Are you crushed by HCW absences?
One of the highest rates of FMLA leave
Too many hospital employees are missing in action. Health care workers have among the highest rates of family and medical leave, with about 39% missing an average of almost a month of work each year, according to a recent report from a human resources consulting firm.
About half of the Family and Medical Leave Act (FMLA) leave is intermittent, with health care workers missing an average of 13 days, or about one day per month, according to customer data from ComPsych Corp., a Chicago-based international provider of employee assistance programs and other human resources services to more than 19,000 employees.
That intermittent leave causes a great difficulty for health care employers, who have to staff a 24-7 operation with specialized employees, says JoAnn Shea, ARNP, director of Employee Health Services at Tampa (FL) General Hospital, who is scheduled to speak on managing FMLA at the upcoming conference of the Association for Occupational Health Professionals in Healthcare (AOHP). (See editor’s note below for information on the conference.)
It is meant for people who are periodically disabled by ailments such as migraines or who care for a child or other family member with an episodic serious disease, such as asthma. The problem lies with a subset of employees who abuse their ability to take intermittent leave, she says.
"It is an important law to protect people with illnesses. I truly believe in it," she says. "But working with that small element that doesn’t use it appropriately is tough."
Out of 6,500 employees, Tampa General has about 1,500 new FMLA cases a year and recertifies about 1,300, says Shea. At any one time, about 2,000 may be on FMLA, which includes pregnancy leave. About half of those cases involve intermittent leave.
Here are some strategies for preventing FMLA abuse or managing employees who may be using it inappropriately:
Require employees to give proper notification. The employer can set up a system of notification that the employee is required to follow. For example, you may require two hours’ notice for intermittent leave and 30 days for a doctor’s appointment. If the employee provides less notification — and it’s not an emergency — that counts as an unscheduled absence, not leave time, and could trigger disciplinary action, says Shea.
Reassign employees, if necessary. Employees must be able to perform the essential functions of the job. For example, in the hospital’s ambulatory surgery center, an anesthesia tech on intermittent leave said she could not stay late and work past her eight hours. Yet because there is no evening shift at the center, employees there share the responsibility of staying late, when necessary to complete a case. The tech was offered a transfer to another patient care area, Shea says.
Set a system of re-certification. Some employees are on intermittent FMLA leave for years. That may be appropriate for someone with a serious chronic disease, but health circumstances often improve with treatment. You can periodically ask an employee to be recertified, says Shea. If the employee is taking more absences than allowed under the doctor’s certification, you also may ask for a recertification, she says.
Communicate with physicians. If an employee is missing an excessive amount of time, is that an indication that the disease isn’t adequately managed? Or that the employee is taking advantage of FMLA? In either case, it may be helpful to communicate with the doctor. The doctor might change the treatment, approve the higher use of leave, or indicate that the level of absence isn’t warranted by the severity of the illness, says Shea.
Confront employees over discrepancies. Let’s say an employee calls in with migraines on a Friday, then posts photos from Disney World on Facebook. Some co-workers are likely to see the photos, and they may not be too happy that they’re working extra to cover for someone who lied to get their leave. One employee called in for intermittent leave, then texted a coworker to complain that she was still at her daughter’s school, trying to register her. In another case, an employee called in for intermittent leave while he was fishing with co-workers. "We immediately bring the employee in and ask them," Shea says. Texts and Facebook posts are damning evidence, and employees can be terminated for lying, she says.
Keep up with changes in the law. Between FMLA and the Americans with Disabilities Act, it’s complicated to accommodate employees with chronic diseases. Changes in the law may affect who is allowed to take leave or what documentation is required. When in doubt, Shea relies on the advice of an HR lawyer who specializes in FMLA and ADA.
(Editor’s note: The AOHP 2013 annual conference will be held September 14-16 at the Walt Disney World Resort in Orlando, FL. More information is available at www.aohp.org.)