Mandatory overtime laws for nurses by state

If you run a nursing home, the useful question is not how many states restrict mandatory overtime. It is whether your facility is covered. Four states clearly reach long-term care, while seven confirmed laws stop at hospitals. Chronic short staffing is not a standing emergency exception.

Start with your facility type

New Jersey's health care overtime law applies to Department of Health licensed health care facilities, including nursing homes.Source: New Jersey Department of Labor
Pennsylvania Act 102 expressly includes long-term care nursing facilities in its definition of a covered health care facility.Source: Pennsylvania General Assembly, Act 102 of 2008
New York Labor Law Section 167 covers Article 28 facilities, which include nursing homes, and requires a Nurse Coverage Plan.Source: New York State Department of Labor
Minnesota's nurse overtime law explicitly does not apply to a nursing facility, with a separate exception for state-employed nurses.Source: Minnesota Revisor of Statutes, Section 181.275
The Fair Labor Standards Act does not cap the number of hours an adult employee may work; it governs overtime compensation and preserves other state or federal hour limits.Source: Electronic Code of Federal Regulations, 29 C.F.R. Section 778.102

What this means for an SNF

The confirmed list has 17 states, but the list alone is a poor compliance tool for a skilled nursing facility. Connecticut, Illinois, Massachusetts, Oregon, Rhode Island, Texas, and West Virginia define the covered facility around hospitals. Missouri's rule is for ambulatory surgical centers. Minnesota expressly carves out nursing facilities.

New Jersey, Pennsylvania, and New York clearly reach nursing homes. Washington reaches a nursing home operating under a covered facility's license, but its coverage is not obviously the same for a freestanding, independently licensed SNF. Alaska, Maine, Maryland, and New Hampshire are written in employer-based or broad facility terms. Do not assume that means your SNF is covered. Check the statutory definition, your license, and any collective bargaining agreement before relying on a restriction.

The practical rule is simple: do not build your staffing plan around a forced double shift until you know your facility is covered and the exception actually fits. In several states, an employer has not made reasonable efforts if it uses mandatory overtime to fill chronic vacancies.

The state-by-state scope that matters to a nursing home

This table summarizes the 17 confirmed state restrictions in the research file. The last column is the part a nursing-home administrator should read first. A check mark means the research found clear long-term-care coverage, not that every employee or every shift is covered.

State	What the rule does	Covers long-term care?	Primary source
Alaska	Restricts requiring or coercing a nurse beyond a predetermined shift or into overtime the nurse believes threatens safety. Provides 10 consecutive hours off after a scheduled shift.	Unclear for a freestanding SNF. The statute uses broad health care facility language.	AS 18.20.400-.499
Connecticut	Prohibits a hospital from requiring nurse overtime. The definition includes more than 12 hours in 24 or more than 48 hours in a hospital work week.	No. Hospitals only.	Conn. Gen. Stat. Section 19a-490l
Illinois	Prohibits mandated overtime except for an unforeseen emergency, as a last resort, with a four-hour cap beyond the scheduled shift.	No. Hospitals only.	210 ILCS 85/10.9
Maine	A nurse may not be disciplined for refusing more than 12 consecutive hours. More than 12 consecutive hours triggers at least 10 consecutive hours off.	Unclear for SNFs. The law applies to employers rather than naming a facility type.	26 M.R.S. Section 603
Maryland	Bars an employer from requiring a nurse to work more than the hours in the predetermined regular schedule.	Unclear for SNFs. The statute is employer-based on its face.	Md. Code Section 3-421
Massachusetts	Allows mandatory overtime only for an emergency where patient safety requires it and there is no reasonable alternative. Regularly scheduled hours may not exceed 12 in 24, with a 16-hour consecutive ceiling.	No. Hospitals only.	M.G.L. c. 111 Section 226
Minnesota	Protects a nurse who refuses extra consecutive hours when, in the nurse's judgment, the work may jeopardize patient safety. It is not a blanket ban.	No. Nursing facilities are explicitly excluded, except for state-employed nurses.	Minn. Stat. Section 181.275
Missouri	Restricts mandatory overtime for licensed nursing personnel after an unexpected staffing shortage and verified reasonable efforts to find coverage.	No for a typical SNF. The confirmed rule is for ambulatory surgical centers.	19 CSR 30-30.020
New Hampshire	A nurse may not be disciplined for refusing more than 12 consecutive hours. A written employer-employee agreement can opt out of the protection.	Unclear for SNFs. The law is not facility-limited on its face, and the opt-out matters.	RSA 275:67 and 275:68
New Jersey	Bars a health care facility from requiring work beyond an agreed, predetermined daily shift. The employer must document reasonable efforts to find coverage.	Yes. The research confirms coverage for nursing homes licensed by the NJ Department of Health.	NJ health care overtime law
New York	Restricts requiring a nurse beyond regularly scheduled hours. The employer must make good-faith efforts to obtain voluntary coverage and maintain a Nurse Coverage Plan.	Yes. Article 28 facilities include nursing homes.	NYS DOL guidance on Labor Law Section 167
Oregon	Requires reasonable efforts to find replacement staff and restricts work beyond the agreed shift, more than 12 hours in 24, more than 48 hours in a hospital work week, and the 10-hour period after hour 12.	No. Hospitals only. The current citation is ORS 441.770, formerly ORS 441.166.	ORS 441.770
Pennsylvania	Bars a facility from requiring work beyond an agreed, predetermined daily shift. More than 12 consecutive hours triggers at least 10 consecutive hours off.	Yes. Act 102 expressly names long-term care nursing facilities.	Act 102 of 2008
Rhode Island	Restricts requiring work beyond an agreed shift except for an unforeseeable emergency. In no case may a covered facility require more than 12 consecutive hours.	No. The defined health care facility is a hospital.	R.I. Gen. Laws Section 23-17.20-3
Texas	Prohibits a hospital from requiring a nurse to work mandatory overtime. Refusal is not patient abandonment or neglect under the cited occupational code provision.	No. Hospitals only.	Texas SB 476, Chapter 258
Washington	Prohibits covered health care employers from requiring overtime. The current functional definition covers hourly or CBA-covered direct-care and clinical-services employees.	Limited. A nursing home under a covered facility's license is treated as part of that facility. A freestanding SNF is not clearly covered by the research.	RCW 49.28.130 and 2024 c 354
West Virginia	Prohibits a hospital from mandating overtime and protects a nurse who declines extra hours over a safety concern. No nurse may work more than 16 hours in 24, subject to listed exceptions.	No. Hospitals only, excluding state and federal hospitals.	W. Va. Code Section 21-5F-3

