Planning NEMT around holidays: dialysis shifts, closures, and driver coverage

The holidays that move the schedule

A handful of days each year change when dialysis centers, clinics, and day programs are open, and every change ripples into your pickups. The federal holiday list is the place to start, though each facility sets its own hours.

In-center dialysis is the schedule to watch most closely. According to the NIDDK, part of the National Institutes of Health, center patients get a set time, most often three days a week (Monday, Wednesday, Friday, or else Tuesday, Thursday, Saturday), and sit for roughly four hours each visit. A holiday that lands on a treatment day affects every patient on that pattern.

Dates come from the Office of Personnel Management’s federal holiday schedules. This season, Christmas Day and New Year’s Day fall on back-to-back Fridays, so riders on a Monday, Wednesday, Friday schedule can have two treatments moved one week apart. Thanksgiving falls on a Thursday, a Tuesday, Thursday, Saturday day.

The federal list is not the whole picture. Your riders and drivers observe other cultural and religious holidays, and CareOregon’s provider manual (February 2024) accepts cultural or religious holidays as a reason to ask a broker to reassign trips. Add the days that matter in your service area to the same calendar.

Dialysis centers: get each center’s plan in writing

A dialysis center that closes on a treatment day has to put that shift’s patients somewhere else, and its plan becomes your schedule. Washington University’s dialysis centers in St. Louis, for example, run Monday through Saturday and may also open on Sundays around major holidays. A Sunday shift can land on a day your fleet does not normally cover.

Contact every center you serve four to six weeks before each major holiday and ask:

1. Which dates it will close or run shorter hours.
2. Where each affected shift moves, with the new date and chair time.
3. Which of your riders are affected.
4. Whether it is adding early-morning or late-evening shifts.
5. Who to call for last-minute changes.

Ask for the answer by email so you have it in writing, then confirm it again the week before. Watch for moved chair times that put a pickup earlier than your first driver normally starts, and staff for them. The dialysis transportation contracts guide covers building this kind of working relationship with centers year round.

Update standing orders without breaking them

A standing order keeps running until someone changes it. That is its strength most weeks and its risk on a holiday, when an untouched series sends a van to a locked door. Go through every rider on the center’s list and adjust the series for that week only:

• Skip the closed date.
• Add the make-up date the center gave you.
• Retime pickups to the new chair times, including the ride home.

Keep the weekly pattern itself intact so normal service resumes the following week. The standing orders guide covers setting up and maintaining a series.

Broker trips need one more step. Under CareOregon’s rules, the brokerage has to sign off before you change when a rider is picked up, the appointment time, or either address, and a trip that strays from its authorization goes unpaid. The MAS manual in New York wants changes to reach MAS ahead of time, requested by the rider or the medical provider, and notes that a change asked for once the trip is over might be refused. Before a van runs a moved dialysis date, confirm that the broker’s trip record shows the new date and time. Georgia’s broker must refresh or reconfirm every standing order at 30-day intervals, so holiday changes belong in that routine rather than in a phone call on the day.

Driver continuity counts too. Virginia’s MTM handbook (approved August 10, 2026) asks providers to try hard to give recurring riders the same driver, and to note it whenever someone else covers. Holiday weeks are when that documentation gets written most, so note substitutes as you assign them.

Clinics and day programs that close

Outpatient clinics, therapy offices, and adult day programs set their own holiday hours, and many close on the major holidays. Check every destination on your holiday-week schedule, not only the dialysis centers.

A ride to a closed facility is worse than a cancelled ride. The MAS manual bars dropping riders at ambulette level or higher before a facility opens, says a rider on door-through-door service must never be left at a closed or inaccessible facility, and has a rider who can’t get in safely driven back to where the trip started. Unless the rider asks for it, CareOregon does not allow a drop-off more than a quarter hour ahead of a facility’s opening time.

The check takes an hour:

1. Pull every trip for the holiday week.
2. Match each destination against the closure list.
3. Cancel the rides to closed sites and tell each rider.
4. Record who cancelled and why. Texas requires providers to document every cancellation, whoever asked for it.

