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Diving Into Exempt vs. Non-Exempt Status in the Healthcare Industry in California (2025)

| 04/07/2025 | Blog

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:

  1. Earn $66,560+/year (CA salary threshold)
  2. Be salaried
  3. Perform exempt duties (independent judgment, supervision, licensed work)

If any part fails, they’re non-exempt.