A large segment of the health care industry provides care to patients who need it 24 hours per day, seven days per week. Because quality of care is important, the health care industry is highly dependent on shift workers to provide needed care. Quite often, shift workers work 12 hours at a time, at least three days per week.

Based on the Fair Labor Standards Act (FLSA), employers must pay all workers for every hour worked, and all non-exempt employees are required to be paid a salary of at least $7.25 per hour, or whatever the minimum wage rate is in their state or municipality. They are also entitled to compensation for overtime that is equal to one-and-a-half times their “regular rate” for all hours worked over 40 in a given work week. The overtime laws also generally apply to workers who work more than eight hours in a single workday, although some states allow workers to work up to 12 hours per day, and there are some provisions that allow for Alternative Work Schedules, which allow workers to work longer shifts of up to 12 hours in a day without overtime being applicable. The minimum wage is also applicable to salaried workers. If a salaried worker is expected to work 40 hours in a standard work week, his or her salary must be 40 times the minimum wage rate in the state or municipality in which the business is located.

There are some health care employees who meet the “Learned Professional Exemption,” like registered nurses or doctors, and those professionals are often paid a salary and the length of their work week will usually be spelled out in a contract. Under the FLSA, the only applicable rule is that they receive a salary of at least $455 per week. However, everyone else who does not fit into a specific category of exemption is considered non-exempt, and FLSA wage and hour regulations do apply.

There is considerable question as to what “every hour worked” means. The Supreme Court recently heard arguments on a case, Staffing Solutions, Inc. v. Busk , in which workers for Amazon who were required to stand in long security lines for as much as half an hour to enter the workplace argued that they should be paid for the time they spend in that activity. The U.S. Supreme Court disagreed, reasoning that the activity in question – standing in a security line – was not “integral and indispensable” to the Amazon employees’ work, meaning that it was not absolutely essential to the workers’ principal activities, and thus not compensable.

Wages are not always the only compensation to be considered when figuring the “regular rate” to use as a basis for overtime pay. In some cases, health care shift workers are also paid certain types of mandatory bonuses and “shift differentials,” and those should also be figured into an employee’s “regular rate” when calculating overtime. Too often, these regular payments are not factored in, and they should be. A proper rule of thumb would be, if they would normally be paid that money, they should be paid one-and-a-half times that amount for every hour they work over 40 in a week.

The protections given workers by the FLSA are applicable to all employees, including temporary or contract workers. In the latter case, health care employers should also be aware that they will be considered a “joint employer” for FLSA purposes, so if the temporary worker is not paid the legal rate, the health care employer will be considered just as responsible as the staffing company that originally hired the worker.

While health care employers who operate every hour of every day with the use of shift workers face different challenges than companies that operate traditional business hours, they still have a responsibility and an obligation to follow the law and treat their employees fairly.

References:

Shift Worker Rules Warrant Special Attention

U.S. Department of Labor Fact Sheet – The Health Care Industry and Calculating Overtime Pay

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