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Overtime Pay for Healthcare Workers

Overtime Pay for RNs, LPNs/LVNs, Dental Assistants, Sleep Techs, PAs, NPs and similar Medical / Healthcare Workers

Under federal overtime labor laws, all non-exempt employees are required to receive time and one-half the regular rate of pay after 40 hours of work in a 7-day workweek. However, some healthcare workers employed by hospitals, nursing homes, or certain other residential facilities may use the “8 and 80” system to determine overtime pay allotment.

overtime pay for healthcare workers

Which Healthcare Workers are Exempt from Overtime Pay Rules?

It can be challenging to differentiate which healthcare works are exempt from the overtime pay rules and which ones are not. If your job is considered to be exempt, you are not required to receive overtime pay. Non-exempt workers, on the other hand, must be paid overtime wages.

For your career to be considered exempt from abiding by overtime pay guidelines, it would need to meet every requirement of a specific exemption. Merely paying an employee on a per visit or salary basis does not exempt them from overtime pay. Although pay is a factor, it is not the only requirement that must be met.

Are Registered Nurses (RNs) Exempt from Overtime Pay Regulations?

Depending on the job duties and method of pay, registered nurses (RNs) may be either exempt or non-exempt from overtime pay rules. An RN may qualify for overtime pay executive exemption if they:

  • Be paid on a salary basis
  • Supervise at least two employees
  • Have the ability to both hire and terminate employees

If an RN is performing professional nursing duties and is paid on either a salary or fee basis, they may meet the requirements for the professional exemption. RNs paid on an hourly basis, however, will almost always be considered non-exempt and thus entitled to overtime pay.

Are Licensed Practical Nurses (LPNs) and Licensed Vocational Nurses (LVNs) Overtime Exempt?

Licensed practical nurses, licensed vocational nurses, and other comparable medical workers normally do not qualify as exempt learned professionals. Regardless of work experience and training, having a specialized advanced academic degree is not a standard prerequisite for entry into such occupations.

In other words, although individuals must be highly trained and experienced to work in these professions, they do not meet the formal educational requirements for the professional exemption. While it is possible for these workers to fall under another exemption, they are usually entitled to overtime pay even if they are paid on a per-visit or salary basis.

Are Nurse Practitioners (NPs) Overtime Exempt from Overtime Pay?

Courts have repeatedly held that nurse practitioners are not exempt medical professionals and are entitled to overtime pay. This is particularly true in cases where they are paid on an hourly basis instead of on a salary basis. According to an opinion letter by the United States Department of Labor, nurse practitioners do not “practice medicine” as described by the Fair Labor Standards Act.

Are Utilization Management Nurses and Utilization Review Nurses Exempt from Overtime?

In most cases, utilization review nurses are required to be paid overtime even if they are paid on a salary basis. Utilization management nurses and utilization review nurses (also known as medical management nurses, nurse reviewers, care management nurses, and other similar job titles) who work for insurance companies or service providers to insurance companies are often misclassified as exempt from the overtime pay laws and paid a set salary with no overtime premium. Multiple courts have found nurse reviewers to be non-exempt and entitled to overtime pay. The classification of utilization review nurses as non-exempt does not center solely on their licensing and qualifications but rather on the standardized and structured nature of production work they perform.

Even in cases where a registered nurse license is required, the exemption requirements may not be met. If the duties performed by a utilization nurse primarily involve reviewing authorization requests and applying predetermined criteria to determine if the requested benefit, procedure, treatment, or equipment should be covered by insurance, neither the exemption requirement for the regular exercise of independent judgment and discretion or administrative business operation are met.

Are Dental Hygienists Exempt from Overtime Pay Regulations?

Dental hygienists are most often entitled to overtime pay. However, if they have successfully completed four academic years of pre-professional and professional study at an accredited college or university approved by the Commission on Accreditation of Dental and Dental Auxiliary Educational Programs of the American Dental Association, they may be exempt.

Are Sleep Techs and Medical Technologists Overtime Exempt?

Unless they have successfully completed three academic years of pre-professional study at an accredited college or university and a fourth year of professional course work at a school of medical technology approved by the Council of Medical Education of the American Medical Association, sleep techs, lab technicians, and certified medical technologists usually do not meet the duty requirements for the learned professional exemption.

Are Physical Therapy or Occupational Therapy Assistants Overtime Exempt?

Therapy assistants typically do not meet the educational requirements necessary for the professional exemption. Therefore, physical therapy assistants and certified occupational therapy assistants are normally entitled to receiving overtime pay.

Are Physician Assistants (PA) Overtime Exempt?

Physician assistants who have successfully completed four academic years of pre-professional and professional study (including graduation from a physician assistant program accredited by the Accreditation Review Commission on Education for the Physician Assistant) and who are certified by the National Commission on Certification of Physician Assistants generally meet the duty requirements for the learned professional exemption and are not required to be compensated overtime.

Common Overtime Pay Violations in the Healthcare Field

Overtime pay violations usually occur in instances where healthcare employers:

  • Pay a salary to non-exempt employees but do not pay overtime, misclassifying them as exempt employees.
  • Neglect to pay overtime after eight hours of work in a day for workers who are under the “8 and 80” system.
  • Pay overtime after 80 hours worked during a biweekly period rather than after 40 hours in a workweek to employees who do not fall under the “8 and 80” system.
  • Fail to combine hours worked in multiple departments or locations when determining the total overtime hours worked.
  • Neglect to include the time spent or hours worked during meal breaks, while attending staff meetings, completing training sessions, or performing on-call assignments.
  • Automatically subtract time from employees’ time for meal breaks even when they worked during those breaks.
  • Modify time records or pressure workers to work off the clock and not record overtime.
  • Fail to incorporate shift differential, bonuses, or on-call fees when calculating an employee’s regular rate.

Hospitals and other healthcare facilities may elect to use the Eight and Eighty Overtime system for disbursing overtime. Under this system, an employee must be paid time and a half pay for any hours worked over 8 in a workday and 80 in 14 days.

Recent Healthcare Worker Overtime Case

Over 250 healthcare workers recovered overtime wages in a case where a large employer in the long-term care and rehabilitation field violated the Fair Labor Standards Act. The company failed to include earned sign-on bonuses, retention bonuses, and bonuses for working extra shifts in the calculation of employees’ overtime pay. By not including bonuses in the overtime calculation, workers were paid overtime at rates lower than what is required by federal law.

Recent Healthcare Worker Overtime Case

Healthcare workers should not rely on their supervisor or human resources representative for critical information regarding the laws on overtime pay and how they apply to their specific job.

Due to the strict time limits imposed by the federal overtime pay laws, procrastination can be costly.If you have any doubts considering your entitlement to overtime pay, contact the experts at Lore Law Firm for a free and confidential review of your case. Call 1-866-559-0400 or submit your information using our convenient contact form to schedule your review today ­– because time is money.