Covered Health Care Employer Notification of Mandatory Overtime Pursuant to New York State Labor Law Section 167

JavaScript is currently disabled in your web browser.
For full functionality of this site, it may be necessary to enable JavaScript. Here are instructions how to enable JavaScript.

You are using an outdated browser.
For full functionality of this site, you may need to upgrade your browser.

Covered Health Care Employer Notification of Mandatory Overtime Pursuant to New York State Labor Law Section 167

Please select the Facility type:

Hospital

Nursing Home

Other

FACILITY INFORMATION

Nursing Home providing health care services licensed or operated pursuant to article twenty-eight of the public health law

Facility Name

Address of Facility

Address Line 1:

Address Line 2:

City/Town:

County:

State:

Zip Code:

Contact Person Name:

Contact Person Title:

Contact Person Phone:

Contact Person Email:

FACILITY INFORMATION

Other Covered Employer Non-Hospital or Nursing Home

Facilities providing health care services operated by the State, a political subdivision or a public corporation as defined by section 66 of the General Construction Law, operated or licensed pursuant to the:

Mental Hygiene Law

Education Law

Correction Law

Executive Law (section five hundred four)