Solo and small pediatric practices in New Jersey seldom have a dedicated human resources department. The owner is often the human resources department, and usually in the 15 minutes between patients. Sometimes when the practice grows, that task is offloaded to an office manager or other trusted staff member who must play double duty with their primary responsibilities. That might be a manageable arrangement if New Jersey were not one of the most employee-protective states in the country, with overlapping leave, sick time, wage, and anti-retaliation laws that reach employers far smaller than most owners assume. The good news is that most of the employment disputes I see are avoidable, and avoiding them does not require sophistication so much as a handful of proactive habits, starting with knowing the law’s requirements and which ones apply to the practice. This column walks through the areas where small practices stumble most often, starting with a change in New Jersey law that took effect over the summer.
The Leave Alphabet Soup
Practice owners tend to know the federal Family and Medical Leave Act (FMLA) by name, and many stop their analysis there because the FMLA only applies to employers with 50 or more employees. The harder-working law in New Jersey is the New Jersey Family Leave Act (NJFLA), which requires employers to provide certain employees up to 12 weeks of job-protected leave in a 24-month period to care for a family member or bond with a new child. Historically, the NJFLA applied only to employers with 30 or more employees, which kept most independent practices out of its reach.
That has changed. Under amendments signed into law in January 2026 by outgoing Governor Phil Murphy, the threshold dropped to 15 employees effective July 17, 2026, and eligibility relaxed so that a staff member qualifies after only three months of employment and 250 base hours worked. A practice with multiple locations, or one that counts its part-time and per diem staff accurately, may cross the 15-employee threshold sooner than the owner assumes, and a covered employer has obligations the moment an employee mentions having a sick parent or a baby on the way.
Separate from job protection, New Jersey runs two wage-replacement programs that have no employer size threshold: Temporary Disability Insurance (TDI) for an employee’s own medical condition, and Family Leave Insurance (FLI) for bonding with a new child or caring for a family member. Both are funded through payroll and administered by the State (or the employer may elect a private plan), which means employees of even a three-person office may qualify for benefits. An employer’s obligations are mostly administrative, including required notices and responding to the State’s paperwork, but the anti-retaliation provisions are very real. The same January amendments gave employees who take these benefits an express right to reinstatement and a new private cause of action to sue employers who refuse to restore them. The most common small-practice mistake in this area is the assumption that being too small for the FMLA means being too small for leave laws generally.
Pregnancy deserves a special mention because it is where these laws pile up. A pregnant employee may have rights to reasonable accommodation under the New Jersey Law Against Discrimination, which applies to employers of all sizes, then TDI for the disability period surrounding delivery, then FLI for bonding, with NJFLA or FMLA job protection potentially layered on top. Each piece runs on its own clock with its own notice rules, and the right answer to a simple question like how much time off is an employee entitled to depends entirely on how they sequence, because some of these protections run at the same time and others only begin when another ends.
Sick Leave Is Not Optional
The New Jersey Earned Sick Leave Law applies to every private employer in the state regardless of size, and it covers part-time staff. Employees must be allowed to accrue one hour of paid sick leave for every 30 hours worked, up to 40 hours per year, and the permitted uses are broader than many employers realize. They include not only the employee’s own illness but also a child’s medical appointments, parent-teacher conferences, school closures for public health reasons, and even school recitals. Two features of the law catch practices off guard. First, employers cannot require an employee who uses sick leave to find their own coverage; they can ask, but the absence cannot be conditioned on it, which stings in a small office where one missing nurse changes the whole day. Second, the law prohibits counting protected sick leave against an employee under an attendance policy. Disciplining an employee for an absence pattern that consists of lawful sick-leave use is itself a violation, even if the absences are painful operationally. Keep accrual and usage records both because the law requires recordkeeping and because incomplete records can make an employment dispute significantly harder to defend.
Time-In, Time-Out: Wage Traps
Wage claims are the quiet ones. Nobody announces them in the breakroom, and by the time they surface, the damage is done and the lookback period is long. Since New Jersey’s 2019 wage-theft amendments, employees can reach back six years and recover unpaid wages, liquidated damages of up to 200 percent of the wages owed, plus attorneys’ fees. Small habits compound at those multiples.
The traps I see most often in medical offices are familiar:
(1) the working lunch, where the front desk person eats at the desk and keeps answering phones, which is compensable time even if policy deducts 30 minutes automatically;
(2) off-the-clock charting, where hourly clinical staff finish notes or answer portal messages from home in the evening, which is work time and frequently unrecorded hours or overtime;
(3) travel between office locations in the middle of the day, which counts as hours worked; and
(4) the salaried staff member who is treated as exempt from overtime because they are paid a salary, when the exemption actually depends on their duties, not pay structure.
