Where I worked for major hospital in Michigan, you could only accumulate 360 hours per year. Once you hit that number, you would lose the hours. So people had to take quick time off so they wouldn’t lose their hours. But they would be back up again in a month. 21 hrs a month for vacation/sick time. When you retired, they would payout whatever you had in your PTO bank in a separate check.
Worked the same with Walmart. Come Feb 28 each year you got a check for PTO, but you could leave 80 hours in the bank.