Labor IssuesCare WorkforcePolicy

When Case Managers Don’t Get Paid: What the Wisconsin Ruling Means for Care Workers and Families

ccaring

2026-02-14

11 min read

A 2025 Wisconsin ruling on back wages reveals how underpaying case managers threatens care continuity — and what families should do now.

When case managers don’t get paid, care breaks down — and a recent Wisconsin ruling shows why families should pay attention

Caregivers and families worry: what happens to the people we rely on when case managers and care workers are underpaid, overworked, or working off the clock? A late-2025 federal judgment in Wisconsin that ordered a medical care partnership to pay more than $162,000 in back wages and damages to 68 case managers highlights an urgent, often-overlooked risk to care continuity: wage violations destabilize the workforce and put vulnerable people at risk.

The headline: what the Wisconsin decision says (briefly)

On Dec. 4, 2025, a U.S. District Court for the Western District of Wisconsin entered a consent judgment requiring North Central Health Care (operating as a multicounty medical care partnership) to pay $81,243 in back wages and an equal amount in liquidated damages to 68 case managers after a U.S. Department of Labor Wage and Hour Division investigation found the employer failed to record and pay for all hours worked — including overtime — between June 17, 2021, and June 16, 2023.

Federal investigators concluded case managers performed unrecorded work and were not paid time-and-a-half for hours over 40 in a workweek, violating the Fair Labor Standards Act (FLSA).

Why this ruling matters to families and care recipients

The legal finding is about payroll and labor law, but its ripple effects are practical and immediate for families who depend on community-based care:

Care continuity erodes: underpaid staff are more likely to leave, creating gaps in visits, missed assessments, and delayed service planning.
Quality drops: overtime and off-the-clock work contribute to burnout and errors — and exhausted case managers can’t advocate consistently for clients.
Access narrows: strained public providers may reduce caseloads, triage services, or shift responsibilities in ways that leave families scrambling for alternatives.
Costs shift to families: when public case management falters, families often pay for private aides, respite, or emergency services — expenses not always anticipated in household budgets.

Real-world example: how a payroll problem becomes a care problem

Consider the common pattern we hear from caregivers: Margaret’s mother relied on a county case manager to coordinate home care, medical appointments, and community services. When staff turnover spiked because case managers were routinely working unpaid overtime, Margaret experienced missed reassessments, delayed authorization of home health aides, and confusion about medications. Those gaps led to two emergency room visits in six months — more stress and higher costs that families must shoulder.

Back wages, wage theft, and the laws that protect workers (and indirectly protect families)

Wage violations range from unpaid overtime to failure to record hours or requiring employees to work off the clock. In this Wisconsin case, the Department of Labor found both overtime and recordkeeping violations under the FLSA. Key legal points families should know:

Overtime under FLSA: nonexempt employees must be paid 1.5 times their regular rate for hours worked over 40 in a workweek.
Recordkeeping: employers must keep accurate records of hours worked. Failure to do so can trigger back-wage awards if violations are found.
Back wages and liquidated damages: when violations occur, courts can order unpaid wages plus liquidated damages equal to those wages, which is what happened in the Wisconsin judgment.
Statute of limitations: under the FLSA, workers generally have two years to file claims; three years if the violations are willful. That matters for case managers considering legal action.

2026 trends that make this ruling especially relevant

As we move through 2026, several workforce and policy trends amplify the consequences of wage violations in community care:

Heightened enforcement: federal and state labor agencies increased investigations in late 2025 and early 2026, particularly into health and social service employers with complex funding streams.
Ongoing workforce shortages: many regions still face shortfalls in qualified case managers and home health workers. Wage violations accelerate exits from the field.
Medicaid and reimbursement pressure: stagnant or constrained public reimbursement rates leave county and nonprofit providers struggling to balance budgets while meeting legal payroll obligations.
Technology adoption: 2026 sees wider use of electronic timekeeping and scheduling tools designed to prevent off-the-clock work — a positive trend but one that requires investment.
Organizing and collective action: more care workers are turning to unions or associations to demand fair pay and recordkeeping; expect more legal settlements and bargaining activity in 2026.

