Practice Management Alert

Question: I’m in charge of scheduling employees and need to figure out what’s best for the practice, but I also want to make sure I’m complying with labor laws. Are registered nurses (RNs) considered exempt? If they have to travel between different practices, is the travel considered time on the clock?

Codify Subscriber

Answer: No — RNs are not automatically exempt just because they are licensed. Under the federal Fair Labor Standards Act (FLSA), exemption and overtime obligations depend on the employee’s pay basis and primary job duties rather than job title or credentials.

Generally, according to the U.S. Department of Labor, RNs paid on an hourly basis are nonexempt — meaning they should receive overtime. Salaried RNs may be exempt from overtime pay requirements if they meet applicable salary-basis/salary-level requirements and pass the “learned professional duties” criteria.

For scheduling and overtime purposes, you can stay compliant with FLSA rules by classifying each position/role by:

• Whether the RN is paid hourly or salaried, and whether there are salary-basis requirements
• The RN’s primary job duties, like direct care versus supervising other nurses

Many staff RNs are nonexempt and must be paid overtime for hours worked beyond 40 in a workweek. If an RN role is considered exempt, you should document the rationale for that specific position and recheck it when duties change.

Regarding travel time: Distinguish commuting from work travel. Generally, workers aren’t compensated for their commutes to work, but once a nurse starts work and their principal activities, if they need to travel to a different clinic or practice location during the workday, then travel is considered time on the clock.

If your human resources (HR) department hasn’t already established policies regarding exempt/nonexempt status, it should do so! Make sure the policies include special situations, too — like same-day out-of-town assignments or mandatory training at a different site — as those scenarios can change the analysis.

To stay compliant, mandate some of these best practices:

• Require staff to record all inter-site travel time.
• Build travel into the schedule when possible.
• Use a consistent process for overtime approval.
• Keep job descriptions current.
• Train supervisors not to allow off-the-clock work, including travel-related tasks.
• Audit time records periodically for missed travel time.

Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC