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Posted by Sarah Ramsey

  • Sep 14, 2023

Understanding Important Healthcare Labor Laws

For most people, when discussions of law come up they don’t understand all of the nuances and complexities that it entails. This is true for every profession, but when it comes to healthcare labor laws, they can be particularly difficult to navigate. The healthcare system has a complex regulatory landscape, but ignorance won’t account for much of a defense if you find yourself on the wrong end of things in court. That’s why we’re pulling back the curtain in this post on labor laws for healthcare workers.


Below, we’ll provide an informational overview of key healthcare labor regulations in the U.S. including the Fair Labor Standards Act, Family Medical Leave Act, Affordable Care Act, OSHA standards, anti-discrimination laws, and the National Labor Relations Act. Understanding these important laws and an organization's responsibilities can help healthcare employers just like you to take proactive steps towards legal compliance, uphold workplace rights, avoid violations, and focus on delivering quality patient care. Let’s dive in!


Legal Disclaimer: This blog post is intended for general informational purposes only. It provides an overview of several key labor laws that commonly impact healthcare organizations in the United States. However, it does not constitute legal advice and should not be relied upon as such. The application of these laws can vary based on jurisdiction, individual circumstances, and current legal interpretations. For guidance on specific compliance issues and questions, healthcare organizations should consult qualified legal counsel. This post also does not create an attorney-client relationship between the reader and author.


What’s The Big Deal with Healthcare Labor Laws? Why You Should Get Schooled in the Rules and Regulations

There are several reasons your organization should be well versed in healthcare labor laws.


-- Avoid penalties and litigation: Violating labor laws can result in fines, lawsuits, back pay awards, and other penalties that impact the organization's bottom line.


-- Promote recruitment and retention: Following labor laws helps attract and retain top talent by demonstrating a commitment to fair pay and benefits. This is especially important for healthcare with high turnover.


-- Uphold workplace rights: Labor laws establish important workplace rights around things like medical leave, overtime pay, workplace safety etc. Not adhering to them denies basic rights and protections to healthcare employees.


-- Manage reputational risks: Allegations or records of labor law violations can damage an organization's public reputation and standing, which are especially important in the healthcare industry.


-- Streamline HR processes: Having compliant payroll, leave management and other HR/workforce processes reduces administrative burdens and headaches down the line.


-- Foster positive work culture: Respecting workplace rights through compliance fosters higher employee engagement, satisfaction, productivity and quality of care.


-- Align with ethical care standards: The healthcare industry emphasizes ethics and caregiver rights, so compliance indicates an organization that upholds those standards from within.


-- Focus on patient care: Staying compliant allows healthcare leaders to focus on delivering quality patient care rather than dealing with regulatory issues.


Compliance supports healthcare organizations' operations, culture, reputation and most importantly, their ability to provide excellent patient care. In the next several sections, we’ll take a closer look at the following labor laws for healthcare workers:

  • The Fair Labor Standards Act (FLSA)
  • The Affordable Care Act (ACA)
  • Occupational Safety and Health Administration (OSHA) Standards
  • Anti-Discrimination Laws in Healthcare, and
  • The National Labor Relations Act (NLRA).

The Fair Labor Standards Act (FLSA)


The Fair Labor Standards Act established minimum wage, overtime pay, recordkeeping, and child labor standards. This law applies to employees of healthcare organizations in both public and private sectors. As of 2009, that meant offering a minimum wage of $7.25/hr. However, it’s important to note that many states also have minimum wage laws that exceed that number


A workweek is to be no longer than 40 hours. In the event you keep someone over that 40 hours, you must pay them for all additional hours worked at 1.5 times their hourly wage. That said, there are some exemptions to the overtime wage laws for certain executive, administrative, and professional employees. You’ll need to speak with your lawyer to find out the rules and regulations for your unique situation.


Common FLSA compliance challenges in the healthcare industry and strategies for compliance

Compliance challenges include classification of exempt status, calculating hourly rates for salaries, and monitoring overtime across multiple sites. Strategies include worker classifications audits, overtime pre-approvals, and automating timekeeping.