How wage violations disrupt care continuity — the mechanics

Understanding the specific pathways from payroll violations to interrupted care helps families and policymakers design fixes. Common mechanisms include:

Turnover cascades: unpaid overtime leads to burnout; staff leave; remaining workers pick up more hours, increasing error risk and creating more departures.
Reduced availability: agencies restrict in-person visits or shrink caseloads to meet budgets, leaving lower-priority clients with less oversight.
Informal shifts: unpaid work dims supervisors’ visibility into staff workloads, making resource allocation less responsive.
Compliance-driven slowdowns: once violations are detected, organizations may temporarily reassign duties, conduct audits, or freeze hiring — short-term steps that can disrupt services.

Why families feel the impact first

Case managers are often the hub of a care network: they connect medical providers, authorize services, and monitor safety plans. When that hub weakens, coordination breaks down. For frail elders, people with disabilities, and complex care cases, those breakdowns can mean missed medications, delayed therapy, or missed safety checks.

Practical, actionable steps for families

Families can’t solve labor-law problems, but they can reduce risk, protect continuity of care, and advocate effectively. Here’s a checklist:

Short-term actions (what to do now)

Document interruptions: Keep a log of missed visits, late authorizations, or changes in assigned staff. Note dates, times, and effects on the person you care for.
Ask direct questions: When you speak with a case manager or agency, ask about staffing stability, expected visit frequency, backup plans, and who to call when services lapse.
Request written care plans: Get authorization, care plans, and service agreements in writing. Clear documentation helps when escalating issues.
Escalate quickly: If services drop, contact the supervisor, the county aging unit, or the long-term care ombudsman right away. Don’t assume gaps are permanent without asking for an explanation and timeline.
Use community resources: Local Area Agencies on Aging, faith-based organizations, and volunteer respite networks can provide short-term coverage while you secure longer-term solutions.

Mid- and long-term actions (advocacy and prevention)

Raise the issue with funders: Contact county officials, Medicaid managed care plans, or state agencies to report systemic care gaps. They control funding and contracting and can press providers to fix problems.
Partner with other families: Collective complaints from several affected families carry more weight than a single call.
Support workforce stability: Advocate for fair pay and proper scheduling in local forums, county board meetings, or through petitions. Stable pay reduces churn and improves continuity.
Know the legal resources: If you suspect persistent wage theft led to care failures, talk to legal aid or an employment attorney about reporting channels and possible remedies — and consider audit and legal-prep resources to understand your options.
Plan financially: Build a contingency fund or identify alternative paid services that can step in when public systems falter. Start with small steps like budgeting advice and short-term savings tips from practical guides such as quick budgeting playbooks.

Questions to ask providers and agencies

How do you track case manager hours and overtime?
What is your backup plan when a case manager leaves or is absent?
How many clients does each case manager handle on average?
Are case managers considered nonexempt under FLSA? How are overtime hours handled?
Can you provide a written timeline for scheduled visits and reassessments?

What case managers and care workers can do (if they're reading)

Case managers who suspect wage violations should take steps to protect their rights — and those steps also help families who rely on them:

Keep detailed time records: Note clock-in/out times, work done off the clock, and supervisory requests that required extra time. Consider modern evidence and logging practices described in an evidence capture playbook to preserve records.
Use technology: When possible, use employer timekeeping systems, personal time logs, or simple spreadsheets to record hours. Integrating timekeeping tools with scheduling and payroll systems is easier when you follow an integration blueprint.
Know your rights: Review FLSA basics: overtime pay, recordkeeping rules, and statute of limitations (two years; three for willful violations).
File complaints: Wage complaints can be filed with the U.S. Department of Labor Wage and Hour Division or your state labor agency. You can also learn about protected-reporting channels in modern whistleblower and reporting programs that help protect sources.
Consider collective action: Joining a union or worker association can amplify bargaining power and reduce the risk of retaliation. After rulings or legal actions, look for practical guides on supporting staff through tribunals and transitions.

