If toileting were a billable service …

If toileting were a billable service …

The other day over lunch a colleague said to me, “Imagine how things would change if toileting were a billable service.” I laughed, briefly considered that fanciful notion and continued eating my meal.

As I gave the idea further reflection, however, it might not be as laughable as it first appears.

Consider the following:


Remuneration for toileting would mean that aides would hold income-generating positions. We’d expect that nursing departments would become fully staffed in order to take advantage of this new funding stream and that compensation for aides would increase.


We might also anticipate that CNAs would become more highly valued for their services by others in the facility.

Philosophical shift

Direct payment for the tasks of aides would strengthen incentives for employers to support ways for employees to manage their jobs around their lives, which often entail demanding family caregiving responsibilities.

Retention programs/employee benefits

The funds could be used to develop retention efforts such as flexible schedules, onsite daycare, financial contributions to staff education and other employee benefits.


Increased remuneration for personal care would lead to more resources for training and for creating programs that promote the development of CNAs, such as peer mentorships.

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If toileting were a billable service …


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