TH ANNUAL SALARY SURVEY Are You Overworked and … · (includes any bonus and overtime pay) (income...

JA N U A RY 2010 | OU T PAT I E N T SU R G E RY MA G A Z I N E 3 1

7 T H A N N U A L S A L A R Y S U R V E Y

What They Make What They Think They Ought to Make

$80,001 to $90,000 19.6% $100,714

more than $110,000 17.4% $151,400

$90,001 to $100,000 17.1% $112,959

$70,001 to $80,000 13.3% $92,949

$100,001 to $110,000 12.2% $121,000

$60,001 to $70,000 9.1% $89,167

less than $50,000 6.6% $85,625

$50,001 to $60,000 4.5% $91,364

(includes any bonus and overtime pay) (income n=286; desired salaries n=280)

ASC Administrators’ 2009 Salaries

What They Make What They Think They Ought to Make

$90,001 to $100,000 21% $110,862

$70,001 to $80,000 17.4% $95,870

$60,001 to $70,000 15.2% $87,000

$80,001 to $90,000 13% $103,889

$100,001 to $110,000 11.6% $128,333

more than $110,000 10.2% $145,625

less than $50,000 5.8% $91,250

$50,001 to $60,000 4.3% $85,000

(includes any bonus and overtime pay) (income n=138; desired salary n=135)

HOPD Administrators’ 2009 Salaries

Join the club. According to our 7th annual salary survey, surgicaladministrators believe they’re worth a lot more than they’re making.

Irene Tsikitas | Associate Editor

Are You Overworked and Underpaid?During the typical 8-to-5 workday,

Emilie Keene, MHA, administratorof Parkridge Surgery Center in

Columbia, S.C., spends the bulk of hertime attending to what she calls “immedi-ate issues” — conference calls, meetings,employee- and patient-related concerns,and anything else that comes across thethreshold of her always-open office door.When the lights go out in the clinical areasand the rest of the staff leaves for the day,Ms. Keene returns to her desk and beginsattending to the mounting piles of regula-tory paperwork, unread e-mails and finan-cial invoices vying for her attention. Whenshe finally closes up shop and heads homefor the day, she knows that whatever dentshe’s made in the workload will probablybe refilled by the time 5 o’clock rollsaround tomorrow.

LABOR OF LOVE “Although I love my job and I love my profession,I definitely feel underpaid and underappreciated,” says Emilie Keene,MHA, administrator of Parkridge Surgery Center in Columbia, S.C.

Sound familiar? “Unless you actually work in a position such as thisfrom day to day,” says Ms. Keene, “it’s impossible to appreciate whatadministrators really do: The extra hours that are worked, the con-stant fires that are put out, continuously ensuring new regulations arefollowed — which happensmore now than ever before —and the many, many hats thatare expected to be worn at anygiven time. Although I love myjob and I love my profession, Idefinitely feel underpaid andunderappreciated.”

She’s in good company,according to the results of our7th annual salary survey, inwhich 54.5% of respondents(291 [35%] from ambulatorysurgery centers and 138 [23%]from hospitals) said they don’t feel they’re fairly compensated for thework they do and another 8.6% said they’re only somewhat satisfiedwith their compensation. One-third of respondents in both groups saidtheir pre-tax annual income didn’t change from 2008 to 2009; 10.5% ofASC administrators and 5% of HOPD administrators actually saw adecrease in pay over that time period. Meanwhile, many indicated thatmounting regulatory burdens and the added pressure of keeping busi-ness afloat during an economic recession have only made their jobsmore difficult.

Putting the job in perspectiveReading the job description of the typical ASC administrator, one getsthe mental image of a 1-man band: trumpet in his left hand, guitar inhis right, a drum strapped to his back and a harmonica dangling fromhis neck. Whereas a small business of a comparable size to an ASCmight have separate management positions for people in charge ofhuman resources, marketing, legal and regulatory issues, inventoryand accounting, surgical administrators are often expected to juggle— or at least oversee — all of these duties simultaneously. In manycases, they’re also expected to help out in clinical areas, too.

