If you operate a medical or dental practice you likely have a staff of employees that help keep your practice running smoothly. That means you must comply with all relevant state and federal employment laws, including those relating to rest and meal breaks. To ensure that you remain in compliance it is best to consult with an experienced employment law attorney or hiring a company like HR for Health that can keep you compliant with a monthly fee; however, the following overview of rest and meal break laws and regulations for medical and dental offices provides a good place to start.

The Right to Breaks

Most employees in the United States are protected under various state and federal laws that ensure them things such as a minimum wage, a workplace free of discrimination and harassment, and designated times for rest and meal breaks. State laws can provide additional protection for workers above and beyond that provided by federal law. In California, for example, employers need to be aware of the additional laws relating to lactating mothers and “day of rest” if they wish to avoid violating the law.

What Is a Rest Break?

The law defines a rest break, or rest period, as a paid uninterrupted ten-minute period during which an employee is not required to work, but an employee cannot be required to remain on-site or on-call during rest periods. An employer is legally required to provide suitable facilities for rest breaks separate from the restroom and an employee is entitled to be paid during a rest break. All non-exempt employees in California are entitled to rest breaks. While exempt employees may still be entitled to meal breaks, they are not entitled to rest breaks.

What Are the Basic Rest Break Requirements?

Although these laws vary state-by-state, in California for example, employees have a right to ten minutes of rest time for every four-hour period they work; however, they must work at least three-and-a-half hours to be entitled to a rest period.⁠ In addition, if an employee works a “major fraction” of a four-hour period the employee is entitled to a ten-minute rest period for the entire four-hour period.⁠ If this sounds confusing, consider the following examples of hours worked by an employee:

• Less than 3.5 hours. No rest break required.
• 3.5 to 6 hours. One ten-minute rest period required.
• 6 to 10 hours. Two ten-minute rest breaks required for a total of 20 minutes of paid rest breaks.
• 10 to 12 hours. Three ten-minute rest breaks required for a total of 30 minutes of paid rest breaks.

California requires rest breaks to fall in the middle of work periods “insofar as practicable.”⁠ This has generally been interpreted to require a good faith effort on the part of the employer; however, it leaves room for scheduling breaks at other times during a shift if there is a good reason to do so.

What Is a Meal Break?

A meal break is an unpaid 30-minute period during which the employee is officially “off the clock.” Although it is intended to allow the employee to eat while working a lengthy shift, an employee is certainly not required to use the break to eat. As with rest periods, an employee cannot be required to remain on-call or on the premises during a meal break. For an employer to remain compliant with the meal break requirements, the employer must:

• Relieve employees of all duties.
• Relinquish control over the employee’s activities.
• Provide a reasonable opportunity for the break.
• Not impede or discourage workers from taking their meal break.

What Are the Basic Meal Break Requirements?

California law entitles all nonexempt employees to be relieved from their work duties for a 30-minute meal break if the employee is scheduled to work more than five hours. An employee is entitled to a second meal break for every additional five yours scheduled thereafter. By way of illustration, consider the following shifts:

• Less than 5 hours. No meal break required.
• 5 to 10 hours. One meal break required.
• 10 to 15 hours. Two meal breaks required.
• 15 to 20 hours. Three meal breaks required.

The first meal break must begin before the end of the employee’s fifth hour at work. Keep in mind that when analyzing if an employee was entitled to a meal break (or several meal breaks) the focus is on how many hours the employee actually worked not how many hours they were scheduled to work.

Can an Employee Waive Rest or Meal Breaks?

A California employee is legally permitted to voluntarily skip a rest period. In that case, an employer will not be penalized; however, an employer cannot pressure or even encourage an employee to waive a rest period to which the employee is legally entitled.

A meal break may be waived by mutual consent of the employer and employee if the employee’s work shift is not more than six hours. For a work shift of up to 12 hours, one meal break may be waived, but the second meal break may not be waived.

