I am a salaried Director of Client Services at a home health agency. Am I really exempt from overtime?

Probably not. The title is doing the work, not the duties. To be exempt under the executive exemption at 29 C.F.R. § 541.100, you must regularly direct the work of two or more full-time employees and have real authority over hiring and firing. Most directors of client services supervise a scheduler and no one else, and the rest of the day is spent on care coordination, intake calls, family communication, and Medicare documentation. The administrative exemption at 29 C.F.R. § 541.200 fails for a different reason: applying agency policy, regulatory requirements, and a clinical protocol written by someone else is executing policy, not exercising discretion and independent judgment on matters of significance. Salary plus a fancy title is not an exemption.

I am an RN paid a salary as a case manager at a hospice. Does the learned professional exemption mean I do not get overtime?

Maybe, but probably not, and the answer depends on what you actually do day to day. The learned professional exemption at 29 C.F.R. § 541.300 covers RNs who are paid on a salary basis and whose primary duty is the actual practice of nursing, which 29 C.F.R. § 541.301(e)(2) describes as work requiring advanced knowledge in the field. An RN whose primary duty is direct patient assessment, clinical judgment, and the practice of nursing typically does fall within the exemption. An RN case manager whose primary duty is scheduling visits, coordinating across disciplines, managing the chart, communicating with families, and overseeing billing compliance is doing administrative and operational work, not the practice of nursing. The salaried RN case manager who spends most of her week on coordination rather than clinical assessment usually falls outside the learned professional exemption and is owed overtime.

I am a salaried care coordinator at an HCBS agency. Why am I working 55 hours a week without overtime?

Because a salary by itself does not exempt anyone from overtime. The FLSA exemptions at 29 C.F.R. §§ 541.100, 541.200, and 541.300 each require two things: a salary at or above the federal threshold, and a duties test that turns on what you actually do at work. Most salaried coordinator roles at home health, hospice, and HCBS agencies fail the duties test. The executive test fails because there are no two full-time direct reports. The administrative test fails because the work is execution, not policy. The professional test fails when the primary duty is coordination rather than the practice of a learned profession. If none of the three exemptions actually fits, every hour over 40 in the workweek is owed at time and a half, no matter what the salary is.

My agency deducts pay when I take a half day for a doctor visit. Does that affect my exempt status?

Yes, and it can be the issue that wins your case. The salary basis test at 29 C.F.R. § 541.602 requires that you be paid a predetermined salary that is not reduced based on the quality or quantity of work in any given week. Deducting pay for partial-day absences (a half day for a doctor visit, a late arrival because of traffic, leaving an hour early because the kids were sick) is the classic salary basis violation. A pattern of these deductions can destroy the exemption entirely, which means the employer owes overtime for every hour over 40 across the entire period of improper deductions, not just the weeks where a deduction was actually taken.

Does answering family calls and charting from home at night count as paid work even though I am salaried?

Yes. If your employer requires or expects the work, the time is compensable, period, even if you are at home, even if you are salaried, and even if no one specifically asked you to do it that night. Answering family or staff calls after hours, doing electronic charting from home in Therap or Homecare Homebase, completing OASIS documentation, running quality assurance reviews, and after-hours on-call coordination are all paid work. For a non-exempt employee, those hours go on top of the workweek and produce overtime when the total crosses 40. The fact that no one made you log the hours does not change the analysis. If the employer suffers or permits the work, the FLSA requires it to be paid.

Home Health Administrators and Coordinators

You are paid a salary at a home health agency, a hospice, or an HCBS provider. Your title is something like Director of Client Services, Patient Services Manager, Care Coordinator, RN Case Manager, Clinical Director, Hospice Coordinator, Assistant Administrator, Quality Assurance Coordinator, Intake Coordinator, or Scheduling Manager. You work 50, 55, sometimes 60 hours a week. You answer family calls at night, chart from home, and you carry the on-call phone on weekends. Your employer tells you that you are exempt because you are salaried and you have a manager title, so overtime is not owed.

Most of the time that is wrong. I represent these workers, and I want to explain why.