“As administrator, I probably spend about 50% of my time in clinicdoing direct patient care, then I have to do payroll, QA studies andanalysis, incident reports … and human resources,” says a surgicalnurse administrator at a small, physician-owned ASC in Minnesota.Even in areas where the duties have been delegated, she still has tomaintain an oversight role. “And yet, my salary reflects that of a highlypaid staff nurse and doesn’t take into account my administrative role.”

3 2 OU T PAT I E N T SU R G E RY MA G A Z I N E | JA N U A RY 2010


What HOPD Administrators And Their Staffs Make

What ASC Administrators And Their Staffs Make

Administrator $91,015Director of nursing $72,282OR manager/supervisor $63,907Pre-op nurse $60,483OR nurse $62,334Recovery nurse $61,795LPN $37,689OR tech $39,876CRNA $161,567Nursing assistant/orderly $28,172Housekeeper $26,275Materials manager $45,476Radiology tech $42,423Instrument tech $30,854Reprocessing tech $35,049Business manager $54,113Coder/biller $36,400Scheduler $33,479Receptionist $30,063Collector $34,214(n=286)

Administrator $217,065 Director of nursing $119,443 OR manager/supervisor $86,695Pre-op nurse $64,596OR nurse $65,655Recovery nurse $65,450LPN $40,017OR tech $40,455CRNA $190,456Nursing assistant/orderly $27,739Housekeeper $23,091Materials manager $58,884Instrument tech $26,856Reprocessing tech $31,349Scheduler $34,298Receptionist $29,197(n=138)

AFTER HOURS The average administrator’s salary doesn’t take into account the extra hours spent dealing withincreasing regulatory and financial burdens, says Ms. Keene.

a center don’t understand the differ-ence between how ASCs operateand how hospitals operate. “Wedon’t have all those ancillarydepartments” to take care ofthings like maintenanceand risk management.

Meanwhile, adminis-trators are all too famil-iar with how the work-load is distributed —and how the money is,too. “The people I meet atconferences are all prettymuch happy in their job,”says Greg DeConciliis, PA-C,administrator of Boston Out-patientSurgical Suites. “The big thing is, we haveintimate knowledge of the center’s profitability and

what the owners are makingand what some of our staffmembers are making. That’swhat drives the frustration.”He notes that, particularly inlarge metropolitan areas,

nurses’ salaries are on the rise,so it’s possible that an ASC

could have a nurse on staff who’smaking $110,000 working 40 hours

a week, but if you calculate theadministrator’s hourly wage, it comes out

to a lesser amount despite the greater degreeof responsibility that comes with the job.

RemainedRemainedthe samethe same

33%33%

Reduction Reduction 5.1%5.1%+1%+1%

6.6%6.6%

+2%+2%17.6%17.6%

+3%+3%22.8%22.8%

+4%+4%5.9%5.9%

More than +5%More than +5% – 2.1%– 2.1%(n=136)

Percent Change in HOPD Administrators’ Salaries in 2009

+5%+5%6.6%6.6%

A Nebraska surgery center’s director of nursingsays her workload increased significantly when shemoved from the hospital to the ASC setting. “Iworked at a hospital for about 16years as the OR director, and we had alot of outside resources. Here wedon’t — I wear all those hats,”she explains, naming infectioncontrol, risk management,quality improvement, cre-dentialing and personnelas just some of her dutiesthat lie outside of thenursing realm. “ASCs arejust a lot tighter onstaffing, so you can’t justdelegate everything.”

