Labor Laws: Do They Apply To Hospital Work?

Labor laws are an essential aspect of workplace protection, and their application in hospitals is particularly crucial given the nature of the work. Hospitals, as institutions engaged in caring for the vulnerable, are subject to specific labor regulations that safeguard both patients and employees. The Fair Labor Standards Act (FLSA) is a key piece of legislation in this context, setting standards for minimum wage, overtime pay, record-keeping, and youth employment. Additionally, hospitals must navigate compliance with laws like the Family Medical Leave Act, the Affordable Care Act, and the Occupational Safety and Health Act, which ensure safe and equitable working conditions for healthcare workers. Understanding and adhering to these laws are vital to avoid penalties, promote employee retention, and foster a positive work culture in hospitals.

The Fair Labor Standards Act (FLSA)

The FLSA also sets out requirements for overtime pay. Nonexempt employees must receive overtime pay for hours worked over 40 per workweek (defined as any fixed and regularly recurring period of 168 hours, or seven consecutive 24-hour periods) at a rate of not less than one and a half times their regular rate of pay. There is no limit on the number of hours employees aged 16 or older can work in any workweek. Additionally, the FLSA does not require overtime pay for work on weekends, holidays, or regular days of rest unless overtime is worked on those days.

The FLSA also includes provisions on hours worked, which include all the time during which an employee is required to be on the employer's premises, on duty, or at a prescribed workplace. Employers must keep records of employee time and pay and display an official poster outlining the requirements of the FLSA.

The FLSA also includes protections for minors, with provisions designed to protect their educational opportunities and prohibit their employment in jobs or under conditions detrimental to their health or well-being. Federal child labor law generally prohibits the employment of minors under the age of 14, restricts the hours of work for minors under 16, and prohibits the employment of minors under 18 in hazardous occupations.

Overtime and regular rate

Overtime pay and regular rates of pay are a complex issue for healthcare employers, who are at particular risk of violating the Fair Labor Standards Act (FLSA). The FLSA requires that non-exempt employees receive time-and-a-half their regular rate of pay for all hours worked over 40 in a workweek. The regular rate includes an employee's hourly rate plus the value of other types of compensation, such as bonuses and shift differentials.

In the healthcare industry, there are two systems for calculating overtime: the standard 40-hour workweek system and the Eight and Eighty (8 and 80) Overtime System. Under the 8 and 80 system, hospitals and residential care establishments may use a fixed work period of 14 consecutive days instead of the standard 40-hour workweek for the purpose of computing overtime. This system allows employers to pay time-and-a-half the regular rate for all hours worked over eight in any workday and 80 hours in the 14-day period. An employer can use both systems for different employees in the same workplace but cannot use both for a single individual employee.

Calculating overtime pay can be tricky, especially when various laws and protocols are considered. For example, some states, like California, have unique rules for overtime pay. In California, employees are paid for anything over 40 hours per week, but they are also paid for working more than eight hours in a workday and for the first eight hours of work on the seventh consecutive workday in a single workweek.

To ensure compliance with the FLSA, healthcare employers should review their wage payment policies and practices and ensure that managers understand and consistently apply these policies. Accurate record-keeping and time tracking are crucial to avoiding violations.

Failure to comply with the FLSA can result in significant financial liability for healthcare employers. Employees can file wage claims, lawsuits to recover lost wages, and claims for waiting-time penalties. Additionally, the Secretary of Labor can bring suit for back wages and liquidated damages.

Child labor laws

For non-agricultural jobs, children under 14 may not be employed. Children between 14 and 16 may be employed in allowed occupations during limited hours, and children between 16 and 17 may be employed for unlimited hours in non-hazardous occupations. There are exceptions to these rules, such as for employment by parents, newspaper delivery, and child actors. The regulations for agricultural employment are generally less strict.

Each state has its own minimum requirements for youth employment, including the earliest age a child may begin working, the number of hours they are allowed to work during the day, and the total number of hours allowed in a week. The United States Department of Labor lists the minimum requirements for agricultural work in each state. Where state law differs from federal law on child labor, the law with the more rigorous standard applies.

Hospitals and other institutions primarily engaged in the care of the sick, the aged, or the mentally ill are considered covered employers under Section 3(s)(1)(B) of the FLSA and must comply with the minimum wage, overtime, and child labor requirements of the Act.

The federal child labor provisions include specific rules for 14- and 15-year-olds, such as restrictions on the number of hours and times of day they can work, as well as the types of jobs they may perform. For example, they may perform office work, sales work, food service jobs, and certain cooking tasks, but they are prohibited from performing any baking activities or operating most power-driven machinery.

Violations of child labor laws have been on the rise in recent years, and there have been attempts by state lawmakers to weaken the standards that protect children in the workplace. Industry groups have been pushing for changes to state child labor laws, and in 2023, several states introduced or passed laws that weakened protections for young workers.

The Occupational Safety and Health Act

The OSH Act is designed to protect workers from hazards that may affect their safety and health, such as exposure to toxic chemicals, damaging noise, thermal stressors, and unsanitary conditions. It requires employers to provide a safe working environment for their employees and to take steps to correct any hazards. For example, employers must first try to fix problems by changing working conditions rather than simply providing personal protective equipment.

OSHA has the authority to create industry-specific guidelines and enforce its regulations by conducting inspections of workplaces and work sites. Violators face penalties and fines, which are adjusted annually for inflation. In 2024, infractions can incur penalties ranging from $1,190 to $16,131 per violation, with the most extreme cases resulting in a maximum fine of $161,323 per violation.

The OSH Act also established the National Institute for Occupational Safety and Health (NIOSH), which conducts research and recommends solutions for the prevention of work-related illnesses and injuries.

The Family and Medical Leave Act (FMLA)

The FMLA applies to all public agencies, public and private elementary and secondary schools, and companies with 50 or more employees. Eligible employees are entitled to 12 workweeks of leave in a 12-month period for specific reasons, including the birth or adoption of a child, caring for a family member with a serious health condition, or addressing their own serious health condition. Employees must meet certain criteria to be eligible for FMLA leave, including a minimum length of service and a specified number of work hours.

The FMLA also includes military family leave provisions, offering protections tailored to the unique needs of military families. These provisions were added to the FMLA in 2008. The US Department of Labor administers the FMLA, while the Office of Personnel Management handles FMLA for most federal employees.

The FMLA is just one of several labour laws in place to protect healthcare workers in the US. Others include the Fair Labor Standards Act (FLSA), which establishes minimum wage, overtime pay, record-keeping, and youth employment standards, and the Occupational Safety and Health Act, which ensures safe and healthy working conditions and led to the creation of the Occupational Safety and Health Administration (OSHA).

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