Can BEG handle high W-2 volume from CNA and aide turnover?

Yes. Year-end W-2 preparation for high-turnover care staff is fully included with no additional fees.

Managed Payroll · Senior Care

Senior care facilities have the most regulated payroll environment in healthcare. We manage all of it.

24/7 staffing, CNA and aide overtime, CMS compliance requirements, shift differentials for overnight and weekend staff, benefit tracking for high-turnover employees, and year-end W-2 volume make senior care payroll one of the most demanding in any industry. BEG manages all of it at $25-$45 per employee per month - fully managed, no migration required.

See your exact monthly & annual price - no call required

CMS-awarePayroll built around CMS staffing and compliance requirements

CNA complianceOvertime, shift differentials, and aide pay handled

Shift differentialsOvernight, weekend, and holiday pay automated

The Cost of Running It Yourself

What does in-house payroll actually cost a senior care facility?

24/7 pressure

Round-the-clock staffing means payroll never has a simple week

Senior care operations run three shifts every day. Night differential, weekend premium, holiday pay, and on-call callback calculations must be right every cycle. One error triggers complaints from CNAs and aides whose income depends on precision.

High turnover

Senior care facilities average 50-100% annual CNA turnover - W-2 volume is enormous

High turnover means constant new hire setup, mid-year terminations, and year-end W-2 preparation for a large and changing population. An internal payroll processor spending time on W-2 volume is not available for anything else in Q4.

CMS exposure

CMS staffing data is public - payroll records that do not reconcile with staffing ratios create survey risk

CMS publishes staffing data on Nursing Home Compare. Payroll records that show hours worked do not match staffing reports create deficiency findings during surveys. Accurate payroll is not just a financial obligation - it is a regulatory one.

How It Works

Three steps to fully managed senior care payroll

Scope review

We map your staffing classification structure (RN, LPN, CNA, aide, administrative), shift differential rates, benefit elections for high-turnover staff, and state minimum wage requirements for care workers. You get a fixed monthly cost.

Setup and first cycle

We configure shift differential rules, CNA overtime calculations, benefit deduction tracking, and state-specific minimum wage compliance. Your first payroll cycles run alongside ours for verification.

Ongoing managed service

Every pay cycle, every shift differential calculation, every year-end W-2 for your full workforce - fully managed by BEG. Your administrator reviews and approves; we execute.

What BEG Handles

Senior care payroll complexity - fully covered

✓Shift differential calculations for night, weekend, and holiday shifts for all care staff

✓CNA and aide overtime under FLSA, including daily and weekly threshold calculations

✓State-specific minimum wage compliance for care workers in states above federal floor

✓Benefit deduction tracking for high-turnover staff: health, dental, and supplemental elections

✓New hire payroll setup and termination processing for frequent staffing changes

✓Year-end W-2 volume preparation for large and frequently changing care staff populations

✓On-call and callback pay calculations for clinical staff required to remain reachable off-shift

✓CMS-aware payroll records that support staffing ratio documentation for survey compliance

✓Multi-location payroll for senior care groups operating multiple facilities

✓Garnishment administration for care staff wages

Side by Side

BEG Managed Payroll vs. In-House vs. Software

Factor	BEG Managed	In-House Hire	Payroll Software
Shift differential automation	Fully managed	Manual configuration	You configure it
CNA overtime calculations	Included	Included	You verify it
High-turnover W-2 volume	Included	Time-consuming in Q4	Extra fee
CMS staffing record alignment	Managed	Varies by hire	Not built in
State-specific care worker minimums	Auto-updated	Must track manually	Manual update
Monthly cost (75 workers)	$1,875-$3,375	$5,800-$8,300	$600-$1,400 + risk
Single point of failure risk	None	High	None

The Math on Waiting

Every shift differential error is an argument with a CNA who cannot afford to be underpaid.

Senior care staff have among the lowest margins for payroll error. When a night differential is missed or an overtime calculation is wrong, the employee notices immediately. BEG manages shift differentials, CNA overtime, and every weekly cycle with the precision care facilities need.

Your Next Transition Window

The best time to switch is before the next quarter starts - not in the middle of a survey cycle.

Payroll transitions take 30-60 days. Senior care facilities that start the process before Q4 arrive at year-end W-2 season with a fully managed system handling the volume. Facilities that wait do year-end manually and lose the window for another year.

15 minutes. We scope your facility, give you a fixed monthly cost, and show you what transition looks like. Pricing starts at $25 PEPM.

Explore More

More managed payroll resources

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FAQ

Common questions from senior care facilities

How does BEG handle shift differentials for CNAs and aides?

BEG configures shift differential rates for each staff classification - night, weekend, and holiday premiums - and applies them automatically based on hours worked and shift schedule. Differential pay is included in the regular rate calculation for overtime purposes under FLSA, which is one of the most commonly mishandled aspects of care staff payroll.

Can BEG handle the high W-2 volume from CNA and aide turnover?

Yes. Year-end W-2 preparation for high-turnover care staff populations is fully included in BEG's managed payroll service. We track all employees who worked during the year, prepare accurate W-2s reflecting all compensation types (including shift differentials and overtime), and file on time. There are no additional W-2 fees.

What does CMS-aware payroll mean in practice?

CMS publishes staffing data from payroll records on Nursing Home Compare. Payroll hours-worked data that does not reconcile with staffing reports creates deficiency findings during CMS surveys. BEG maintains payroll records in a format that supports accurate staffing ratio documentation, so your hours-worked records align with what gets reported to CMS.

What does $25-$45 PEPM include for a senior care facility?

Everything: payroll processing, shift differential calculations, CNA overtime, state tax filing, garnishment administration, benefit deduction tracking, year-end W-2 volume, and dedicated BEG support.

Do we need to switch payroll systems?

No. BEG operates as your managed payroll team inside your existing system. Migration is available if you want a better platform, but it is never a requirement to get started.

Can BEG manage payroll for a multi-facility senior care group?

Yes. BEG manages payroll across multiple facilities within the same organization, with separate facility-level cost reporting and consolidated billing. Multi-facility senior care groups can standardize payroll management across all locations through a single BEG engagement.

Is care home payroll different from standard small business payroll?

Yes. Care home payroll (the same complexity described above for senior care and assisted living facilities, just under different naming) has to handle round-the-clock shift coverage, differential pay for nights and weekends, high CNA and aide turnover, and CMS-facing hours-worked records, none of which a generic small business payroll setup is built to manage correctly. BEG configures payroll specifically for the care home staffing model rather than treating it like standard hourly payroll.