Who I Represent

Directors of Client Services and Patient Services Managers at home health agencies
RN Case Managers at home health agencies and hospices whose primary duty is coordination, not clinical assessment
Hospice Coordinators and hospice team leads
Care Coordinators and Service Coordinators
Clinical Directors and Assistant Clinical Directors at HCBS providers
Administrators and Assistant Administrators at small and mid-size home health agencies
Quality Assurance Coordinators and QA Nurses
Intake Coordinators, Referral Coordinators, and Authorization Coordinators
Scheduling Managers and Staffing Coordinators
Anyone salaried in a coordinator or mid-level management role at a home health, hospice, or HCBS agency

Why the Common Defenses Fail

This page sits in between two others on the site. The Healthcare Workers page deals with hourly home health aides, CNAs, nurses, and group home staff. The Salaried Employees page deals with salaried workers across every industry. This page is for the middle: salaried administrative and clinical-administrative roles at agencies that touch Medicare, Medicaid, or HCBS. The defenses these employers raise are predictable, and the same answers come back to them.

Common Violations

Executive exemption that fails on the two-FTE element. Your employer says you are an executive exempt because you have a manager title. The executive exemption at 29 C.F.R. § 541.100 requires four elements, all four of them, and all four have to be satisfied: salary basis at or above the threshold, primary duty of management of the enterprise or a recognized department, customarily and regularly directing the work of two or more full-time employees, and real authority over hiring and firing. Most directors of client services and care coordinators have one assistant, no direct reports at all, or a rotating set of field staff who are not customarily and regularly under their supervision. Without two FTEs reporting up regularly, the exemption fails on its face.

Executive exemption that fails on the primary-duty element. Even when there are direct reports, the primary duty has to be management of the enterprise or a department. A care coordinator whose week is spent on intake, scheduling, family communication, OASIS documentation, Medicare authorization, and chasing physician orders is not primarily managing an enterprise. She is doing care coordination, which is operational, not managerial, work. The case-management work is the job; the supervision is incidental.

Administrative exemption that fails on discretion-and-independent-judgment. The administrative exemption at 29 C.F.R. § 541.200 requires office or non-manual work directly related to management or general business operations and the exercise of discretion and independent judgment on matters of significance. Applying CMS conditions of participation, executing the agency's compliance program, applying a clinical protocol the medical director wrote, and processing authorizations under Medicare or HCBS rules is execution of policy, not formulation. Coordinators do not commit the business. They run it inside the rails someone else built.

Professional exemption claimed for RN case managers whose primary duty is coordination. The learned professional exemption at 29 C.F.R. § 541.300, with the RN-specific guidance at 29 C.F.R. § 541.301(e)(2), covers RNs whose primary duty is the practice of nursing as a learned profession. An RN who spends her week on patient assessment, clinical judgment, and the actual practice of nursing is exempt. An RN case manager who spends her week on scheduling, intake, family communication, chart review, billing compliance, and supervising aides is doing administrative work that happens to require an RN license. The license does not convert the administrative work into the practice of nursing. Courts look at what the worker actually does, not the credentials she holds.

Salary basis destroyed by partial-day deductions. The salary basis test at 29 C.F.R. § 541.602 requires that you be paid a predetermined salary that is not subject to reduction based on the quality or quantity of work in a given week. Deductions for partial-day absences (a half day for a doctor visit, a late arrival, leaving early to pick up a sick child) are the classic violation. A pattern of these deductions destroys the exemption for the entire period of improper deductions and exposes the agency to overtime liability on every hour over 40 worked during that period, regardless of whether any deduction actually hit that particular workweek.

A manager title for what is really a non-managerial coordinator role. Many agencies hand out manager titles because the title sounds professional, reduces turnover, and supports a payroll structure that avoids overtime. But the title does not control the FLSA analysis. The job is what the job is. A "Scheduling Manager" who builds the weekly staffing grid and coordinates with aides is doing scheduling, which is operational work. A "Director of Client Services" who handles intake, family calls, and authorization is doing coordination, which is administrative-execution work. Neither one is an exempt manager just because the badge says so.

Off-the-clock administrative work performed at home. Answering family or staff calls after hours, completing OASIS documentation, charting in Homecare Homebase or Therap from home, on-call clinical questions from field staff, after-hours QA review, weekend authorization work, and end-of-month billing scrub are all compensable work for a non-exempt employee. The FLSA's "suffer or permit" rule means that if the employer knows or should know the work is being performed, the time is paid. The fact that the salary structure was set up to discourage tracking these hours does not change the analysis once the exemption falls.

