In November 2021, the U.S. Department of Labor (DOL) announced a new initiative focused on minimum wage and overtime pay for professional caregivers centered on what it calls "care-focused employers," including skilled nursing facilities, home health services and residential care facilities. Dubbed the "Caregiver Initiative" (the initiative) and led by the DOL's Wage and Hour Division (the division), it includes education and outreach to workers about their rights under the Fair Labor Standards Act (FLSA), relationship building between federal and state/local regulatory agencies and other partners and related enforcement by the DOL.

The Wage and Hour Division recovered over $38.7 million in back wages for health care industry workers in fiscal year 2021. Since the initiative's launch, the dvision has completed 1,600 investigations and identified violations in 80% of those inquiries. The most common violations noted by the division in a press release issued in November 2022 were failure to pay overtime or minimum wage, as well as misclassification of workers as independent contractors. Some investigations also have identified the failure to include COVID-19 premium pay in calculating the regular rate of pay for determining the proper overtime rate. The 1,600 investigations recovered more than $28.6 million in back wages and damages paid to nearly 25,000 workers.