Do Travel Therapy Companies Pay Therapists for Covid Quarantines?

With the Omicron variant of Covid spreading rapidly throughout the country, healthcare workers having to miss work due to testing positive and having to quarantine is becoming much more common. Naturally, this is causing issues with travel therapists who are on short term contracts, which typically don’t include any PTO or sick leave benefits due to the nature of employment. Many travel therapists have reached out to us recently asking how travel therapy companies are handling this situation, because they’re worried about not being paid for their missed hours. We reached out to the dozen or so travel companies that we work with directly to compile information on how they’re handling these situations. As you might guess, it’s very situationally dependent. How this is handled varies not only by the travel company, but also by the specific facility where the traveler is working, the state they’re working in, along with how the traveler contracted Covid. It’s all a little complicated and messy, but in this article, I’ll try to break down some of the variables affecting whether the travel company can pay you or not if you miss work due to testing positive for Covid.

Will the Facility You’re Working for Pay?

The first thing that’s important to understand is where the money comes from that we’re paid as travel therapists. The facility where you’re working pays the travel therapy company an hourly amount for the hours you work called the bill rate. From that bill rate, the travel company has to keep a percentage to pay for all of their expenses, including taxes and insurance that they pay on behalf of the traveler, as well as some extra for profit to stay in business. The remaining amount is then broken down and paid to the traveler in the form of taxable pay, stipends, and reimbursements. Since that hourly bill rate is usually only paid for hours actually worked, the amount of the bill rate and number of hours worked by the traveler are the biggest factors in determining how much a travel therapy company is able to pay a travel therapist during a contract. This concept becomes very important when determining if a traveler will get paid for missed work due to a positive Covid test.

If you test positive for Covid while on a travel assignment, the first question to ask is whether or not the facility that you’re working at will pay the travel company for the hours that you’re missing due to having to quarantine. Just about all of the travel therapy companies will try to bill the facility for those hours that you’re forced to miss, but it’s up to the facility as to whether they will actually pay for those hours or not. Based on our conversations with the travel companies that we work with, the vast majority of facilities are not willing to pay for hours missed by a therapist for a positive Covid test, regardless of if they contracted Covid at work or not. Honestly, this seems insane to me if it was a work related exposure, but it is a testament to the current state of the healthcare system. In most cases, staff is overworked and underpaid while working to help patients, and then the facilities are often not even willing to help out the staff if they contract Covid during the course of their work. If the facility is willing to pay the travel company for the missed hours, then you should always get your full pay for those hours, but unfortunately that isn’t very common right now from what we’re hearing.

If the Facility Won’t Pay, then How does the Travel Company Handle the Situation?

The travel companies that we work with were split pretty evenly on this. Some companies will still pay the traveler their full pay for missed days of work, some will pay stipends but not hourly pay for missed work, and some will not pay for the missed days at all if the facility is not willing to pay for those hours. For the companies that said they wouldn’t pay travelers for the time they had to miss due to not receiving money from the facility, they did all say that they were assisting with worker’s compensation claims to try to get some sort of compensation for the traveler if it was a workplace exposure. Keep in mind though that worker’s compensation claims are almost always a hassle, and it’s a very long and drawn out process. In addition, workers compensation, if received, would only amount to receiving a percentage of the taxable portion of the traveler’s pay, which won’t result in very much.

Is the Travel Company Bad if They Won’t Pay You?

On social media (through writing) it’s very difficult and time consuming to have a nuanced conversation about the pros and cons of things. It’s also very easy to fall prey to believing those who talk about things in black and white terms on social media have it all figured out. I’ve seen many conversations on social media recently discussing travel therapy pay for quarantine time which try to make it a very black and white issue. “If the travel company pays for this time then they’re “good” and “have our back,” and the ones that don’t are “bad” or “don’t care about the therapists.” While I understand that on a surface level it could appear that this is the case, there is more to it than that. The reason for this goes back to the explanation about where pay comes from in the first section of this article.