None of these are uncommon, and all of them are fixable with timekeeping discipline and an honest look at who is genuinely exempt.
Discharge Planning
New Jersey is an at-will employment state, and a practice generally does not need a reason to part ways with an employee, but that ability is not unlimited. Legal exposure is rarely the decision itself but the circumstances around it. Final wages are due no later than the next regular payday, not whenever the bookkeeper gets to it, and whether accrued but unused PTO must be paid out is governed by employer’s written policy, so have one and follow it consistently. Resist the urge toward self-help, such as docking a final check for an unreturned laptop or lab coat, because unauthorized deductions can create a wage claim out of what was otherwise an amicable exit. Finally, do not forget to fill out and give every departing employee a Form BC-10 (Instructions – Claiming Unemployment Benefits) at the time of separation and submit separation information on the state’s Employer Response Portal within seven days.
The larger point is timing. A termination that follows closely on the heels of a leave request, a stretch of sick-leave use, a workers’ compensation claim, or an internal complaint about billing or patient safety practices may be viewed through the lens of retaliation, and New Jersey’s whistleblower and discrimination statutes are among the most employee-friendly in the country. The performance reasons can be entirely real, and the timing can still sink as well-intentioned practice, because these cases turn on what was documented before the decision, not what is reconstructed after it. Write down performance problems when they happen, share them with the employee at the time, and treat similar situations consistently across staff. If the file is thin and the timing is awkward, that is the moment to slow down.
A Final Word
None of this necessarily requires hiring an HR department. It requires proactivity upfront and a few hours each year with payroll records, your handbook, and your employee classifications, ideally before a problem chooses the timing for you. The practices that fare best are not the ones that never have employee issues; they are the ones that build the paper trail and the policies while things are calm. There are technically a few weeks of summer left on the calendar, but this is the week pediatric practices shift into high gear, with back-to-school physicals stacked on top of everything else, phones that do not stop, and that particular brand of controlled chaos that arrives every September. That is precisely why the hour spent now on an HR checkup is worth more than the one you promise yourself for later, and why the problems worth finding are the ones you find before they become claims.
How Frier Levitt Can Help
Frier Levitt is a national boutique law firm exclusively focused on the healthcare and life sciences industries. We represent pediatric and other physician practices, hospitals, health systems, home health agencies, pharmacies, pharmaceutical companies, and medical device manufacturers across New Jersey and nationally. We understand how small clinical offices are actually staffed and what is at stake when a leave request, a sick time policy, a payroll practice, or a termination decision turns into a claim.
Frier Levitt can assist pediatric and other medical practices with navigating employee leave laws, auditing earned sick-leave practices, reviewing wage-and-hour compliance and exempt-classification decisions, drafting and updating employee handbooks and policies, and guiding practices through leave, accommodation, discipline, and separation decisions. Contact Frier Levitt today for a review of your practice’s employment policies and practices.
What’s Your Practice’s HR Apgar?
Score each of the five categories below from 0 to 2, then add them up for a total score out of 10.
Absences.
2: Sick leave accrues for covered employees, including part-time staff, you track accrual and use, and protected sick leave is not counted against employees under your attendance policy.
1: You offer paid sick time but couldn’t produce complete accrual and usage records if asked.
0: Staff don’t get sick leave, or you’ve disciplined someone for using it.
Pay.
2: Hourly staff record all time worked, including working lunches, evening charting, and travel between offices, and exempt classifications are based on duties.
1: Time is recorded, but lunch is auto-deducted, and you’ve never checked what actually happens at the front desk at noon.
0: “Everyone here is salaried.”
Guidance and Policies.
2: A current handbook and policy library covers leave, sick time, and PTO payout, and you follow those policies consistently.
1: There’s a handbook somewhere; it predates your EMR.
0: Policies live in your head.
Accommodations.
2: You know that pregnancy and disability accommodation duties may apply to practices your size, and requests get a documented, interactive response.
1: You’d handle a request kindly but informally.
0: You assume you’re too small for accommodation requirements.
Records.
2: Performance issues are documented when they happen, final paychecks go out by the next regular payday, and nothing is deducted from wages without authorization.
1: Documentation happens, but usually the week of the employment decision.
0: The personnel file is an empty folder.
How did you score?
7–10: A score of 7 or above is reassuring. Your practice has a strong preventive HR foundation. Reassess soon; keep your policies, records, and employment practices current as the law changes.
4–6: Any score below 7 warrants an urgent closer look. Your HR Apgar shows room for improvement, and a review of your policies, recordkeeping, and day-to-day practices may help identify gaps before they become claims.
0–3: A score in this range calls for prompt attention. Your practice may have significant employment-law exposure, and an HR compliance review that addresses the highest-risk gaps belongs at the top of the list.
Senior Associate
