On call pay

Your intrepretation is correct, but it doesn't matter, as the rule is bipolar as hell.

If you are "on call on the employer's premises" you are "working while "on call"", and need to be paid for those hours. However, DOL doesn't care what you get paid, they only care that your total income is greater then minimum wage. So long as you are compensated at a rate greater then $7.25 (or your state's minimum wage) when including the overtime calculation, you're going to lose the fight. If you make more then ~$380/week, DOL is satisfied.

Technically speaking, I believe there is case law that would support you being paid your full rate for the on-call working hours, but the hospital can simply adjust your base rate to make the weekly pay work out the same, which ultimately hurts you as now you make less when on legitimate overtime.

You have no options aside from the potentially destructive (union, quit, or "blue flu"). Sorry.

My understanding is that as long as you are afforded a reasonable amount of time to respond, you are not legally entitled to compensation for on call pay. One of my former employers was sued over that very thing and emerged victorious leaving us all sans on call money just because we were allowed 30 minutes to respond. The lawsuit was in Federal court, so I don't know if or how state law factors in, but I'd say your probably screwed if you are in a right to work state.

I would check with the NLRB. If you are required to stay" in hospital" (or on grounds), you should be being paid time and a half (if OT). If you are able to be at home, that's different. In the 80's - 90's I was employed by a hospital that put us (EMS at that time) on a "restricted on call" from 4am - 8am, the NLRB found in our favor and the hospital paid out BIG time for it (we got some GREAT checks for back pay!).