It’s become something ofa cliché to say that ASCadministrators are expected towear many hats, but according toour survey responses, this characteriza-tion is rather accurate. It’s becoming increasinglytrue of leaders on the hospital side, too. “Not only doI manage 25 FTEs, I also am called upon to performclinical skills,” says Mary R. Peeters, RN, BSN, peri-operative services manager for St. Joseph’s AreaHealth Services in Park Rapids, Minn. “I assist,scrub, circulate, recover, admit and dischargepatients, so I am out of my office frequently, helpingout.” Several hospital-based respondents said that bytaking on management roles and moving to salariedpositions, they lost the opportunity to earn moneyfor the extra hours they spend on call. “I am salaried

as supervisor of the outpatient surgery,” says KarenHausteen, RN, of Hi-Desert Medical Center inJoshua Tree, Calif. “I’m also an RNFA and take half

the call for that role withoutextra compensation for theon-call status and the call-backs.” Explains anotherHOPD supervisor: “My staffnurses are paid $6 an hour for

call. I am salaried and take callwithout compensation. At the

end of the year, the staff nursesgenerally take home more than me.”

Financials foster frustrationWhile Ms. Keene has nothing but praise for thephysician-owners of her center, she admits that shedoesn’t think “they realize exactly how much workadministrators put into the day-to-day operations”of the typical ASC. “It seems one of the problems isthere’s not a good definition or description of theroles,” agrees the clinical manager of a physician-owned ASC in Philadelphia. “When our former clini-cal manager resigned,” she recalls, “a question fromone of the surgeons was, ‘Why do you have toreplace her?’” She speculates that physicians whoaren’t heavily involved in the day-to-day operations of



2010 Salary Survey Results At a GlanceThe average ASC administrator: The average HOPD surgical services director:Manages 10 to 25 full-time equivalents Manages 20 to 50 full-time equivalentsCommands a $3 to $5 million budget Commands a $5 to $9 million budgetSpends about 48 hours a week on the job Spends about 50 hours a week on the jobMade $91,015 in Made about $217,065 (administrator),pre-tax annual income in 2009 $119,443 (director of nursing), $86,695 (OR manager)

in pre-tax annual income in 2009Received a bonus or was eligible to in 2009 (32.6% did not). Did not receive a bonus in 2009 (29.7% did).

RemainedRemainedthe samethe same

33%33%

Reduction Reduction 10.5%10.5%

+1%+1%5.4%5.4%

+2%+2%15.2%15.2%

+3%+3%12%12%

+4%+4%9.4%9.4%

+5% to +10%+5% to +10% – 10.5%– 10.5%

More than +10%More than +10% – 4%– 4%(n=276)

Percent Change in ASC Administrators’ Salaries in 2009

nity to earn bonuses when theyperform well and contribute togrowing the facility’s bottomline, especially in this tougheconomy. “As an owner, whywouldn’t you incentivize that?”asks Mr. DeConciliis. “If you paythem a straight salary, there’s noincentive to make the businessbetter or worse, to squeezeevery penny out of things.”

A quarterly bonus structureawarded across the board foradvances in productivity and cost-containment at the Plastic Surgical Center ofRapid City, S.D., keeps both Director ColetteKlein, RN, and her staff satisfied. “If there are dis-persements made to the physicians, a certain per-centage” is allocated for staff bonuses, which are

divided evenly among the staff, from the receptiondesk to the OR to the back office. “It’s very impor-tant to our physicians to recognize the staff and

Are You Fairly Compensated for the Work That You Do?

ASC34.7%

Hospital23.2% ASC

48.5%Hospital65.7% ASC

9.4%Hospital7.1%

YYeses

SomewhatSomewhatNoNo

(ASC results n=202;

HOPD results n=99)

A tough year all aroundSeveral survey respondents were reluctant to gripeabout their compensation packages at a time whenmany Americans are facing layoffs. “I’m very fortu-nate to have a job in the current economy and thank-ful for the salary!” wrote an administrator. Anotherwas less thankful than resigned to reality: “In theseeconomic times, you take what you can get.”

But in more than one instance, respondentsexpressed frustration that they’d endured salaryfreezes or taken pay cuts, only to have to worktwice as hard to keep the business — and staffmorale — afloat. “Our center is a very profitableand stable center even in these bad economictimes,” says the administrator of a surgery center inSt. Louis. “I work very hard at every aspect toensure a profitable and high-quality center,” and yet,she says, her salary is 23% below the average for herregion. Stuart Katz, MBA, CASC, FACHE, executivedirector of Tucson Orthopaedic Surgery Center,says he’s taken a reduction in pay because of theeconomic downturn, even as he’s “worked harderfor an increased financial bottom line.”