The Family and Medical Leave Act (FMLA)


What is the Family and Medical Leave Act? FMLA provides job-protected, unpaid leave for medical and family reasons. Allows employees to take reasonable leave without employment consequences. Important for healthcare workforce needs.


Eligibility requirements and employee rights under the FMLA

FMLA covers private sector employers with 50+ employees. Employees are typically eligible after one year of service and 1250 hours worked. It provides 12 weeks of leave.


Employers must maintain benefits, and return rights after leave. Best practices for FMLA include:

  • Clear policies
  • Prompt eligibility notices
  • Tracking leave usage, and
  • Requesting certifications

The Affordable Care Act (ACA)


What is the affordable care act and how does it apply to healthcare workers?

The ACA enacted significant reforms impacting employer-provided healthcare benefits and coverage. It requires applicable large employers to offer affordable coverage.


Applicable large employers (50+ FTEs) must offer affordable, minimum value coverage to full-time employees working 30+ hours/week. Includes reporting obligations.


Strategies for compliance include:

  • Tracking employee hours
  • Conducting affordability tests, and
  • Staying updated on IRS reporting forms and deadlines

Using HR/payroll systems helps navigate requirements as most payroll software has these types of laws “baked in.” However, they should not be relied on solely for compliance.


Occupational Safety and Health Administration (OSHA) Standards


Occupational Safety and Health Administration (OSHA) Standards promotes safe workplaces. Crucial in healthcare due to exposure to infectious diseases, hazardous drugs, waste, and patient lifting injuries.


Key OSHA standards cover PPE, exposure controls, workplace violence protections, patient handling procedures. There are also limits for workplace exposures, and OSHA standards require injury reporting in the event injuries occur on the job and/or on the job site.


What are some strategies for maintaining a safe and compliant work environment as per OSHA standards?

Strategies include:

  • Creating and implementing written safety plans and training
  • Providing PPE
  • Developing and implementing safety committees, and
  • Corrective action tracking

It’s also a good idea to stay current on standards through OSHA communications as this helps maintain compliance.


Anti-Discrimination Laws in Healthcare

There are several federal laws that prohibit discrimination in healthcare that you must keep in mind. Federal laws that are applicable to all employers, not just healthcare workers, prohibit workplace discrimination based on protected classes such as race, gender, age, disability. Title VII, Age Discrimination in Employment Act, and the Americans with Disabilities Act are just a few of the laws you should be aware of.


It’s critical that your organization prohibit discrimination in hiring, discipline, training, benefits, and other employment actions. Employers must have clear EEO and anti-harassment policies, complaint processes, employee training, and document personnel decisions. It’s advisable for healthcare organizations just like yours to conduct audits to identify potential areas of discrimination as this helps ensure compliance.


The National Labor Relations Act (NLRA)

What is the National Labor Relations Act?

The NLRA governs relations between employers, employees, and labor unions. It regulates union organizing and collective bargaining processes, and is applicable to most private sector healthcare employers.


The NLRA protects employees' rights to organize, join unions, strike, collectively bargain. It also prohibits employers from interfering with these rights. Employers are obligated to bargain with unions in good faith, allow union access, and avoid coercion. It is in the best interest of all healthcare organizations to train supervisors on NLRA rights and prohibited practices, and to ensure consistent application of policies during union activity (if it should occur).


Is Your Healthcare Organization in Compliance with Healthcare Labor Laws?

Understanding key labor laws is crucial for healthcare organizations to ensure compliance and fair treatment of employees. Adhering to regulations promotes productive work environments, protects employees, and avoids penalties.


If you’re not doing so already, your healthcare organization should stay informed on evolving regulations, review policies/practices for alignment, and seek legal expertise to navigate compliance requirements. Knowledge of labor laws enables proactive management of obligations, and helps to keep your healthcare workers happier on the job ultimately improving workplace morale and reducing turnover.



Healthcare labor laws

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