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Massachusetts Administrator & Director of NursesWage & Benefit Update

For

The Massachusetts Chapter of the American College of Health Care Administrators

Notre Dame Healthcare Center

Worcester, Massachusetts

June 23rd,, 2011

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Footnotes

• Facilities are unique in their reporting needs and it is not uncommon to code general ledger items differently, which effects comparison reporting. Many facilities report FTE’s greater than 1.0 for Administrator & Wage Benefit.

• Some organizations may compensate Administrator’s completely or partially through the HCF-3 Management Company cost report.

• Median equals the mid-point of cost reported.

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2009 – 2008 Mass Administrator Salary & Benefits

SalaryHealth

Insurance PensionOther

Benefits TotalPayroll

TaxWorkers

CompPurchase Service

Average

2009 $123,978 $7,856 $1,293 $1,386 $134,513 $9,808 $2,106 $101,033

2008 $117,437 $7,125 $1,851 $901 $127,314 $7,779 $1,015 $100,208

Median

2009 $111,372 $6,915 $414 $233 $118,934 $8,197 $1,069 $74,625

2008 $108,211 $6,575 $733 $67 $115,586 $8,224 $286 $81,607

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2009 – 2008 Mass Administrator Wage & Benefits – Not-for-Profit

SalaryHealth

InsurancePension

Other Benefits

TotalPayroll

TaxWorkers

CompPurchase Service

Average

2009 $117,609 $8,908 $3,109 $1,993 $131,619 $8,027 $762 $156,972

2008 $109,499 $8,144 $4,040 $1,256 $122,939 $6,714 $841 $88,259

Median

2009 $112,101 $7,760 $1,677 $150 $121,688 $8,324 $222 $126,064

2008 $108,647 $8,726 $2,195 $223 $119,791 $7,898 $232 $81,930

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2009 – 2008 Mass Administrator Wage & Benefits – For-Profit

SalaryHealth

InsurancePension

Other Benefits

TotalPayroll

TaxWorkers

CompPurchase Service

Average

2009$124,823 $7,386 $597 $1,152 $133,958 $9,133 $2,591 $88,249

2008$116,320 $6,479 $841 $739 $124,379 $8,076 $1,104 $69,306

Median

2009$111,057 $6,694 $188 $245 $118,184 $8,842 $976 $99,158

2008$107,278 $6,035 $557 $12 $113,882 $8,405 $500 $76,673

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Massachusetts Counties

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2009 Administrator Compensation Average by County

County # of Facilities SalaryHealth

Insurance PensionOther

Benefits TotalPayroll

TaxWorkers

Comp

Barnstable 18 $122,080 $10,201 $1,100 $889 $134,270 $8,420 $2,569

Berkshire 14 $104,363 $9,008 $109 $891 $114,371 $8,425 $2,056

Bristol 31 $119,193 $8,096 $2,638 $1,178 $131,105 $8,557 $3,067

Dukes 1 $228,233 $10,844 $6,831 $2,238 $248,146 $9,948 $273

Essex 48 $112,140 $8,294 $779 $2,463 $123,676 $8,759 $1,506

Franklin 6 $92,381 $10,632 $1,065 $332 $104,410 $7,465 $1,028

Hampden 25 $108,545 $6,253 $935 $1,115 $116,848 $7,869 $1,556

Hampshire 7 $150,553 $6,799 $3,484 $214 $161,050 $8,236 $1,407

Middlesex 69 $139,093 $8,304 $1,234 $2,254 $150,885 $8,913 $1,952

Nantucket 1 $56,686 $4,666 $2 $2 $61,356 $1,521 $109

Norfolk 37 $124,379 $6,155 $1,167 $1,481 $133,182 $9,556 $3,183

Plymouth 26 $111,801 $7,760 $524 $697 $120,782 $8,293 $1,744

Suffolk 26 $127,762 $6,318 $2,308 $1,047 $137,435 $10,432 $1,424

Worcester 44 $115,240 $7,186 $869 $1,580 $124,875 $8,307 $2,183

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Administrator Average Wages & Benefits 2009 vs 2008

