
Jeanette Benigas 50:25
what it's frozen on!
Preston Lewis 50:27
This is an awful photo.
Jeanette Benigas 50:30
Dying.
Preston Lewis 50:31
I hate zoom.
Jeanette Benigas 50:32
We're going to share this with the... this is going to be the cover art for this episode.
Preston Lewis 50:38
You share this. I am done.
Jeanette Benigas 50:41
Preston... I... you know you've been paying attention, but recently I've been, uh, off the back end of these things. I've been sharing these threats that you (laughing)...
Preston Lewis 50:54
Preston's threats.
Transcribed by https://otter.ai