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Run the Payroll Fee Auditor →Blog · Payroll Management · Healthcare
Healthcare Practices: Payroll Recordkeeping Requirements (2026)
Payroll recordkeeping for healthcare practices starts at the federal baseline, three years for payroll records and two for the time records behind them, then adds what reaches this industry: 45 CFR 164.530(b) and (j) and OSHA 29 CFR 1904 Subpart B, Appendix A. BEG: $45 per employee per month inside the payroll software you already use, live in 3 to 5 days.
Records specific to healthcare practices
HIPAA covered entities must train every workforce member on their privacy policies, train each new hire within a reasonable period after joining, document that the training was provided, and retain that documentation for 6 years from creation or the date it was last in effect.
Offices of physicians (NAICS 6211), dentists (6212), other health practitioners (6213), outpatient care centers (6214) and medical labs (6215) are on OSHA's partially exempt list and need not keep OSHA 300 injury and illness logs unless OSHA or BLS asks in writing. Hospitals (6221) and nursing care facilities are not on the list, and every employer must still report a fatality, in-patient hospitalization, amputation or loss of an eye.
The federal baseline every employer keeps
29 CFR 516 requires payroll records for three years and the records they were computed from, time cards, schedules and piece or commission records, for two years. Employment tax records stay four years after the return they support. Forms I-9 stay three years from hire or one year from separation, whichever is later. For healthcare practices the practical rule is that the pay codes for shift differentials and on-call pay produce records of their own, and an audit reads those, not the summary.
The rules behind this page, with sources
General information, not legal advice. Every rule below was read on the agency page linked next to it.
- HIPAA covered entities must train every workforce member on their privacy policies, train each new hire within a reasonable period after joining, document that the training was provided, and retain that documentation for 6 years from creation or the date it was last in effect. [45 CFR 164.530(b) and (j)]
- Offices of physicians (NAICS 6211), dentists (6212), other health practitioners (6213), outpatient care centers (6214) and medical labs (6215) are on OSHA's partially exempt list and need not keep OSHA 300 injury and illness logs unless OSHA or BLS asks in writing. Hospitals (6221) and nursing care facilities are not on the list, and every employer must still report a fatality, in-patient hospitalization, amputation or loss of an eye. [OSHA 29 CFR 1904 Subpart B, Appendix A]
Read the full guide to how to prepare for a payroll audit, and the rest of the healthcare practice payroll library.
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Frequently Asked Questions
Healthcare practice records: 45 CFR 164.530(b) and (j)
HIPAA covered entities must train every workforce member on their privacy policies, train each new hire within a reasonable period after joining, document that the training was provided, and retain that documentation for 6 years from creation or the date it was last in effect.
Healthcare practice records: OSHA 29 CFR 1904 Subpart B, Appendix A
Offices of physicians (NAICS 6211), dentists (6212), other health practitioners (6213), outpatient care centers (6214) and medical labs (6215) are on OSHA's partially exempt list and need not keep OSHA 300 injury and illness logs unless OSHA or BLS asks in writing. Hospitals (6221) and nursing care facilities are not on the list, and every employer must still report a fatality, in-patient hospitalization, amputation or loss of an eye.
How long does a healthcare practice keep payroll records?
Three years for payroll records and two for supporting time records under the FLSA, four years for employment tax records under the IRS rule, and longer where an industry rule cited above says so.
What does managed payroll cost for a healthcare practice?
$45 per employee per month, all-inclusive, inside the payroll software you already use, with no monthly minimum. Shift differentials, on-call pay and credentialing-based pay tiers are configured at setup, not billed as add-ons.
Related Resources
Anthony leads payroll solutions at Business Executive Group, a national managed payroll firm serving businesses across industries including Healthcare Practices. BEG manages payroll at $45 PEPM, all-inclusive, with deep expertise in compliance, multi-state filing, and industry-specific payroll requirements. Get instant pricing at beghr.com.
Authoritative source: U.S. Department of Labor: Wage and Hour Division
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