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A California court case concerning waived breaks could have widespread implications for healthcare workers encouraged to give up meal time during extra-long shifts.

The state’s Court of Appeal ruled in February that an industrial commission erred when it allowed nurses and other shift workers to surrender a second break required under state labor code. Three former employees of Orange Coast Memorial Medical Center filed a class-action suit, arguing they sometimes worked longer than 12 hours without two mandated breaks.

If it stands, the ruling could produce back wages for California healthcare workers who signed away those 30-minute periods. 

It might also have a ripple effect in states where medical facilities let employees skip breaks they’ve earned.

After the decision, an attorney for the California Hospital Association told the San Francisco Chronicle that employees liked a voluntary waiver policy because it got them home sooner without surrendering pay. The California Nurses Association argued that employees signed the waivers to spend more time with patients in under-staffed facilities.

The hospital could still appeal to the California Supreme Court.