Employers can’t require covered healthcare employees to work overtime in excess of agreed upon, regularly scheduled, shifts. This page discusses who’s covered, and specific rights under the law.

Who’s covered under the law

Certain health care employees entitled to mandatory overtime protections include those:

• Employed by a covered healthcare facility.
• Involved in direct patient care activities or clinical services.
• Receiving an hourly wage or are covered by a collective bargaining agreement.

Where you work matters

The list of state-licensed and other facilities covered under the law includes:

• Hospitals.
• Rural health care facilities.
• Hospices.
• Psychiatric hospitals.
• Department of Corrections facilities.
• Regulated nursing homes or home health agency.

Note: Health care facilities not covered under the law are those that do not operate on a 24-hour per day, seven-day-a-week basis. Also excluded are nursing homes the Department of Social and Health Services operates, and state psychiatric hospitals.

Specific rights under the law

The law prohibits three types of mandated overtime, unless an exception applies (see below):

1. Hours worked in excess of an agreed upon, predetermined, regular shift.
2. Exceeding 12 hours worked in a 24-hour period.
3. Exceeding 80 hours worked in a consecutive 14-day period.

Exceptions:

• Specific, unforeseeable emergency. These include when a local, state, or national government declares an emergency; when a facility disaster plan is activated, or other unforeseen catastrophic event.
• When the overtime is the result of a prescheduled on-call time.
• Completing a patient care procedure already in progress, and it could be detrimental if the employee left.
• When the employer uses and documents “reasonable efforts” to obtain staffing but cannot avoid overtime.

“Reasonable efforts”

In some cases, employers may mandate overtime work when they have made “reasonable efforts” to obtain alternative staffing. The employer must complete each of the following steps before requesting overtime:

1. Seek qualified staff who are willing to volunteer for extra work;
2. Contact qualified staff who have made themselves available for extra work;
3. Seek the use of qualified per diem staff; and
4. Seek personnel from a contracted temporary staffing agency.

See the “HLS complaint form” under a separate tab to file a complaint.
For a summary of these rights, view a fact sheet about mandatory overtime for certain health care workers (F701-001-000).

Under the law, L&I receives and investigates complaints from covered medical professionals. There are two ways a complaint L&I receives complaints:

• directly regarding alleged violations of meal and rest breaks or overtime, and;
• referred from the state Department of Health through complaints filed regarding the hospital staffing plan.

Direct to L&I

File complaints online regarding meal and rest breaks and mandatory overtime. You can also download and mail a complaint form, or visit your nearest L&I office.

L&I will respond generally within seven (7) business days. The message will say we’ve started an investigation and what additional information is needed. L&I can file a Notice of Assessment for unpaid wages.

We expect to complete investigations for meal and rest breaks within about 60 business days. Investigations of overtime violations will take about 90 business days.

Before you begin filing the complaint, gather the following items:

• Personal contact information.
• Employer’s contact information.
• Supporting documents, or other relevant information, to back your complaint.

Referred complaints

L&I can also receive complaints regarding hospital staffing plans. Here’s the process to file a complaint:

1. Hospital Staffing Committee. The committee has 60 days to respond.
2. State Department of Health complaint form. The department has up to three weeks for review. It will refer to L&I cases involving labor rights.
3. L&I review. L&I has 60 days to investigate.
4. Hospital takes corrective action. If L&I finds that there has been a violation, the hospital has 45 days to develop a corrective plan. The health department and L&I oversee the hospital response and implementation of the plan.

Note: It is against the law for a business to fire or otherwise retaliate against an employee who exercises a protected right or intends to file a complaint, or who has discussed potential violations of their rights. File a complaint if you feel you have been retaliated against.

Health care facilities covered under the law must comply with staffing plans and Hospital Meal and Rest Break Quarterly Reports submitted to L&I. This page covers those requirements, along with technical support available.

Note: View a 30-minute webinar for hospital and health care representatives about the requirements.

Who’s Covered

Hospitals, including state-operated hospitals, are required to meet plan and reporting requirements.

Staffing plan compliance

Starting July 1, 2025, hospitals are required to follow staffing plans. Hospital Staffing Committees develop annual staffing plans that consider:

• Patient activity.
• Intensity level.
• Nature of care required.
• Staff experience.

After July 1, 2025, hospitals must report to DOH if they fail to meet 80 percent of the nurse staffing assignments in a month. Starting in 2026, a hospital must file a report two times a year on how well it’s following the staffing plan.

Complaints from health care workers related to the staffing plan must first go to the Hospital Staffing Committee. If unresolved, you can file a complaint with the state Department of Health. For cases involving labor rights, the health department will refer the matter to L&I.

Direct questions about staffing compliance plans to the state Department of Health.

Meal and rest break quarterly reports

Covered hospitals use the report to document their compliance regarding meal and rest breaks. These forms go to L&I. Hospitals must meet 80 percent compliance in providing meal and rest breaks.

View the reporting form
View the guidance document
View the Hospital Quarterly Self Reporting External User's Guide

Who’s included

Employees to track on the self-report form include a variety of positions – everything from ARNPs to Vascular Sonographer. Find a complete list on the last page of the “Meal and Rest Break Hospital Quarterly Self Report Guide.”

What’s tracked

Medical facilities have a variety of reporting categories to track for the report. The list includes:

• Total breaks required.
• Total breaks missed.
• Total breaks successfully taken.

Find a complete description of the categories, and the formula to determine the percent compliance rate in the “Hospital Meal and Rest Break Quarterly Report Guidance.”

Here is a list of reporting periods for 2025-26. Ongoing quarters will have the same outline of report due dates and reporting periods covered.

Failure to provide at least 80 percent

L&I will review the compliance reports. The agency can take action against employers failing to meet 80 percent of the required meal and rest breaks in a quarter.

Until June 30, 2026:

L&I will provide technical assistance for hospitals failing to meet the 80 percent standard or failing to file a report.

July 1, 2026:

• L&I imposes penalties on hospitals failing to meet the 80 percent standard. The penalties range from $5,000-$20,000, depending on the size of the hospital.
• A hospital in violation of the standard for three consecutive quarters will be subject to a double penalty amount.
• The law covers smaller and more remote medical facilities. The list includes:
  • Certified critical access hospitals.
  • Hospitals with fewer than 25 acute care licensed beds.
  • Sole community hospitals independent of a health system

July 1, 2028:

Penalties for smaller and more remote medical facilities take effect for failure to meet the reporting standard.