A travel company has to make a profit on each contract in order to stay in business. If the facility isn’t paying the travel company for the hours missed due to a positive Covid test while on a contract, but the travel company is still paying the therapist for those hours, then the travel company has to account for that cost in their expenses. So what does that mean? It means that the companies that are still paying for those hours to therapists even though they’re not receiving money from the facility have to have a budget to account for these extra costs, or they are just losing money.

Likely what is happening is that they are keeping a slightly higher percentage of each traveler’s bill rate, on every contract, in order to have the money set aside to pay for those missed hours in the event that they happen due to a Covid exposure. So with all else being equal, the companies that still pay therapists for missed hours that they’re not being paid for by the facility, have to pay their travelers less across the board to account for that cost in their budget. Otherwise, they’re just taking a direct financial hit on those contracts where they have to pay for quarantines that they’re not getting paid for. It’s possible that in the beginning of Covid some companies did take a hit directly on each individual contract, but it’s been almost two years now. So, the companies are having to make decisions that keep them in business, and you can bet they’re probably adjusting their margins/overhead across all contracts to take care of potential financial setbacks due to quarantine costs.

So the companies that don’t pay for missed hours due to a positive test aren’t necessarily “bad,” they’re just choosing to not pay travelers less on their weekly pay to account for that potential expense up front. Instead, they just don’t pay the therapists for the quarantine period, which then only directly affects that one therapist if they test positive and have to quarantine, rather than affecting the pay of all travelers across the board, whether they do or don’t test positive and have to quarantine.

Neither of these methods is either “good “or bad, just different. As a traveler, you have to decide if you’d rather make less on your contract each week for having the security of knowing if you miss work due to a quarantine you’ll still be compensated, or if you’d rather get paid more each week and take the risk of not being paid if you test positive for Covid.

This is exactly the same cost-benefit analysis to consider when choosing between companies that either “guarantee full stipends” even if you have missed hours on your contract, vs. taking away from your weekly pay (both hourly and stipends) for missed hours. There is no “free” money in travel healthcare. If the company is paying you money when they can’t bill the facility for your services (for example if you have to quarantine and miss work, or if census is low and you miss hours), then that means they’re accounting for paying out this extra money sometimes by keeping a higher margin to budget across the board. So, would you rather work with a company where you have the security of guaranteed pay every week, knowing that you’re likely making slightly less across the board on all weeks worked? Or would you rather get paid a little more on a week to week basis by a company that isn’t keeping this separate budget, knowing that there is a risk your pay would be directly affected if you missed hours due to quarantine or low census?

Take Home Message

As you can see, there is a lot that goes on “behind the scenes” with how a travel therapist gets paid. Therefore, you should never look at issues surrounding travel therapy pay as simply black vs. white, good vs. bad. This is always the case in our industry, and it applies here in the scenario that you have to miss work due to a positive Covid test. Since this is a timely issue right now, you can take some of these factors into account when you’re choosing your next contract. Companies won’t always be fully transparent about how their company budgets and accounts for costs, but you can ask them what’s the policy on paying for travelers who have to quarantine for Covid to get an idea, as well as their policy on guaranteed hours & stipends. Once you find out the answers to these questions, it may be in your best interest to run a thought experiment with yourself before accepting a contract to see what is most important to you as an individual: would you prefer to have guaranteed pay each week, even if issues arise such as low census or having to quarantine for a Covid exposure? Or do you prefer to make the highest pay possible up front, and budget on your own in case of any missed work?

You have a lot of choices when it comes to working with different travel companies, and sometimes it can be difficult to know which ones are going to be better for you. If you’re looking to get connected with companies and recruiters that we personally recommend, fill out our recruiter recommendations form, and we will take a look at your personal preferences in order to help point you in the right direction of companies that should work well for you.

Jared Casazza
Written by Jared Casazza, PT, DPT

Jared is a Doctor of Physical Therapy who has been a travel therapist since 2015. He has mentored thousands of therapists and therapy students to help them get started on their own travel therapy careers.