Healthcare 8 and 80 Overtime Calculator: Hospitals and Nursing Homes

Qualifying hospitals and residential care establishments may use a special 14-day overtime system. The arrangement requires an advance agreement and overtime after eight hours in a day or 80 hours in the work period.

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Healthcare 8 and 80 Overtime Calculator: Hospitals and Nursing Homes

Quick answer: Under a valid 8-and-80 plan, overtime is due for hours over eight in a day and for hours over 80 in the 14-day work period, with calculations structured to avoid double counting the same hours.

Who can use the 8-and-80 system

The federal option applies to hospitals and establishments primarily engaged in the care of the sick, aged, or mentally ill or disabled people who reside on the premises. It is not a general alternative available to every healthcare office or employer.

The employer and employee must have an agreement or understanding before the work is performed.

Daily overtime component

Hours worked over eight in any workday are overtime under the plan, even when total hours remain below 80. A 12-hour shift therefore generally contains four overtime hours.

Fourteen-day component

The employer totals the hours in the fixed 14-day work period. Hours over 80 can create additional overtime after accounting for daily overtime already identified.

Payroll should not simply pay daily overtime and ignore the 80-hour test.

Example

A nursing-home employee works seven 12-hour shifts during a 14-day period, totaling 84 hours.

The exact allocation should be calculated from daily time records and the established work period.

Regular rate in healthcare

Shift differentials, nondiscretionary bonuses, and multiple job rates often increase the regular rate. A nurse working part of the period as a charge nurse and part at a lower rate may require a weighted average.

Paid vacation, holiday, and sick time generally do not count as hours worked for the federal overtime threshold, although policies and state law may be more generous.

Common violations

Frequently Asked Questions

What is the 8-and-80 overtime rule?

It is a federal option for qualifying healthcare establishments using a 14-day work period with overtime after eight daily hours or 80 period hours.

Can every medical office use it?

No. The employer must be a qualifying hospital or residential care establishment.

Is an agreement required?

Yes, an agreement or understanding must be reached before the work is performed.

Do shift differentials affect the rate?

They generally do when they are compensation for work performed.

Can the employer ignore daily overtime if hours stay under 80?

No. Hours over eight in a day are independently overtime under a valid plan.

Official Sources

This article is for general educational purposes and is not legal, tax, accounting, or payroll advice. Federal, state, local, contractual, and industry-specific rules may produce a different result.

Reviewed for accuracy by the OvertimePayUSA editorial team using official labor sources such as the U.S. Department of Labor and state agencies.
Official Sources

This calculator is for educational purposes only. Consult your employer or a labor attorney for advice specific to your situation.

Frequently Asked Questions

Can my employer require me to work overtime?
Yes. Employers can require overtime work. However, they must pay the required overtime premium (1.5x or higher per state law) for hours over the threshold. Refusing to work overtime may result in termination, but employers cannot refuse to pay overtime premiums that are legally owed.
What should I do if I think I'm owed unpaid overtime?
Document everything: save pay stubs, time records, emails, and any communications about hours worked. Calculate what you believe is owed. Contact your employer in writing first. If they don't respond satisfactorily, file a complaint with your state Department of Labor or the U.S. Department of Labor Wage and Hour Division. Consider consulting an employment attorney for large amounts.
Is my salaried position automatically exempt from overtime?
No. Many salaried positions still qualify for overtime pay. Exemption requires: (1) earning above the minimum threshold (~$35,500 federally, varies by state), and (2) spending more than 50% of time in exempt duties (executive, professional, administrative). If unsure, file a wage claim or consult an employment attorney.
Can I get overtime pay if I work multiple jobs?
Federal overtime laws (FLSA) typically count only hours for a single employer. However, some states have more generous rules. Hours worked for different employers at the same time usually don't combine for overtime purposes unless you're an independent contractor. Check your state's Department of Labor for specific rules.
What's the statute of limitations for claiming unpaid overtime?
Federally, you have 2-3 years to file a lawsuit for unpaid wages (3 years for willful violations). State laws vary: California allows 3-4 years, New York allows 6 years. For administrative complaints, the timeframe is often shorter (1-2 years). Act quickly if you believe you're owed wages.
Do I have to be paid for meal breaks?
If you work during a meal break or cannot take a true break away from your workstation, that time must be paid. If you take an actual, uninterrupted break (usually 20+ minutes), it can be unpaid. Rules vary by state—check your state's Department of Labor for specifics.
What is the 8-and-80 overtime rule?
It is a federal option for qualifying healthcare establishments using a 14-day work period with overtime after eight daily hours or 80 period hours.
Can every medical office use it?
No. The employer must be a qualifying hospital or residential care establishment.
Is an agreement required?
Yes, an agreement or understanding must be reached before the work is performed.
Do shift differentials affect the rate?
They generally do when they are compensation for work performed.
Can the employer ignore daily overtime if hours stay under 80?
No. Hours over eight in a day are independently overtime under a valid plan.