“An industry practice has been for healthcare employers to say if you come in at 11 p.m. and you want to work eight hours, we are going to designate all those hours of work to the day you clocked in or clocked out or the day you worked the majority of hours,” Gournis says. “That is not a compliant practice and it can skew whether someone is entitled to overtime or not.”
Gournis recommends that hospital human resource and compliance officers focus on the basics. “Make sure you are doing a full policy audit and review with legal counsel. That’s looking not just at handbooks, but at administrative policies and procedures—not only in HR but in payroll to make sure they, on their face, are compliant,” she says.
“The next basic thing is to engage in an education process with managers and employees. A healthcare employer can have the best policies in the world, but if those policies are not being implemented by frontline managers, then the policies are just words on paper. A lot of lawsuits we see in healthcare are because frontline managers are not enforcing hospital policies.”
MJ Hamilton, director of compensation and human resources information system at the five-hospital Franciscan Health System in Tacoma, WA, says effective compliance requires constant monitoring, educating staff and managers from their first day on the job, and fostering an open environment that encourages staff to report issues.
“The education is critical, and having that openness where they can come to you if they have an issue that needs to be resolved. And then having good policies in place so that if you have to counsel someone, you have the policies there and the employees know and understand the policies,” Hamilton says.
Grace Moffitt, vice president of human resources at four-hospital Moses Cone Health System in Greensboro, NC, says a sound wage and hour compliance structure requires teamwork from HR and compliance staff, department managers, and the employees themselves.
“With 7,500 employees across multiple hospital campuses in multiple cities, it is very important that the employees take ownership of being sure that they do clock in and out appropriately and that they notify us if they are not being paid appropriately,” she says.
At Moses Cone, employees take annual refresher courses on corporate policies, including wage and hour compliance. In addition, compliance officers, department leaders, and the administrator of the health system’s electronic time-keeping system routinely audit the process to identify problem areas, systemically and with individual employees or managers.
“We always in healthcare have been aware that wage and hour compliance is very challenging with the type of work we perform as a 24/7 operation in multiple settings,” Moffitt says.
“It’s something that has always been in the front of our minds, and even more so now with all the attention that wage-and-hour attorneys are placing on healthcare.”