Most U.S. hospitals recognize six core holidays: New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, and Christmas Day. These are the days when administrative offices, outpatient clinics, and elective procedures typically shut down. Emergency departments, intensive care units, and labor and delivery units never close, regardless of the holiday.
What “recognizing” a holiday actually means varies depending on whether you’re a patient trying to book an appointment or a staff member wondering about your schedule and pay.
The Standard Six Holidays
The six holidays listed above form the baseline at most private and non-profit hospital systems. Hackensack Meridian Health, one of the largest systems in New Jersey, is a typical example: it observes exactly these six days as designated holidays, separate from general paid time off. Many systems add Martin Luther King Jr. Day, Presidents’ Day, Columbus Day, Veterans Day, or the day after Thanksgiving, but those additions vary widely from one employer to the next. Religious holidays like Easter, Good Friday, or Rosh Hashanah are rarely designated as official hospital holidays, though individual staff members can usually use PTO to cover them.
VA and Government Hospitals Follow Federal Rules
If you receive care through a VA hospital or another federally run facility, the holiday calendar is longer and standardized. Federal hospitals observe all 11 federal holidays established by law:
- New Year’s Day
- Martin Luther King Jr. Day
- Presidents’ Day (officially “Washington’s Birthday” under federal statute)
- Memorial Day
- Juneteenth
- Independence Day
- Labor Day
- Columbus Day
- Veterans Day
- Thanksgiving Day
- Christmas Day
On these days, VA ambulatory clinics, outpatient clinics, surgery departments, and administrative offices close. Emergency and urgent inpatient services continue. If you have a scheduled VA appointment that falls on one of these holidays, expect it to be rescheduled automatically. Private hospitals, by contrast, have no legal obligation to observe any particular holiday. Their lists are set internally by hospital leadership or negotiated through union contracts.
What Stays Open on Holidays
Hospitals are 24/7 operations at their core. Emergency departments never close. Neither do inpatient units caring for people already admitted, ICUs, neonatal units, or labor and delivery floors. Pharmacies inside hospitals typically remain open with reduced hours. Lab and imaging services stay available for emergency and inpatient needs but usually stop accepting outpatient or routine orders.
What does shut down is everything scheduled and non-urgent: outpatient clinics, elective surgeries, routine imaging appointments, physical therapy sessions, and administrative departments like billing and medical records. If you need to reach someone about insurance verification or a non-urgent referral, you’ll likely get a voicemail on a recognized holiday.
How Holiday Closures Affect ER Volume
When clinics and doctor’s offices close for holidays, more people end up in the emergency department. Research published in the Turkish Journal of Emergency Medicine found that patient volume in emergency departments increases during public holidays specifically because services in other departments are interrupted. People who might otherwise visit their primary care doctor or an outpatient specialist during the week go to the ER instead.
The good news is that longer wait times aren’t guaranteed. The same study found that despite higher patient volumes, overall length of stay in the emergency department didn’t increase during holiday periods. Physicians tended to limit unnecessary testing and specialist consultations during those shifts, keeping things moving. Still, if your concern isn’t a true emergency, urgent care centers (many of which operate on holidays with reduced hours) are often a faster option than the ER on days like Thanksgiving or Christmas.
Holiday Pay for Hospital Staff
If you’re a hospital employee, how you’re compensated for holiday work depends on whether you work for a government or private employer. Federal employees required to work on a holiday receive double their base pay rate (200%) for each hour of holiday work, with a minimum of two hours of holiday premium pay even if the actual work is shorter. This is set by federal law, not employer discretion.
Private hospitals set their own holiday pay policies. Time-and-a-half (150% of base pay) is the most common arrangement for clinical staff working recognized holidays, though some systems offer double time for major holidays like Christmas and Thanksgiving. Others fold holiday compensation into a general “premium pay” structure or give compensatory time off instead of extra money. Union contracts often lock in specific rates, so two nurses at different hospitals in the same city can have very different holiday pay. There is no federal law requiring private employers to pay a premium for holiday work, so everything comes down to your employer’s policy or your collective bargaining agreement.
Planning Around Hospital Holidays
If you have an upcoming procedure or appointment, the practical impact is straightforward. Elective surgeries are almost never scheduled on recognized holidays or the days immediately surrounding them, since support staff and anesthesia teams run on skeleton crews. Outpatient lab work, imaging, and specialist visits will also be unavailable. Most hospitals post their holiday schedule on their website or patient portal, and scheduling departments can confirm closures when you book.
For prescription refills, call your hospital’s pharmacy a few days before any holiday to confirm their hours. Many hospital pharmacies operate on reduced weekend-style hours rather than closing entirely, but retail pharmacies outside the hospital may have different closures. If you rely on time-sensitive medications, planning a day or two ahead avoids a stressful scramble.