County 2009 2008 % Change

Barnstable $122,080 $123,783 -1%

Berkshire $104,363 $90,469 15%

Bristol $119,193 $120,577 -1%

Dukes $228,233 $242,502 -6%

Essex $112,140 $104,426 7%

Franklin $92,381 $85,669 8%

Hampden $108,545 $104,872 4%

Hampshire $150,553 $151,889 -1%

Middlesex $139,093 $136,405 2%

Nantucket $56,686 $73,593 -23%

Norfolk $124,379 $122,416 2%

Plymouth $111,801 $115,513 -3%

Suffolk $127,762 $112,668 13%

Worcester $115,270 $109,521 5%

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2009 - 2008 Average Administrator Salary by County(Salary , Health Ins, Pensions, Other Benefits)

$40,000

$65,000

$90,000

$115,000

$140,000

$165,000

$190,000

$215,000

$240,000

$265,000

2009 2008

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2009-2008 Average Director of Nurses Salary & Benefits

# of Facilities

SalaryHealth

InsurancePension

Other Benefits

TotalPayroll

TaxWorkers

Comp

Average

2009403 $84,020 $5,287 $717 $955 $90,979 $6,862 $1,317

2008365 $91,767 $6,037 $1,070 $844 $108,391 $7,608 $1,533

Median

2009$94,827 $6,064 $369 $299 $101,559 $7,706 $1,400

2008$94,653 $5,877 $460 $303 $100,965 $7,835 $1,419

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2009-2008 Director of Nurses Wage & Benefit for Non-Profit

SalaryHealth

InsurancePension

Other Benefits

TotalPayroll

TaxWorkers

Comp

Average

2009$95,042 $7,522 $1,824 $625 $105,013 $6,920 $1,332

2008$95,434 $7,780 $2,781 $361 $106,356 $7,102 $1,506

Median

2009$93,975 $7,281 $1,197 $274 $102,726 $7,002 $1,375

2008$92,677 $7,088 $1,456 $273 $101,494 $7,108 $1,338

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2009-2008 Director of Nurses Wage & Benefit For Profit

SalaryHealth

InsurancePension

Other Benefits

TotalPayroll

TaxWorkers

Comp

Average

2009$90,951 $5,212 $385 $1,165 $97,713 $7,402 $1,421

2008$91,803 $5,540 $478 $1,010 $98,831 $7,925 $1,564

Median

2009$95,010 $5,552 $242 $302 $101,106 $7,702 $1,400

2008$95,040 $5,736 $312 $325 $101,413 $8,089 $1,428

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2009 Director of Nurses Salary & Benefits by County

County# of

Facilities SalaryHealth

Insurance PensionOther

Benefits TotalPayroll

TaxWorkers

Comp

Dukes 1 $118,968 $17,957 $3,614 $0 $140,539 $8,343 $2,819

Nantucket 1 $120,588 $0 $0 $0 $120,588 $1,670 $105

Norfolk 43 $100,969 $5,073 $650 $453 $107,145 $8,457 $1,588

Suffolk 29 $100,178 $5,124 $1,134 $503 $106,939 $8,176 $1,384

Bristol 37 $91,599 $7,122 $1,621 $341 $100,683 $7,581 $1,692

Worcester 56 $90,681 $5,818 $547 $2,200 $99,246 $7,545 $1,241

Barnstable 18 $86,432 $7,804 $367 $4,435 $99,038 $7,465 $1,724

Essex 49 $89,681 $5,253 $546 $646 $96,126 $7,451 $1,240

Plymouth 33 $90,462 $4,324 $558 $327 $95,671 $7,539 $1,235

Middlesex 82 $88,433 $5,210 $738 $1,279 $95,660 $7,113 $1,522

Hampden 27 $87,019 $5,030 $1,197 $264 $93,510 $6,828 $1,443

Berkshire 14 $82,085 $9,637 $790 $194 $92,706 $6,808 $946

Franklin 6 $81,905 $5,416 $927 $300 $88,548 $6,434 $1,611

Hampshire 6 $80,842 $6,886 $238 $253 $88,219 $6,607 $1,962

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2009-2003 Selected Cost Centers PPD Comparison

