Most salaried positions in the healthcare industry are at a management or supervisory level. These positions often have a 24-hour level of responsibility built into the job description. This 24-hour responsibility includes oversight of both human resources and operations. The number of managers in the rotation cycle usually determines the frequency of house-coverage rotation. Because these positions are designed to allow responsibility for human resources and operations, there is built-in flexibility for managers to schedule themselves to meet the needs of their units or departments.
Managers often work off-shifts and weekends to complete all of the expectations for their role.
Their salaried status makes it more convenient for them to do this and to have autonomy over their schedules. It is each manager's responsibility to balance the needs of patients and staff with the manager's personal need for time off. If you are regularly scheduled to cover the house, fill in on weekends, or cover off-shifts, then you may want to discuss with your manager what is acceptable in recouping this time. There is a lot of confusion and misunderstanding about capitated contracts and shared risk contracts. At that time, Congress increased its focus on cost containment and incremental reforms, which reduced federal payments to most healthcare providers.