Understanding the Impact of the FMLA on Your Healthcare Practice

If you own and operate a private healthcare practice, the acronym “FMLA” is probably familiar to you. What is it, and how might it affect how you manage your practice?

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Following labor laws is an integral part of running a legally compliant healthcare practice. One key piece of legislation often comes into play: the federal Family and Medical Leave Act (FMLA). In this article, we’ll discuss what the FMLA is all about, how it applies to healthcare practices, and the steps practice owners should take if they fall under its scope.

What Is the FMLA?

The Family and Medical Leave Act (FMLA) allows employees of covered employers to take 12 weeks of leave for significant life events such as childbirth, adoption, fostering, caring for an immediate family member with a medical condition, or serious health issues that impair their ability to work. In cases involving caring for an injured next of kin who is a service member, the leave extends to 26 weeks. 

The FMLA doesn’t mandate paid leave. However, employers can allow employees to use accrued paid vacation time, paid sick leave, or paid family leave while maintaining FMLA protections. 

The FMLA stipulates specific conditions for employers to be considered “covered” employers and for employees to be eligible to take leave. 

Who Is Subject to the FMLA?

The FMLA applies to “covered” employers, including local, state, and federal employers, local education agencies (schools), and private sector employers with 50 or more employees. While a few other criteria determine whether you’re a “covered employer,” if your practice employs 50 or more people, it is likely subject to the FMLA. 

Employees must also meet specific eligibility requirements to take advantage of FMLA benefits. For example, employees must work for a covered employer, have worked at least 1,250 hours in the twelve months before leave starts, work at a location where the employer has 50 or more employees within 75 miles, and have worked for the employer for at least 12 months (whether or not those months were consecutive).

What Should You Do If FMLA Applies to Your Practice?

First, employers covered by the FMLA must display a poster created by the U.S. Department of Labor in a conspicuous place. The poster details a) the FMLA’s provisions and b) the process for filing a complaint with the Department of Labor Wage and Hour Division should the employer violate the FMLA.

Second, if you determine that your practice is a covered employer under the FMLA or anticipate it might be in the future, strongly consider writing employment policies and procedures for FMLA activities. These policies should reinforce your responsibilities under the FMLA and anticipate how you might handle likely scenarios.


If an employee requests a leave due to a serious health condition, the FMLA allows the employer to require certification — that is, medical confirmation from a healthcare provider or other third party. Written policies and procedures might include:

  • the legal requirement to allow the employee at least 15 calendar days to provide certification
  • scenarios where the practice could request additional medical opinions
  • a process for notifying an employee that their certification is incomplete, along with a timeframe for them to remedy the deficiency (usually seven days)

Fitness for Duty

You should also consider policies and procedures that govern what happens when an employee is ready to return to work. For example, you may require an employee who took leave for a serious health condition to submit a fitness-for-duty certification. 

Job Equivalence

If an employee is returning to a job different from the one they held before their leave, your policies should ensure the new position is nearly identical in several respects: 

  • The schedule and geographic location should be the same or very similar.
  • The duties, responsibilities, and status should be comparable.
  • The required skill, effort, responsibility, and authority levels should be generally the same.
  • The compensation must be identical, including standard premium pay, overtime, bonus opportunities, profit-sharing, other payments, and any automatic pay raises that would have occurred during FMLA leave.
  • Benefits such as sick leave, vacation time, and life, health, and disability insurance must be the same.

FMLA violations, including willful neglect of the FMLA’s posting requirements, can lead to civil monetary penalties.

Get Legal Support

Understanding and implementing the Family and Medical Leave Act is a key responsibility for private healthcare practice owners. By ensuring compliance, you not only uphold your legal duties but also support the well-being of your employees during critical times in their lives. 

Remember, when in doubt, seek advice from a legal professional who can help you navigate the complex web of state and federal laws. The experienced attorneys at Jackson LLP Healthcare Lawyers know the difficulties you encounter as the owner of a small to medium independent practice. We’re here to help you succeed despite the challenges! If you operate in one of the states where we have licensed attorneys, book a free consultation with us to find out if we’re a good fit for your needs.

This article is made for educational purposes and is not intended to be specific legal advice to any particular person. It does not create an attorney-client relationship between our firm and the reader. It should not be used as a substitute for competent legal advice from a licensed attorney in your jurisdiction.

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