Healthcare Practices: State Payroll Compliance Issues (2026)

Where state law touches healthcare practices specifically

Registered nurses licensed by the state examining board generally meet the learned professional duties test and may be treated as exempt only if paid on a salary basis of at least $684 per week; hourly-paid RNs must receive overtime. Licensed practical nurses generally do not qualify as exempt regardless of experience and are entitled to overtime pay.

Physicians, dentists, podiatrists, optometrists and other employees holding a valid license to practice medicine, and residents or interns who hold the required degree, are exempt professionals without regard to the salary level or salary basis tests.

Hospitals and residential care establishments may compute overtime over a fixed 14 consecutive day work period instead of the 40 hour workweek, paying time and one half for hours over 8 in a day and over 80 in the period. The employer must have a prior agreement or understanding with the affected employees before the work is performed, and cannot use both systems for the same employee.

The state layer every employer carries

Each state where an employee of a healthcare practice works can set its own minimum wage, its own overtime trigger, a pay-frequency law, a new hire reporting deadline shorter than the federal 20 days, a final paycheck deadline, and a continuation coverage rule below the federal COBRA threshold. The state pages on this site carry those facts state by state from one data file, so the numbers here and on the multi-state checker never disagree.