BRINGING LEAVE BACK IN-HOUSE: SCRIPPS PERSONALIZES LEAVE MANAGEMENT WITH PRESAGIA

Healthcare worker who works at Scripps

Scripps Health is a San Diego-based health care system committed to providing consistent, quality care to patients across its 40+ facilities. To do so, Scripps remains dedicated to treating not only its patients, but also its employees, like family. A happy and healthy workforce is the best way to keep everything running smoothly.

In its efforts to treat its employees like valued customers, however, Scripps faces some unique challenges. For a workforce of around 14,000 employees working in many locations, consistency and efficiency in employee care are important, and can be a challenge. Moreover, many healthcare positions, such as those of nurses and doctors, must be filled 24/7, and the work can be physically demanding and stressful, contributing to a large number of leave requests.

Over the years, Scripps has risen to these challenges admirably, leading to its landing on Fortune Magazine’s list of America’s 100 Best Companies to Work For for the seventh year in a row. Scripps also recently ranked among the nation’s best hospitals in U.S. News & World Report’s annual “America’s Best Hospitals” issue. This ongoing commitment to quality has led them to keep growing and changing as a company. One of those changes came several years ago, with the decision to revamp their leave management system for increased efficiency, employee satisfaction, and cost savings.

With roughly 3.5% of employees on leave at any given time, Scripps felt that bringing leave
management back in-house was the only way to ensure its employees received a consistently high standard of treatment. To make that change, Scripps needed a software solution to support the volume of leave cases generated by the workforce on a daily basis. The search for a new solution led Scripps’ team to Presagia, which has remained their trusted system for the five years since.

In-House Solutions

Today, Scripps’ leave management team consists of 3 case managers and their supervisor, Bree Lopez, handling around 2,000 open, active leave cases at any given time. On top of the federal FMLA and military leaves, California has more of its own leave laws than any other state, including CFRA (California Family Rights Act), PDL (Pregnancy Disability Leave) and many others. Thus, for a large 24/7 workforce on a multitude of different schedules, managing leave is both complicated and essential in order to maintain a high quality of work at all times.

“We use Presagia everyday to manage federal and state leave, as well as our own health system leave policies,” explains Lopez.

With the switch to in-house leave management and Presagia, Lopez said their concerns about providing support to employees are gone. “It’s better customer service,” she explained, “because now we can provide employees the information they need. For instance, we know our pay practices whereas our outsourced vendor did not.”

A nurse who works at Scripps

Presagia’s ability to account for Scripps’ unique needs has also been a key part of the success of bringing leave in-house. From the initial implementation through to the present day, Presagia and Scripps’ teams have worked closely together to ensure the system is optimized for Scripps’ needs. All of the health system’s own leave policies were configured into the system so that they are managed alongside the FMLA and California’s many state-specific policies, which come built into the system and are kept up to date by Presagia. As well, Presagia integrated with Scripps’ existing HR software to automatically receive the employee data needed for leave management, like employment profile, date of hire and hours worked. Going a step farther, Presagia transmits important leave data such as leave status and return to work dates back into Scripps’ payroll system in an Advice-to-Pay report.

Looking beyond the initial implementation, Lopez notes that, “the system’s ease of navigation, and ability to automatically run the eligibility and entitlement calculations, and generate documentation,” are some of the features that she considers most valuable in a leave management software solution.

Presagia’s absence management solutions are cloud-based and easy to use. The system calculates entitlement and eligibility, evaluating every leave request against a continuously updated list of the nation’s 450+ federal and state leave laws. It provides workflow automation and decision support based on legal best practices developed and maintained in consultation with Jackson Lewis P.C., leaders in national employment law. Thus, Lopez and her team don’t worry about inaccuracies or compliance risks. Moreover, Presagia automates many of the time-consuming tasks associated with leave management, such as generating correspondence and ensuring it is sent out on time.

“The ability to generate letters is awesome and huge time-saver,” said Lopez. The system creates tasks to tell users when to send leave correspondence according to the legislation and automatically generates the correspondence, filling in cover letters and forms that adhere to legal best practices.

Moreover, and especially useful to Scripps, Presagia automates many of the tasks related to intermittent leave tracking. The system keeps track of the duration, frequency, usage and reason for each approved intermittent leave case. It then automatically creates alerts when an employee is approaching entitlement exhaustion or when there is potential intermittent leave abuse, for instance if an employee always takes leave on the same day of the week.

A Small, Efficient Team

“The simplicity is what I like most about the system,” states Lopez. Streamlining the many administrative tasks required for leave management both ensured compliance and brought great savings in time and workload. Scripps leave team is much smaller and more efficient because they have Presagia’s system.


“In the old days when we managed leave manually, we needed 7 employees plus a supervisor, and we had less employees back then,” Lopez remembered. “Now we have 3 employees plus a supervisor managing more leave and we have fewer complaints.”


In fact, Lopez recently had a unique opportunity to compare her team’s leave management practices, automated by Presagia, with manual leave management. Scripps grows fast, constantly evolving to remain at the cutting edge of healthcare and technology, and through a recent acquisition brought a large group of new employees onboard that Lopez and her team had to briefly manage manually.

“Manual leave management is a nightmare,” said Lopez. “The new group didn’t have that many leaves but it takes more time for one of them than it does for 6 or 10 of our other employees who we manage with Presagia. It can take me 45 minutes to write a letter manually, whereas with Presagia this step only takes about a minute. We also save a lot of time on the initial intake of the leave, which definitely lets me appreciate the automated system.”

Having confidence that employees are getting the amount of leave they are entitled to, and not exceeding leave or cheating, is also very important. Scripps is much more comfortable using the secure, automated system compared with the error-prone manual method. “With Presagia, you can easily navigate and see people’s leave history,” said Lopez. This feature enables the leave management team to easily verify employee behavior for themselves.

As well, Lopez uses the reporting functions to keep her team on track. “Everyday I have the team come in and talk about where they’re at with their worklists. We look at deadlines and return to work schedules, and I can just run a report to see where the team is at with their work,” Lopez explained. Seeing orderly lists of tasks “helps people focus,” Lopez reported. “I like that a lot. Without the reminders and with thousands of cases on the go, you would get lost and miss deadlines.”

Absence Well Managed 

Throughout five years working with Presagia, Scripps’ leave management strategy has evolved continuously to ensure it is up to date. Scripps’ leave management team is confident its employees are treated well, and that no one is exceeding their leave entitlement.

According to Lopez, success is about setting the right goals and moving from a reactive to a proactive approach. “We’ve gotten out of the mindset of simply reducing the number of days that people are out and have moved to asking if there is something we could have done to get that person back sooner.” She emphasized the importance of communication in the leave and accommodation process; communicating with the supervisor and the employee, and opening up a constructive discussion about the employee’s case.

Whereas before it could be difficult to ensure standardization across locations, and to make sure all employees were educated about leave consistently, now it is much easier, and leaves are being reduced and being managed better due to employees receiving consistent information, and managers being correctly educated about how to talk to employees who are out on leave or requesting leave.


We’ve seen a huge improvement,” said Lopez. “We are now getting people back to work earlier than their original leave requests. We can also focus on properly managing intermittent leave, saving money and improving overall employee morale by ensuring employees only take what they are supposed to, reducing lost workdays and the need for other employees to cover for their absent colleagues.”