Diving Into Exempt vs. Non-Exempt Status in the Healthcare Industry in California (2025)
Let’s dive into exempt vs. non-exempt status in the healthcare industry in California (2025). This sector has some unique rules, especially in CA, and roles can be either depending on duties, pay, and schedule.
🏥 Healthcare Roles: Exempt vs. Non-Exempt in 2025
🔹 Non-Exempt (Most Common)
These roles are generally non-exempt, meaning:
- Entitled to overtime, meal/rest breaks, and wage/hour protections
Common Non-Exempt Roles:
- RNs (unless advanced duties + salary threshold met)
- CNAs, LVNs
- Medical Assistants
- Receptionists
- Phlebotomists
- Lab techs (if duties are routine)
- Schedulers and billing staff
🧠 Even if salaried, these roles must be non-exempt if they don’t meet exemption tests or salary threshold.
🔹 Exempt Roles
These roles may qualify as exempt — but only if they meet the salary AND duties test:
Common Exempt Roles:
- Doctors and surgeons (automatically exempt, no salary minimum required)
- Physician Assistants (if salary & duties align)
- Advanced Practice Nurses (e.g., Nurse Practitioners with clinical autonomy)
- Healthcare Executives (e.g., Clinical Directors, Hospital Admins)
- HR, finance, compliance, and admin managers at healthcare orgs
📝 RNs can sometimes be exempt only if:
- They perform advanced clinical judgment or supervision
- Are paid at least $66,560/year (2025 threshold)
- Duties meet the “learned professional” exemption
💼 Unique California Healthcare Rules
🕒 Alternative Workweek Schedules (AWS)
Some healthcare employers use alternative workweeks, like:
- 4 days × 10 hours
- 3 days × 12 hours
If legally adopted, these schedules allow extended shifts without triggering daily overtime, but:
- Workers must vote to approve it
- Extra hours beyond the AWS still require overtime
🛑 Common Misclassification Traps
- Calling RNs or medical assistants “exempt” just because they’re salaried
- Giving “lead” or “supervisor” titles without actual management authority
- Misusing alternative schedules without proper approval
🧾 Tip: Run the 3-Part Test (2025)
To be exempt in healthcare (except MDs), the employee must:
- Earn $66,560+/year (CA salary threshold)
- Be salaried
- Perform exempt duties (independent judgment, supervision, licensed work)
If any part fails, they’re non-exempt.