Off-the-clock weekend on-call coverage. Many agencies require the salaried coordinator or director to carry the on-call phone on a rotation. For a non-exempt employee, the analysis turns on whether the on-call time is so restricted that it is effectively working time. Active responses to calls are always compensable. A weekend of waiting for the phone to ring while being restricted to a small geographic area, with frequent interruptions, can become entirely compensable.

How the Law Protects You

The FLSA's overtime requirement at 29 U.S.C. § 207(a) covers every non-exempt employee in interstate commerce. Home health, hospice, and HCBS agencies that bill Medicare, Medicaid, or commercial insurance are squarely in interstate commerce and are covered enterprises. The default rule is overtime on every hour over 40 in a workweek, unless the employer proves that one of the specific exemptions applies. The employer carries the burden of proof on every element of the exemption.

The executive exemption at 29 C.F.R. § 541.100 requires four elements: salary basis at the federal threshold, primary duty of management of the enterprise or a recognized department, customarily and regularly directing the work of two or more full-time employees or their equivalent, and authority to hire and fire (or recommendations given particular weight). All four elements have to be met. The two-FTE element is where most coordinator roles fail.

The administrative exemption at 29 C.F.R. § 541.200 requires salary basis at the threshold, primary duty of office or non-manual work directly related to the management or general business operations of the employer, and the exercise of discretion and independent judgment with respect to matters of significance. The discretion element is where most coordinator roles fail. Applying clinical protocols, executing agency policy, and processing authorizations under regulatory frameworks written by CMS or the state Medicaid agency is execution, not formulation.

The learned professional exemption at 29 C.F.R. § 541.300 requires salary basis and a primary duty requiring advanced knowledge in a field of science or learning customarily acquired by a prolonged course of specialized intellectual instruction. The RN-specific guidance at 29 C.F.R. § 541.301(e)(2) confirms that registered nurses generally satisfy the duties test when their primary duty is the practice of nursing. The key word is "primary." An RN whose primary duty is coordination, scheduling, family communication, and chart management, with patient assessment as a secondary activity, falls outside the exemption.

The salary basis test at 29 C.F.R. § 541.602 requires a predetermined salary not reduced based on the quality or quantity of work in a given week. Permissible deductions are narrow and include full-day absences for personal reasons, certain disciplinary suspensions, and the first and last weeks of employment. Improper partial-day deductions can destroy the exemption.

The Supreme Court has reaffirmed in recent years that the FLSA's exemptions are to be given a fair reading based on the regulatory text, not narrowly construed against the employer. The employer still carries the burden of proof on every element, and the question is always what the worker actually does, not what the title says.

For off-the-clock work, the FLSA's "suffer or permit" standard at 29 C.F.R. § 785.11 controls. If the employer knows or has reason to know that work is being performed, the time is compensable, regardless of where it is performed and regardless of whether anyone told the employee to do it.

The lookback period is two years for ordinary violations and three years for willful violations. Recovery includes the unpaid overtime, an equal amount in liquidated damages under 29 U.S.C. § 216(b), and post-judgment interest.

When These Roles Actually Are Exempt

I want to be straight about this. Not every salaried administrator or coordinator at a home health agency is misclassified. There are real administrator and clinical-administrator roles that satisfy one of the FLSA exemptions, and a worker in one of those roles probably does not have an overtime claim.

The clearest example is the RN whose primary duty really is the practice of nursing. An RN who spends most of her week on direct patient assessment, OASIS scoring as a clinical judgment, plan-of-care decisions, and clinical supervision of skilled visits is performing the work the learned professional exemption was designed to cover. The exemption at 29 C.F.R. § 541.300 with the guidance at 29 C.F.R. § 541.301(e)(2) fits, and the RN is exempt as long as she is paid on a salary basis at the threshold and the salary basis is not destroyed by improper deductions.

A second example is the true administrator. An agency administrator whose primary duty is running the business (P&L responsibility, strategic planning, decisions on services lines, real authority over personnel structure, real authority over agency policy, financial decisions that commit the business) is exercising discretion and independent judgment on matters of significance. The administrative exemption at 29 C.F.R. § 541.200 applies. The same analysis can apply to a clinical director whose primary duty is setting clinical policy for the agency rather than executing it.

