08/10/2026
🌱 Healthcare CFO Brief
The Same 40 Hours. A Very Different Financial Result.
After attending a seminar on improving business financial performance, one home care agency owner went back to the office determined to look at the business differently.
Instead of immediately asking how to find more clients or increase revenue, the owner decided to first understand whether the agency was getting the best financial return from the resources it already had.
One payroll record immediately stood out.
A caregiver had been paid 80 hours over two weeks. Nothing unusual about that. But when the owner compared the payroll hours with the agency’s billing records, the numbers told a very different story.
Week One:
40 paid hours. 36 billable hours.
Week Two:
40 paid hours. 24 billable hours.
Same caregiver. Same 40 paid hours. Same hourly wage. Very different financial results.
The owner stared at the numbers and asked a question that would eventually change how the agency looked at payroll:
“What happened to the other 16 hours?”
That question opened the door to a much bigger conversation.
The agency had always monitored payroll. Leadership knew how much caregivers were paid. They reviewed overtime. They knew when payroll was due. But they had spent far less time asking how much of those paid hours were actually connected to billable client care.
In the first week, 36 of the 40 paid hours were billable. In the second week, only 24 were. That’s 12 fewer billable hours from exactly the same 40-hour payroll investment.
Now imagine that difference occurring across 20, 30, or 50 caregivers. The financial impact can become significant very quickly.
At first, it would be easy to conclude that those non-billable hours were simply waste. But that would be the wrong conclusion.
Some non-billable paid time is necessary.
Caregivers need training. Orientation is important. Travel between clients may be necessary and compensable. Meetings, supervision, and other responsibilities may be essential to operating a quality agency.
The real question isn’t:
“How do we eliminate non-billable hours?”
It’s:
“How much of our non-billable paid time is necessary, and how much could be avoided through better management?”
Maybe the caregiver spent more time traveling between clients that week. Maybe there were large gaps between assignments. Maybe a client canceled and the schedule couldn’t be filled. Maybe actual hours repeatedly exceeded scheduled hours. Maybe training or another legitimate activity occurred that week.
Until leadership understands why, simply looking at total payroll doesn’t tell the whole story. And that’s where this owner’s discovery became more than a payroll issue. It became a lesson in labor productivity.
Payroll tells you what you spent. Productivity helps you understand what that spending produced.
🧩 Healthcare CFO Insight
The same 40 paid hours can produce very different financial results.
The goal isn’t to eliminate every non-billable hour. The goal is to understand where those hours are going and reduce avoidable inefficiency without compromising care, compliance, or your workforce.
👥 Leadership Challenge
Choose one recent payroll period and compare:
• Total Paid Caregiver Hours
• Billable Caregiver Hours
Then look at the difference. Don’t immediately assume it’s good or bad. Ask: “What happened during those hours?”
That question may tell you more about your operation than the payroll total itself.
🎯 Executive Takeaway
Before assuming that payroll is too high, understand how effectively your existing payroll is being converted into billable client care.
Sometimes the opportunity isn’t paying people less. It’s managing the hours you’re already paying for better.
💬 Boardroom Question
If the same caregiver generated 36 billable hours one week and only 24 the next from the same 40 paid hours, would your leadership team be able to explain the difference?
More importantly: would you know whether that difference was necessary — or avoidable?
(Content owners by Samuel Accountant LLC)