Policy solutions and what to expect in 2026

Fixing the root causes requires policy action. Watch for these developments in 2026:

Increased audits and enforcement: as the DOL continues high-profile investigations, more organizations may face scrutiny for recordkeeping and overtime violations.
Funding pushes: advocates and some state legislatures are pressing for higher Medicaid reimbursement rates tied to workforce stability; any increases could ease payroll pressure on public providers.
Electronic compliance: more agencies will adopt digital timekeeping and scheduling systems — but technology must be paired with policy to prevent gaming or off-the-clock work. Reliable remote infrastructure and devices also play a role; see reviews of edge-first home hubs and home-edge routers and failover kits that support remote staff.
Stronger contracting standards: counties and states may write enforceable wage and scheduling clauses into contracts with providers to protect workers and service recipients.

When to escalate beyond the provider: who to contact

If you’ve documented lapses and provider responses are inadequate, escalate to these authorities:

County aging services or human services department — they oversee many local providers and contracts.
State long-term care ombudsman — advocates for people receiving long-term services and supports.
U.S. Department of Labor, Wage and Hour Division — to report suspected wage and hour violations.
State labor department (e.g., Wisconsin Department of Workforce Development) — for state-level enforcement and guidance.
Local legal aid and elder law attorneys — for advice about rights, compensatory claims, and emergency action. If you expect litigation or need to prepare invoices or claims, practical templates such as invoice templates can save time in documenting costs.

What families can expect after a ruling like Wisconsin’s

A court-ordered settlement or judgment can result in back pay for workers and may spur organizational changes, but it doesn’t instantly restore staffing or quality. Families should expect a period of transition:

Employers may adopt stricter scheduling and timekeeping practices to avoid repeat violations.
Some staff may return or be compensated, improving retention; others may leave, requiring temporary coverage plans.
Public agencies and counties may renegotiate contracts or push for funding changes — potential long-term fixes that take months to implement.

Bottom line: what families should do right now

If you rely on case management or community-based care, take these immediate steps to protect your loved one’s safety and service continuity:

Start a simple care continuity log today — record missed visits and service changes.
Ask your provider direct questions about staffing, backup plans, and written care agreements.
Escalate quickly to supervisors, county aging units, or the ombudsman when services lapse.
Explore community-based short-term support options while the provider corrects course.
Join or form a local family advocacy group to push for stable funding and fair pay — improving worker pay improves care.

Looking ahead: predictions for the care workforce in 2026

Expect to see more enforcement actions like the Wisconsin case, wider adoption of digital timekeeping, and renewed pressure on public payers to adjust reimbursement to reflect true costs of care coordination. For families, that means a window of uncertainty followed by gradual stabilization if policymakers and payers act. In the meantime, vigilance, documentation, and advocacy are your most effective tools.

Final takeaways

Wage violations are a care issue: when case managers aren’t paid for work they do, the people they serve are put at risk.
The Wisconsin ruling matters: it shows federal enforcement can recover wages and catalyze change — but families should be prepared during the transition.
Families can act: document, ask questions, escalate, and connect with community resources to protect care continuity.

If this story affects you or someone you care for, don’t wait. Document service gaps, contact the appropriate oversight agency, and join other families advocating for stable, fairly compensated care teams. Stable pay for case managers is not just a workers’ rights issue — it’s a public-health imperative.

Call to action

Have you experienced missed visits or care gaps because a case manager left or services were interrupted? Share your experience with your local ombudsman and sign up for updates from our newsroom to get alerts about policy changes, enforcement actions, and practical tips to protect your family’s care. Together, families can push for the stable, well-paid care workforce our loved ones deserve.

caring

Contributor

Senior editor and content strategist. Writing about technology, design, and the future of digital media. Follow along for deep dives into the industry's moving parts.