Healthcare Facility Employee Overtime Law

The purpose of this law is to limit when healthcare facilities may require employees to work beyond their predetermined regularly scheduled shift. Additionally, it provides employees who work more than 12 consecutive hours to be given the option to have at least eight consecutive hours of uninterrupted time off.

New health care labor standards requirements go into effect July 1, 2024. Find out more at

Healthcare facility is defined in RCW 49.28.130.

Covered employees included are:

  • Licensed Practical Nurses (LPNs).
  • Registered Nurses (RNs).
  • Surgical Technologist.
  • Diagnostic Radiologic Technologist.
  • Cardiovascular Invasive Specialist.
  • Respiratory Care Practitioner.
  • Certified Nursing Assistants.

These employees must be employed by a healthcare facility and involved in direct patient care. They must also be paid an hourly wage or covered by a Collective Bargaining Agreement.

There are four exceptions under this law when an employer may be permitted to mandate overtime.

  1. Unforeseeable Emergent Circumstance
    • any unforeseen declared national, state, or municipal emergency;
    • when a health care facility disaster plan is activated; or
    • any unforeseen disaster or other catastrophic event which substantially affects or increases the need for health care services.
  2. Patient in Progress
    • when an employee is required to work overtime to complete a patient care procedure already in progress where the absence of the employee could have an adverse effect on the patient.
  3. Prescheduled on-call time
    • may not be used in lieu of scheduling employees to work regularly scheduled shift when a staffing plan indicates the need for a scheduled shift;
    • may not be used to address regular changes in patient census or acuity
    • may not be used to address expected increases in the number of employees not reporting for predetermined scheduled shifts.
  4. Reasonable Efforts
    Employers who are chronically short staffed cannot use the “reasonable effort” exception. To use this exception, the employer must document that they have done all of the following:
    • sought individuals to volunteer to work extra time from all available qualified staff who are working;
    • contacted qualified employees who have made themselves available to work extra time;
    • sought the use of per diem staff; and
    • sought personnel from a contracted temporary agency when such staffing is permitted by law or an applicable collective bargaining agreement and when the employer regularly uses a contracted temporary agency.

Chronic Staff Shortages

Being chronically short staffed is defined in two ways: (1) long-standing or (2) frequently recurring.

Long-standing vacancy: results from a position that is open and not filled by the facility within a reasonable period of time.

Frequently recurring vacancies: blanks that result from staff vacations, medical leaves, leaves of absence and other absences that should be readily anticipated by the facility.

The table below illustrates whether the following staffing situations could meet the “reasonable efforts exception:

Staffing Situation Can the facility use the reasonable efforts exception?
Unfilled positions resulting in holes in the schedule No
Anticipated gaps in the schedule due to planned vacation, medical leave or leave of absence No
Frequently recurring increases in census such that the scheduled complement of nurses is inadequate No
Unanticipated increases in census that demands additional staffing Yes
Same-day sick call or other unanticipated absence Yes

Defining chronic staff shortages is determined on a case-by-case basis.

Meal and rest periods for certain healthcare employees

These requirements are enforced under RCW 49.12.480:

  • Rest periods must be scheduled and uninterrupted unless there is an unforeseeable emergent circumstance or a situation that could lead to an adverse effect on a patient.
  • Interrupted rest breaks must include an additional 10 minutes of uninterrupted time and be given as early as possible.
  • Employer must record all missed meal or rest periods and keep these records on file.