A third example is the true executive. A director of nursing at an agency large enough that she actually has two or more full-time RNs or LPNs reporting up customarily and regularly, with real hiring and firing authority and the primary duty of running the clinical department, satisfies the executive exemption at 29 C.F.R. § 541.100.

The pattern in all three of these cases is the same: the title matches the work, the duties test is actually satisfied, and the salary basis is intact. Those are the cases where the exemption sticks. The cases I see most often are the ones where the title sounds executive or professional but the actual day is spent on coordination, scheduling, family communication, and authorization processing. Those are the cases where the exemption fails.

If you are not sure which side of the line your job falls on, the conversation is free. I can usually tell within a few minutes whether the exemption holds up.

What Your Case Could Be Worth

Salaried coordinator misclassification cases produce significant recoveries because the violations recur every workweek and continue for years.

Take a Director of Client Services earning $65,000 per year ($1,250 per week) at a home health agency, working 55 hours per week for two years, with no overtime paid. The regular rate calculation depends on whether the salary was intended to cover only 40 hours or all hours worked, and the half-time method is sometimes available, but using the more straightforward time-and-a-half calculation on a 40-hour salary, the regular rate is $31.25 per hour. The overtime premium is $46.88 per hour on the 15 overtime hours per week, or roughly $703 per week. Over 104 weeks, the back pay is approximately $73,100. Liquidated damages double the recovery to approximately $146,200.

Take an RN Case Manager at a hospice earning $80,000 per year ($1,538 per week), working 50 hours per week for three years on a primary duty that is mostly coordination rather than the practice of nursing. The regular rate is $38.46. The overtime premium is $57.69 per hour on 10 overtime hours per week, or $577 per week. Over 156 weeks (a three-year willful violation), the back pay is approximately $90,000, and with liquidated damages the recovery is approximately $180,000.

These are illustrations, not promises. Every case is different, and the exact math turns on the salary basis analysis, the half-time versus time-and-a-half method, the willfulness finding, and the specific facts of the duties test. Cases with off-the-clock home charting, weekend on-call work, and partial-day deductions scale up further.

Counterarguments You Should Expect

Defense counsel for the agency will usually raise three arguments, and it is worth knowing about them in advance.

The first is the "she was an RN" argument. Defense will point to the nursing license and say the learned professional exemption fits automatically. The answer is that the license is necessary but not sufficient. The exemption turns on the primary duty. An RN whose week is mostly coordination and chart management is not performing the primary duty the exemption was written to cover, even though she could not legally do the job without the license.

The second is the "she ran a department" argument. Defense will identify a handful of direct or indirect reports, point to the budget responsibility, and argue the executive exemption fits. The answer is the four-element test. Two full-time direct reports customarily and regularly is a strict requirement. Indirect reports, rotating reports, and one-helper-plus-some-field-staff usually do not satisfy it, and the primary duty element fails when the day is mostly coordination rather than management.

The third is the "she had discretion" argument. Defense will point to authorization decisions, staffing decisions, and family communication decisions, and argue the administrative exemption fits because the coordinator exercises judgment every day. The answer is the matters-of-significance limitation. Discretion within a clinical protocol or a regulatory framework written by someone else is execution, not formulation. The administrative exemption was designed for the people who write the protocols, set the budgets, and commit the business, not for the people who run the operations inside the rails the protocols and budgets define.

These arguments come up in every case. None of them is a winner by itself.

No Cost to You

I work on a contingency fee basis. You pay nothing upfront. If there is no recovery, you pay nothing, not even the costs.

Contact Me

30+ years employment law experience. 15+ years FLSA-only. I represent home health, hospice, and HCBS administrators and coordinators in federal courts across Texas, New Mexico, Oklahoma, Arkansas, and Indiana.

If you are a salaried Director of Client Services, Care Coordinator, RN Case Manager, Hospice Coordinator, Quality Assurance Coordinator, Clinical Director, or similar mid-level coordinator at a home health, hospice, or HCBS agency, and you are working over 40 hours a week without overtime, call me. I will walk through what your week actually looks like, what your title is doing for the agency, what deductions have been taken from your salary, and whether your role actually satisfies an FLSA exemption.

Call me at (512) 799-2048.