What Happens If an Employer Violates a Rest or Meal Break Law?

An employee is legally entitled to one extra hour of pay based on the employee’s regular hourly rate if an employer does not provide a required rest break. The same applies if an employer violates the meal break requirement, meaning an employee could be entitled to an extra hour of pay for missed rest breaks and a second extra hour for a missed meal break for a total of two extra hours of pay.

Who Qualifies as an Exempt Employee?

Remember that the above-referenced California laws and regulations apply to non-exempt employees. Different rules and regulations may apply for exempt employees. For medical and dental practices, understanding who qualifies as an exempt employee is particularly important. Along with a general exemption for professionals, administrators, and executives, Cal. Code of Regs., tit. 8, §§ 11040⁠–⁠11050, subds. 11(D) address the inherent problems with providing meal breaks to workers in the healthcare industry, reading as follows:

“Notwithstanding any other provision of this order, employees in the health care industry who work shifts in excess of eight (8) total hours in a workday may voluntarily waive their right to one of their two meal periods. In order to be valid, any such waiver must be documented in a written agreement that is voluntarily signed by both the employee and the employer. The employee may revoke the waiver at any time by providing the employer at least one (1) day's written notice. The employee shall be fully compensated for all working time, including any on-the-job meal period, while such a waiver is in effect.”

In essence, the exemption allows workers in the health care industry to agree to on-duty paid meal breaks in lieu of traditional off-the-clock unpaid meal breaks if the agreement is entered into voluntarily and is reduced to writing.

California’s Day of Rest Requirement

Along with rest and meal breaks, California employers need to be aware of the “Day of Rest” requirement. The California Labor Code requires companies to give employees at least one day of rest out of seven as well as prohibits companies from “causing” employees to work more than six days out of seven. The “Day of Rest” rule does not apply if an employee works 30 hours or less in the week or works less than six hours per day in the week.

California’s Break Time for Lactating Mothers

Lactating mothers are also entitled to additional break periods, when necessary, under California law. Employers must accommodate lactating female employees who need to express milk during their work shift. When possible, the lactation break should be scheduled to coincide with a rest or meal break; however, when that is not possible the employer is obligated to provide an additional unpaid break period. The employer must also make a reasonable effort to provide the use of a private room located close to the employee’s workspace that:

• Is safe, clean, and free of hazardous materials.

• Contains a surface for a breast pump and personal items.
• Contains a place to sit.
• Has access to electricity or alternative devices (extension cords, charging stations) needed to operate breast pumps.
• Provides lactating employees with access to a sink with running water and a suitable place for storing expressed milk, such as a refrigerator.

An exception to the lactation break requirement may apply when providing the break would “seriously disrupt the employer’s business operation.” Employers with fewer than 50 employees may qualify for an exemption from one of the requirements listed above if they can prove that providing the accommodation would cause the employer significant difficulty or expense in relation to the size, financial resources, nature, or structure of the employers’ business. Employers face a civil penalty of $100 for every violation of the lactation break requirement.

How Can We Avoid Violating the Rest and Meal Break Requirements?

There are some practical steps a medical or dental practice can take to help ensure compliance with rest and meal break requirements, such as:

1. Evaluate your existing system to ensure that nothing is hindering the ability to schedule and facilitate breaks.
2. Create (and stick to) a schedule for breaks instead of “winging” it.
3. Encourage employees to report violations to management or owners immediately.
4. Ensure that employees are compensated for any missed breaks.
5. Provide a written explanation of your office’s break procedures and scheduling in your employee handbook.

If you operate a medical or dental practice, rest and meal breaks can be particularly difficult to schedule and manage because of the nature of the workplace. This makes it even more important that you consult with an experienced employment law attorney both prior to opening your practice and on a routine basis thereafter to ensure that you understand the current requirements and that you remain in compliance with them. If you have employment law questions, contact Dental & Medical Counsel to schedule a complimentary consultation with attorney Ali Oromchian.