Inclement weather policies for hospitals

August 01, 2018

Natural disasters have become an all-too-common occurrence, and hospitals and other health facilities are on the short list of establishments that never shut down, no matter how threatening the weather becomes. In fact, the exact opposite is often true: as the weather outside becomes more dangerous, the hospital inside becomes more active.

Indeed, some of the most hectic and unpredictable times for hospital employees are when there's inclement weather. After all, these conditions can lead to countless injuries, all while valuable staff are more likely to call in sick or stay with their families to wait things out. Together, it creates the perfect storm of staffing issues.

With the increasing prevalence of weather-related disasters, it's no coincidence that 2018 marked the first year that inclement weather data was included in the Mercer Clinical Pay Practices Survey. Understanding how hospitals adjust their HR policies to incentivize employees to not only attend work, but also to cover shifts for other workers during these trying times has become an important HR topic.

Designating Essential and Nonessential Employees

An essential employee is an employee whose work involves the urgent protection of human life or property. In a hospital setting, essential employees are critical to keeping operations running smoothly, especially under severe weather conditions. Typically, essential employees are those directly responsible for patient care and keeping the facility running.

It's important for organizations to proactively classify their employee functions as either "essential" or "nonessential," based on the criticality of the role they play and it's especially important for organizations that remain open during inclement weather incidences to do so. Of the 53% organizations that actually do use these classifications:


  • Nurses are the most likely employees to be designated as essential: 83% of respondents indicated that nurses were classified as essential employees.
  • HR professionals are the least likely employees to be designated as essential: Only 23% of respondents indicated that their HR functions are classified as "essential."
  • Non-medical service staff are essential too: Members of maintenance (65%) and dietary/food service (55%) were also among the top five functions designated as essential amongst respondents.

83% of respondents indicated that nurses were classified as essential employees.

In addition to prioritizing essential and nonessential personnel, you should also take some time to consider all the unusual ways your employees will be affected. For example, you may need them to stay late, sleep at the facility, or come in when they were not previously scheduled. With policies in place, when inclement weather does jeopardize your immediate staffing, you're prepared to properly reward and incentivize your hard-working employees when they go above and beyond to keep things moving.

Delayed-Release Pay Trends

Keeping essential employees on site is critical to maintaining your operations, especially when you're unsure if the next shift will be able to make it in. Though your first thought may be to provide additional compensation to incentivize your employees for working well after their scheduled shifts come to an end, the majority of hospital systems don't offer additional and/or specialized pay under these conditions. As you can see, the types of hourly pay trends for delayed release throughout the market vary quite significantly:

  • 38% of hospitals continue to pay straight time following a shift's end
  • 27% pay time and a half
  • 2% pay comp time
  • 0% pay double time

Delayed releases also bring various other questions to the table. For example, when you need an employee to stay at the facility, will the employees have time to sleep? And should they be paid while doing so?

Paying for Sleep

During some of the more extreme weather situations, your employees could end up sleeping at the hospital, whether by choice or sheer necessity. When it's a necessity, US hospitals have a variety of philosophies when it comes to compensation:

  • 49% of organizations either pay straight time (26%) or at a set flat rate (23%).
  • 13% pay minimum wage for sleep time.
  • Only 11% of organizations set a maximum number of hours that they'll pay for sleep time.

Setting up appropriate compensation policies for sleep time means considering a variety of scenarios. However, as an HR professional, it's your duty to consider each and every one so you can properly address it on the chance it occurs. To give you an idea of how variable these scenarios could be, consider the following sleep-related questions:

  • What if a sleeping employee is woken up to perform work? How should he or she be paid then?
  • Is there a number of consecutive hours of sleep that an employee must be paid for?
  • If an employee is on site but neither working nor sleeping, are they considered "engaged to wait"?
  • Should you pay differently if an employee is not working but also not sleeping due to unavailable sleeping quarters?

These are just a few of the many potential scenarios that an inclement weather policy should look to address. However, there are a host of other infrequent, yet still very important, considerations to keep in mind as well.

Unique and Less Common Compensation Policies

To reduce stress on your staff during inclement weather conditions, you may also want to consider implementing other policies that encouraging employees to come in despite less-than-friendly weather conditions, such as:

  • Premium compensation: 15% of hospitals pay a premium to their essential employees during a Code White Day (inclement weather day) which might help you encourage employees to report for their shift.
  • Special PTO and sick time policies: Most organizations (74%) don't restrict nonessential employee usage of PTO or sick time on inclement weather days. Still, 11% of hospitals do not pay their nonessential employees who are unable to report to work on these days. You might consider exploring special policies around using PTO or sick time as a way to dissuade employees (essential or not) from avoiding the workplace during inclement weather.
  • Engaged to wait: If you need your staff to stick around "just in case," even though they're not actively working, then you could pay them differently. While 47% of hospitals continue to pay straight time when their employees are simply "engaged to wait," you could explore other options for compensating them during these conditions, including comp time, minimum wage, time and a half, or a custom flat rate.

Regardless of what components your policy ultimately includes, you should always strive to make it as mutually beneficial as possible. This way, it will be as fair for your employees as it is fair for your organization.

Looking for Further Guidance? We've Got You Covered!

As a professional working in the healthcare field, serving your community is a priority. Because of this, you should be prepared to do whatever it takes to keep your facilities properly staffed, especially in times of emergency.

However, there's never just one solution to every potential issue that might arise under adverse conditions. That's why it's so important to be familiar with all your policy specifics and consider how certain new policies might impact overtime rewards, short-term incentives and bonuses, per-diem staffing alternatives, IT and tech issues, shift differentials, and more. Mercer's Clinical Pay Practices Report provides you with all the in-depth industry data you need to fully evaluate and refine your hospital's overall approach. For insights into base pay and total cash compensation for your hospital employees, check out the IHN - Healthcare System & Hospital Compensation Suite.