Department 2009 2008 2007 2006 2005 2004 2003% Change 2009-2008

Plant 13.34 12.99 12.28 11.95 10.99 9.69 8.86 3%

Dietary/ Dietician 19.98 19.63 18.74 17.36 16.75 15.73 14.77 2%

Laundry 3.47 3.43 3.34 3.25 3.13 2.99 2.84 1%

Housekeeping 6.40 6.36 6.28 6.20 5.92 5.69 5.04 1%

Social Service 4.45 4.32 4.43 4.34 4.01 3.30 3.02 3%

Restorative Therapy 16.47 14.34 12.28 10.34 9.56 8.46 4.81 13%

Recreation 4.80 4.45 4.22 3.94 3.68 3.52 2.96 7%

Administrator 4.23 4.09 3.36 3.26 3.10 3.02 2.52 3%

Officer 0.22 0.17 0.13 0.03 0.13 0.10 0.24 23%

Clerical 7.27 6.75 6.43 6.09 5.67 5.65 4.04 7%

Director of Nurses 3.69 3.70 2.86 2.63 2.45 2.56 2.34 0%

RN's 21.89 20.26 20.39 20.22 19.47 19.02 16.89 7%

LPN's 30.13 29.91 28.57 26.82 24.47 21.64 16.83 1%

CNA's 44.36 44.60 43.74 42.93 41.38 40.48 33.54 -1%

DON/RN's P/S 1.65 1.37 0.89 1.17 1.61 2.03 1.84 17%

LPN's P/S 1.47 2.21 1.50 1.61 2.19 2.39 2.03 -50%

CNA's P/S 1.40 1.57 0.52 0.37 0.39 0.35 0.44 -12%

QA Nurse 1.40 1.19 0.41 0.40 0.40 0.36 0.48 15%

Ward Clerks 2.26 2.32 2.37 2.08 2.03 1.80 1.68 -3%

MMQ 1.65 1.50 1.07 1.01 0.98 0.95 0.91 9%

Staff Development 2.01 1.93 1.50 1.36 1.28 1.32 1.00 4%

MDS Nurse 3.62 3.20 2.86 2.55 2.21 1.69 12%

Total 196.16 190.29 178.17 169.91 161.80 152.74 127.08 3%

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2010-2003 Selected Cost Centers PPD Comparison(* 2010 based on 191 Mass Facilities)