California is not in this confirmed table. The research could not reach the primary California code text. Secondary reports say the restriction applies only to nurses and CNAs employed by the State of California, but that scope is not verified here. Do not turn that reported claim into a private-hospital or SNF rule.

Three rules people keep mixing together

Mandatory-overtime law asks: can the employer make the nurse stay? These are state rules. They usually create a right to refuse extra hours plus protection from retaliation, but they do not all use the same definition of overtime or emergency.

Staffing-ratio law asks: how many residents or patients can one nurse be assigned? That is a different compliance question. A ratio or staffing-plan law does not answer whether you can require a nurse to stay late. Illinois is a useful warning: its nurse staffing committee rule is in Section 10.10, while its mandatory-overtime restriction is in Section 10.9.

FLSA overtime pay asks: what must the employer pay for extra hours? Federal law does not stop an adult employee from working past 40 hours. It requires the applicable overtime compensation and preserves other laws that limit hours. A state can restrict compelled hours even when federal wage law would allow the schedule if the premium were paid.

There is also an FLSA "8 and 80" option for a hospital or residential-care institution that adopts a 14-day work period by prior agreement. That changes the pay calculation. It does not create permission to ignore a state mandatory-overtime restriction. See 29 U.S.C. Section 207(j).

What to do when a shift is uncovered

In a covered state, a call-out should trigger a documented coverage process, not an automatic order to stay. Start with the people already scheduled only if they volunteer. Then work through the coverage sources your state rule recognizes, such as qualified off-duty staff, a float or per-diem pool, and an agency. Keep the offer and response record.

Read the exception narrowly. A procedure already in progress or an unforeseeable emergency may be treated differently from an ordinary call-out. A vacancy caused by chronic short staffing is a different fact pattern, and several statutes expressly say it is not the kind of emergency that proves reasonable efforts.

Before publishing the next schedule, check four fields for every likely backfill: facility scope, scheduled shift, consecutive hours, and the employee's weekly or multi-day total. Add any CBA rule and your written policy. If your state is NJ, PA, NY, or WA, confirm the license relationship before treating a nursing-home shift as covered. If the answer is unclear, ask employment counsel or the relevant state agency.

Where scheduling teams get burned

A hospital-only law does not automatically cover a nursing home owned by the same company.
A state's overtime restriction may protect refusal without banning every extra hour, as Minnesota and New Hampshire show.
Do not copy an hour cap from another state. The confirmed rules range from a four-hour Illinois exception to a 16-hour Massachusetts or West Virginia limit, while Texas has no hour cap in the cited law.
Do not use an on-call list as a substitute for mandatory overtime. Several statutes permit prescheduled on-call time while still limiting compelled work.
Do not cite Illinois Section 10.10 as its overtime ban. The overtime restriction is Section 10.9.

Keep the coverage decision visible

Shiftd surfaces coverage gaps, hours conflicts, and overtime before you publish a schedule, then keeps an audit record of schedule changes. It does not interpret state law or replace counsel, but it gives your team a visible record of the staffing decision.

See Shiftd in action →

Questions a DON will ask

Which states clearly cover nursing homes?

The research confirms clear long-term-care coverage in New Jersey, Pennsylvania, and New York. Washington has limited coverage when a nursing home operates under a covered facility's license. Alaska, Maine, Maryland, and New Hampshire need a closer scope check rather than an automatic yes.

Does Minnesota ban mandatory overtime for nursing-home nurses?

Not for a nursing facility under the general rule. Minnesota Section 181.275 explicitly excludes nursing facilities, ICF/DDs, boarding care facilities, and housing-with-services establishments. State-employed nurses are treated separately.

Is mandatory overtime the same as FLSA overtime?

No. Mandatory-overtime law controls whether an employer can compel extra hours. FLSA overtime controls pay for covered overtime hours. Paying a premium does not erase a state limit on compelled work.

Does chronic short staffing count as an emergency?

Do not assume it does. Several confirmed statutes say chronic vacancies do not show that the employer made the reasonable efforts required before using an exception. Check the exact language for your state.

Why is California missing from the state table?

The primary California text could not be verified in the research pass. Secondary reports describe a restriction limited to State of California employees, not a general private-hospital or SNF ban. Treat that as reported only until the code is read directly.