DUHS Time Off Policy - for Employees with a Continuous Service Date on or after January 1, 2026

Click here to see the policy for employees with a Continuous Service Date on or before December 31, 2025:

DUHS Time Off Policy - for Employees with a Continuous Service Date on or before December 31, 2025

Policy Statement

Duke University Health System (DUHS) provides employees time off for personal, family, and other obligations through the "Paid Time Off" (PTO) plan. PTO combines vacation, holiday, and sick leave into one program. DUHS employees accrue time off based on years of service and whether they are in an hourly-paid or monthly-paid position.

Policy Details

• Guidelines
• Accrual & Usage
• Recognized Holidays
• Bereavement Leave

Guidelines

Eligible health system employees receive time off in the form of the DUHS PTO program. PTO provides employees with more flexibility in scheduling time off to meet personal needs and balance work and family life. The design of the PTO program is also intended to assist employees and the health system in managing staffing needs to meet DUHS operational needs. Time away from work must be approved and recorded in a manner that protects the interests of both the institution and its employees.

Eligibility & PTO Structure

DUHS provides PTO for all regular employees who are scheduled to work 20 or more hours per week.

PTO begins accruing on the first day of employment. PTO accrual rates are based on years of service and are prorated to reflect the actual number of hours an employee is paid (up to the appointed hours or Full Time Equivalent (FTE) status) per pay period (biweekly or monthly). No PTO is earned on overtime hours.

FTE represents the percentage of time an employee is expected to work based on a 40-hour work week. For example, a 0.9 FTE is expected to work 36 hours per 40-hour work week.

Usage

DUHS employees will have access to accrued PTO for the purpose of taking time off from work up to their assigned FTE. DUHS employees have the opportunity to accumulate time for rest, relaxation, illness, personal use, family needs, or sell-back.

Employees must use accrued PTO up to their assigned FTE for scheduled or unscheduled time away from work.

Payment

• Payment of PTO for time away from work will be made at the employee’s regular rate of pay at the time of leave and will not include any premium or differential payment.

Scheduling Time Off

• The supervisor and employee schedule time off in accordance with existing department scheduling requirements and operational needs.
• Other factors that may be considered in scheduling time off include department needs, the employee’s length of service, and the employee’s accrued amount of unused PTO.

PTO Advancement

Up to 40 hours of PTO may be advanced to new employees during their first year of employment with manager approval for extenuating circumstances including but not limited to emergencies and pre-planned vacations. After 12 months of employment, employees may not take additional PTO until they have accrued a positive balance that can cover the requested time off. Employees with one year or more of continuous service are not eligible to use PTO advancement. Employees must be in good standing (no active corrective action) to be eligible to use PTO Advancement.

In the event of a negative PTO balance (including advanced) at the time of separation from employment at DUHS, money shall be withheld from the final paycheck of a separated employee to repay the negative PTO balance. If the final paycheck is not sufficient to fully repay the overdrawn PTO, the employee remains liable for the reimbursement of the remaining balance and arrangements should be made to pay the outstanding balance prior to the last day of employment.

Department Closures or Reduced Workload

In the event an employee’s department is closed (for reasons other than DUHS-designated holidays) or operating on a reduced workload due to low census, non-exempt (hourly-paid) employees may choose to use accrued PTO or take the time off unpaid. Exempt (monthly-paid) employees must use PTO when their departments are closed.

Severe Weather and Emergency Conditions

• If an employee does not come to work, they must use accrued PTO.
• Any unapproved absence incurred during a severe weather and/or emergency condition event will be considered unscheduled time off.

Maximum and Minimum Accruals

Earned hours are accrued each pay period. Maximum accrual is 1.5 times their expected annual days accrued (see accrual chart below). Employees may use a maximum of 55 days of PTO each year. There is no Long-Term Bank for employees with a continuous service date on or after January 1, 2026.

Pay for Unused Time

All eligible PTO will be paid in a lump sum at the employee’s current base rate of pay on regular payroll dates. Upon termination of employment or death, unused accrued PTO time is paid to the employee or their estate if the employee has three or more years of continuous service in a PTO eligible role, or as required by applicable state law. Team members who are over 55 and retiring will be paid 100% unused accrued PTO, regardless of years of service. Team members who are part of a Reduction-in-Force (layoff) will be paid 100% of accrued PTO, regardless of years of service. If an employee moves to a part-time status (less than 0.5 FTE), the employee is no longer eligible for PTO and will follow the guidelines outlined in the Payout of Accrued Time Upon Leaving DUHS Policy.

Unused PTO will not be paid for involuntary terminations. Involuntary terminations include, but are not limited to, discharge for causes related to unsatisfactory job performance, attendance, inappropriate behavior, or misconduct.

