We ran risk assessments for 59 health and dental practice owners between October 2025 and April 20261, and we noticed the same kinds of compliance gaps coming up over and over. Our independent research showed that health and dental practices are consistently exposing themselves to compliance risks in documentation, handbooks, and their general understanding of compliance. Most practices we talked to were located in California, land of the strict employment laws, so some of these results were pretty scary.
This is part of an ongoing survey, so if you’d like to check your practice’s compliance risk level, take our five-minute risk assessment here
52.6% Have Outdated Employee Handbooks
44.1% of practice owners have not updated their employee handbooks in over 6 months. 8.5% don’t have one at all. That puts them on thin ice because employment laws change much more often than most people realize… and workers are hesitating less before filing claims. We put out webinars and guides twice a year to cover the most important employment law changes, and honestly, we could probably do them even more often.
To be fair, this means 47.4% of practices have handbooks that have been updated recently. That’s good. We like to see that. But what we don’t like to see is that 28.8% DIY’ed it. We know those handbooks are missing important policies, benefits information, and policies that are unique to their practices.
If you’re among the 8.5% of practices that don’t have an employee handbook at all, we’ll give you a head start: create your free federal employee handbook now.
78% Don’t Provide Enough Onboarding Documentation
That number might sound shocking to you, but it doesn’t surprise us. How many documents do you think a new hire needs? Five? Eight? That’s barely half as many as you really ought to have, and that’s what we call a compliance risk.
On average, we recommend at least 11 documents to cover the federal baseline. Most states are closer to 16+. This includes federal documents like the Form I-9, W-4, and the employment contract, but also information like required state labor law notices, an at-will employment agreement, and your employee handbook.
That’s six documents, which is more than what 44.1% of practice owners are providing their new hires. 33.9% of practices are closer to the mark by providing 5 to 10 onboarding documents, but they’re still missing important details. If you’re in California, we usually recommend 23 documents. Yeah, we know that’s a lot. We make it easy to keep them all organized and current, though.
40.9% Feel Confident in Their Compliance, But Most Make Big Mistakes
22.7% of health and dental practice owners feel totally confident that they’re up to date, aware of changes, and compliant with all HR laws in 2025 and 2026. A further 18.2% are very confident. Well, we can confidently say that the actual level of compliance is not that high.
At least 6.8% of practices aren’t formally tracking employees’ working hours (which is a ginormous compliance risk, especially in California), 16.9% don’t even try to stay up to date on employment laws, and 35.6% handle all of their HR decisions without ever getting professional assistance. Not only is that a risky move… it’s just not necessary.
HR for Health Can Help
Don’t feel too bad if you’re among that 40% of practice owners exposed to major compliance risks. It’s a lot to keep straight, and we know you didn’t open your practice with HR as your top priority. HR for Health was created specifically for practices like yours because we actually understand what makes this industry unique. You take care of the patients, and we’ll give you the resources, the expertise, and the software that makes it all work.
Get a demo to see what makes HR for Health different.
Resource:
- Data on file. HR for Health Risk Assessment. Accessed May 2026.