Department 2010* 2009 2008 2007 2006 2005 2004 2003% Change 2010-2009

Plant 12.99 13.34 12.99 12.28 11.95 10.99 9.69 8.86 -3%

Dietary/ Dietician 20.49 19.98 19.63 18.74 17.36 16.75 15.73 14.77 2%

Laundry 3.56 3.47 3.43 3.34 3.25 3.13 2.99 2.84 3%

Housekeeping 6.34 6.40 6.36 6.28 6.20 5.92 5.69 5.04 -1%

Social Service 5.43 4.45 4.32 4.43 4.34 4.01 3.30 3.02 18%

Restorative Therapy 14.82 16.47 14.34 12.28 10.34 9.56 8.46 4.81 -11%

Recreation 5.20 4.80 4.45 4.22 3.94 3.68 3.52 2.96 8%

Administrator 4.43 4.23 4.09 3.36 3.26 3.10 3.02 2.52 5%

Officer 0.29 0.22 0.17 0.13 0.03 0.13 0.10 0.24 24%

Clerical 6.36 7.27 6.75 6.43 6.09 5.67 5.65 4.04 -14%

Director of Nurses 3.76 3.69 3.70 2.86 2.63 2.45 2.56 2.34 2%

RN's 22.23 21.89 20.26 20.39 20.22 19.47 19.02 16.89 2%

LPN's 29.16 30.13 29.91 28.57 26.82 24.47 21.64 16.83 -3%

CNA's 43.97 44.36 44.60 43.74 42.93 41.38 40.48 33.54 -1%

DON/RN's P/S 1.72 1.65 1.37 0.89 1.17 1.61 2.03 1.84 4%

LPN's P/S 1.02 1.47 2.21 1.50 1.61 2.19 2.39 2.03 -44%

CNA's P/S 1.23 1.40 1.57 0.52 0.37 0.39 0.35 0.44 -14%

QA Nurse 1.35 1.40 1.19 0.41 0.40 0.40 0.36 0.48 -4%

Ward Clerks 2.56 2.26 2.32 2.37 2.08 2.03 1.80 1.68 12%

MMQ 1.62 1.65 1.50 1.07 1.01 0.98 0.95 0.91 -2%

Staff Development 1.91 2.01 1.93 1.50 1.36 1.28 1.32 1.00 -5%

MDS Nurse 3.63 3.62 3.20 2.86 2.55 2.21 1.69 0%

Total 194.07 196.16 190.29 178.17 169.91 161.80 152.74 127.08 -1%

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LarsonAllen LLP – BackgroundCPAs, Consultants & Advisors

History and experience

LarsonAllen is one of the top 20 accounting firms in the nation, according to Accounting Today. We provide assurance, accounting, tax consulting, and advisory services to organizations and individuals managing business ventures and finance. Founded in 1953, LarsonAllen is dedicated to creating a noticeably different experience for our clients.

We provide our clients with industry specialists and high quality business resources. With approximately 1,800 people and more than 40 locations, we have significant depth and talent, experience, and national perspective. LarsonAllen is an independent member of Nexia International, a top 10 worldwide organization providing global connections.

Our mission – Create a noticeable different client experience.

We serve our clients with quality and integrity and meet their needs through a primary advisor relationship. We stress open communication, efficiency, and a relationship grounded in fairness and trust as your accountants, consultants, and advisors.

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LarsonAllen LLP Offices

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Profile ---- Richard Hamilton, CNHA, R.Ph., MBA Principal

• Rick has extensive experience in entitlement, clinical coverage, documentation, billing, audit triggers, and managed care contracting. His specialties include operational strategies maximizing reimbursement and implementing compliance programs.

• Experience in serving clients• Rick has over 25 years of health care experience including long term care operations, administration,

planning and organizing new senior care programs in housing, assisted living, adult day health care, medical model clinics and long term care pharmacy services.

• Technical expertise• Rick’s focus in on regulatory compliance and maximizing operational reimbursement for long term care

organizations. His SNF consulting expertise frequently focuses on benchmark comparisons, operational reviews, survey preparation and assistance, third party reimbursement issues, litigation support, clinical reimbursement appeals, pharmacy pricing analyses and rehabilitation services.

• Educational / professional involvement• Rick holds a Master in Business Administration from Suffolk University, Boston, MA, a Bachelor of

Science Degree in Pharmacy from the Massachusetts College of Pharmacy, Boston, MA, and an Associate Degree in Nursing Home Administration from Northern Essex Community College in Haverhill, MA. He is a Certified Nursing Home Administrator, Fellow of the American College of Health Care Administrators (ACHCA), past Massachusetts Chapter President and a Registered Pharmacist. His professional affiliations include Board Member of the Massachusetts Long Term Care Finance Association (LTCFA) and memberships in the American Society of Consultant Pharmacists (ASCP) and Massachusetts Chapter of the American Medical Directors Association (MAMDA).  A frequent speaker, Rick actively participates and supports state and regional associations and presents from a unique perspective integrating his clinical, operational and fiscal backgrounds.

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