Nurses paid the day of the visit, not two weeks later

Kittering Home Health places contract nurses with patients who are recovering at home: after surgery, after a stroke, through the long middle of a chronic illness. Its 310 nurses are spread across Ohio, Indiana, Michigan and six neighboring states, many of them in towns where the nearest hospital is an hour away.

For years Kittering paid them the way most agencies do, by ACH every other Friday. Dana Whitlock, its VP of Finance, says that schedule was the most common reason nurses gave for leaving. “A nurse fills her tank three times a week. Waiting fourteen days to be paid for a visit is a real cost to her.”

A run every evening

Kittering's visit notes are signed in its scheduling system when a nurse leaves a patient's home. Since last April, each signed visit becomes a line in a daily payout run that Dana's team approves at 4:00 PM ET.

The rails matter more here than they do for a company paying in big cities. Many of Kittering's nurses bank at credit unions, and most of those receive FedNow, not RTP. Pinnacle routes each payment to whichever network the nurse's bank is on.

• 64% of nurses are paid over FedNow and 22% over RTP, within seconds of approval.
• The other 14% are paid same-day ACH, and that share has fallen every quarter as their credit unions join FedNow.

Keeping nine states straight

Paying in nine states means nine sets of rules for which 1099 copies a state wants. Pinnacle files them from each nurse's W-9 address, and when a nurse moves from Indiana to Ohio mid-year, both states get the copy they are owed.

A year later

Kittering's nurse turnover fell by a third in the twelve months after the switch. Dana is careful not to give daily pay all the credit — the agency raised its rates the same year — but in exit interviews, pay timing no longer comes up at all.