For more information, please see the Payout of Accrued Time Upon Leaving DUHS policy.

PTO Sell-Back

Once a year, employees may sell-back a portion of their accrued PTO. Eligible employees must have at least 88 hours of accrued PTO. PTO sell-back will be paid at 50% cash value due to IRS constructive receipt requirements. Employees must maintain a PTO balance of at least 80 hours of accrued PTO after the sell-back. The minimum PTO sell-back is 8 hours, and the maximum is 80 hours. Applicable taxes are withheld. Hours must be redeemed in full hour increments (i.e. partial hours cannot be redeemed).

• This payment will be based on the employee’s base rate of pay as recorded in the payroll system (as of the date of the check).
• Employees must complete a REQUEST form and return it to the Corporate Payroll Office by the assigned date.
• Employees can verify PTO balances in the API Time and Attendance System.

Bank Definitions and Usage Process

Accrued PTO sits in one bank and is available for vacation, holiday, and sick time. Employees may not use more than 55 days a year.

Carry Over Bank (COB) – Employees who are hired directly into the health system do not have a Carry Over Bank. This bank is only for employees who transfer from Duke University to DUHS, where 100% of accrued and unused sick time will be placed in the Carry Over Bank. In some cases, acquisitions may have time transferred into the Carry Over Bank. Please see other acquisition specific policies for more details.

Carry Over Bank for Hourly-Paid Employees from Duke University

Hourly-paid employees who transferred from Duke University, are eligible for retirement from DUHS, and have accrued time in the Carry Over Bank (COB) will receive either a normal or early reduced pension as provided in the Employees’ Retirement Plan and will be eligible for the following:

• At the time of retirement, an hourly-paid employee's total accumulated bank of unused Carry Over Bank hours will be calculated.
• The total of unused Carry Over Bank hours will be used to adjust the hourly-paid employee's credited years of service for benefit calculation.
• This adjustment will be accomplished by taking the total number of these unused Carry Over Bank hours and converting them into additional-length-of-service credits that are then used to calculate the employee's eventual retirement payment.
• The exact method of computation of pension benefits and the conversion of unused Carry Over Bank hours into additional-length-of-service credits will be governed and defined by the Employees’ Retirement Plan (ERP).

Accrual & Usage

Hourly-Paid – PTO Eligibility and Accrual

Continuous Service Date of January 1, 2026 and Later

*Scheduled to work 80 hours each two-week period

**Scheduled to work at least 20 but less than 40 hours per week (or 80 hours per biweekly pay period)

***Scheduled to work less than 20 hours per week

Monthly-salaried – PTO Eligibility and Accrual

Continuous Service Date of January 1, 2026 and later

*Scheduled to work 40 hours or more each week

**Scheduled to work at least 20 but less than 40 hours per week (or 80 hours per biweekly pay period)

***Scheduled to work less than 20 hours per week

For additional information on the PTO system, please contact the Talent Care Center representative or refer to the Paid Time Off web site.

Recognized Holidays

Health System employees, both bi-weekly and monthly, must use accrued PTO time for recognized holidays when departments are closed or requesting time off. Please refer to the list below for further information concerning the Health System’s recognized holidays.

Health System Recognized Holidays

• New Year's Day
• Martin Luther King Day
• Memorial Day
• Juneteenth
• Independence Day
• Labor Day
• Thanksgiving Day
• Christmas Day

Bank Usage

Employees working in departments that close on these holidays or requesting time off on recognized holidays are required to use PTO up to their assigned FTE.

Bereavement Leave

PTO eligible employees have access to three days of bereavement leave to handle matters related to a death in the family.

• Days are defined as distinct calendar days tied to regularly scheduled shifts or working hours.
• Bereavement leave is available for the loss of a direct family member, including a child, spouse, registered same-sex partner, sibling, parent, parent-in-law, grandparent, grandchild, or in the event of pregnancy loss.
• If there is a special relationship, not identified above, where an employee would like to use bereavement, the employee must speak with his or her supervisor when requesting bereavement leave.
• Verification of the reason for this absence, such as a funeral program or obituary, may be requested by the employee's supervisor immediately upon return to work. Verification is the employee's responsibility.
• The employee must arrange time off with his or her supervisor.

Bereavement Pay

• Pay for missed work due to bereavement leave is paid at base rate (with shift differential and weekend work premium not applicable).
• Should the death of a relative occur while the employee is on scheduled time off, the employee should immediately notify their supervisor so that the necessary arrangements can be made for additional time off.

Scheduled Time Off

• Approved time for bereavement leave is considered Scheduled Time Off.

Requesting Additional Time

• Should an employee request additional bereavement leave, PTO must be used up to the employee's assigned FTE.
• Such requests should be coordinated with the employee's supervisor.