Some trips never stop. Georgia’s broker must keep after-hours paging for nights, weekends, and stated holidays, and to arrange non-routine trips and replace disabled vehicles after hours. Hospital discharges and urgent rides still come in on the holiday itself, so keep an on-call driver and dispatcher. See after-hours NEMT for how to staff that coverage.

Brokers: booking deadlines and your hours

Holiday closures squeeze broker booking windows. Under Georgia’s NEMT manual, members must call the broker three or more business days before a routine visit, and the appointment day does not count, and it lets the broker’s scheduling office close for six holidays, from New Year’s Day and Memorial Day through July 4th, Labor Day, Thanksgiving Day, and Christmas Day. Plan for trip requests to arrive earlier and in bigger batches in the days before a holiday.

Tell each broker what you can cover:

• Update your provider profile. The MAS manual puts holidays and closures in the provider’s profile, and the provider has to keep it up to date.
• Hand back early. CareOregon wants reassignment requests as early as you can make them, and lists driver schedule limits such as vacations, along with cultural or religious holidays, as acceptable reasons.
• Report changed hours. CareOregon wants to hear immediately if your hours of operation or service area change.

Some brokers close their booking lines on more days than Georgia does. In North Carolina, the Modivcare reservation line for Partners Health Management’s Tailored Plan members is closed on Sundays and on seven holidays, including the day after Thanksgiving. Check each broker’s holiday list when you plan.

Send your holiday hours to every broker on the day you finish the driver schedule. A trip you know you cannot staff is better returned four weeks out than on the morning of the holiday.

Driver coverage and time-off requests

Holiday time off is easiest to manage with rules everyone knows before the requests start. A workable approach:

• Set a deadline. Collect requests for the Thanksgiving to New Year’s stretch by a fixed date in October.
• Decide how ties are broken. Rotation, seniority, or first-come, stated in writing.
• Cap the number off each day. Base the cap on the moved trip volume, not a normal week.
• Protect vehicle coverage. Keep enough drivers trained on lift vans for every wheelchair rider on the schedule.

Build the holiday schedule from the moved trips, not from last year’s schedule. The driver shifts guide covers turning trip volume into shifts.

Moved treatments can also pack extra hours into the days around a holiday. Under federal law, a non-exempt employee’s hours past 40 in a workweek must be paid at time and one-half the regular rate or more. The law carves out some transportation jobs, such as drivers for taxicab businesses and workers under federal motor carrier hours rules (29 U.S.C. 213(b)), so check the NEMT driver overtime guide before you schedule long weeks. Contractors follow different rules, covered in paying drivers as contractors or employees.

Holiday pay: what the law requires

Federal law leaves holiday pay to you. The Labor Department’s guidance is that the FLSA does not require paying for time off, vacations and holidays included, and that such benefits come down to what the employer and employee agree. Check your state’s labor agency before you finalize the policy.

If you pay extra for working the holiday, the structure affects overtime. DOL Fact Sheet #56A says extra pay at a premium rate for work on holidays can be left out of the regular rate when the premium is 1.5 times the normal rate or more, and that such premiums may count toward overtime owed. Pay for a holiday not worked can also be left out of the regular rate, but excluded payments generally cannot be credited toward overtime.

Write the policy down before the season:

• Which holidays are paid days off
• Who qualifies, for example drivers who have finished a probation period
• The premium, if any, for working a holiday
• How requests are approved and how ties are broken
• What happens when a driver scheduled for the holiday calls out

A holiday planning timeline

This is a suggested timeline for each major holiday. Adjust it to your brokers’ booking windows.

Holiday weeks in HealthRide

In HealthRide, you can skip or move a single day of a recurring trip and the weekly pattern stays exactly as it was, so a holiday week never means rebuilding a standing order. Driver shifts and weekly patterns live in one place, and riders get reminder texts before each ride.