In addition to taking paycuts themselves, some admin-istrators note that salaryfreezes are stoking discontentamong staff, which makesmanaging them that muchharder. “It’s one of the reasonsemployees grumble,” says anASC director of nursing inCalifornia, who adds that whilethe owners of his center use

the economy as an “excuse”for not giving raises over thepast year, he’s not complete-ly buying it. “I do tend to seewhat goes through thisplace, and considering that,it seems to me they couldcompensate their employeesa little better.”

On top of the economicstrains, administrators also

say they’re being squeezed by increasing regulatoryburdens, particularly the new Medicare Conditionsfor Coverage enacted for ASCs last year. “The newinfection control regulations that came out for ASCshave been huge. We now have to designate an infec-tion control person, and that person has to haveofficial training,” says an ASC nurse manager inMissouri. “The CMS requirements pile up every day,and it’s hard to keep up.”

The other side of the coinNot all of you are dissatisfied with the compensationyou receive. According to the survey results, 56.5%of ASC administrators saw their salaries increase byat least 1% from 2008 to 2009, and 57% were eligibleto or did receive a 2009 bonus. On the hospital side,61.6% said their salaries went up at least 1% in 2009,although a much smaller percentage — just 29.7% —received or were eligible for a bonus. Plenty of sur-vey respondents enthusiastically praised theiremployers for being generous with pay and benefits.

• Bonuses should be tied to performanceand profit. Administrators appreciate the opportu-



Didn’t receive a bonusDidn’t receive a bonus – – 25.1%25.1%Less than $1,000Less than $1,000 – – 12.8%12.8%$1,001 to $2,500$1,001 to $2,500 – – 12.8%12.8%$2,501 to $5,000 $2,501 to $5,000 – – 17.6%17.6%

$5,001 to $10,000$5,001 to $10,000 – – 12.8%12.8%$10,001 to $15,000$10,001 to $15,000 – – 8.8%8.8%$15,001 to $20,000$15,001 to $20,000 – – 4.4%4.4%more than $20,000 more than $20,000 – – 5.7%5.7%

ASC Administrators’ 2009 Bonuses

(n=227)

Didn’t receive a bonusDidn’t receive a bonus – 55.9%– 55.9%Less than $1,000Less than $1,000 – – 14%14%$1,001 to $2,500$1,001 to $2,500 – – 7.5%7.5%$2,501 to $5,000$2,501 to $5,000 – – 6.5%6.5%

$5,001 to $10,000$5,001 to $10,000 – – 8.6%8.6%$10,001 to $15,000$10,001 to $15,000 – – 4.3%4.3%$15,001 to $20,000$15,001 to $20,000 – – 3.2%3.2%

HOPD Administrators’ 2009 Bonuses

(n=93)

as some of the reasons they feel satisfied withwhat they make. “I am respected and compliment-ed on successes,” says Diane M. Elmore, RN,administrator of the Metro Surgery Center inPhoenix, Ariz. In contrast, many HOPD respon-dents said they don’t receive enough recognitionand appreciation for the extra hours they put in oncall or doing administrative tasks.

Not just about the moneyConsidering the hours spent onthe job, the headaches and frustra-tions that come with it, and thedissatisfaction many of youexpress with the salary youreceive in return, it’s clear thatvery few, if any, surgical adminis-trators are in it purely for themoney. Indeed, many of you sug-gest the job is something of a

labor of love — one you wouldn’t necessarily trade,even for the higher salary you could get doing com-parable work in a different industry. “I love my job.I love the ambulatory surgery industry,” admits Ms.Keene. “As soon as I landed the job here, I knew Ididn’t want to be anywhere else.” OSM

E-mail [email protected].

PPaatient satient satisfaction scores tisfaction scores – – 65.5%65.5%FFacility’acility’s profitss profits – – 52.7%52.7%

FFinancial benchmarks achieved inancial benchmarks achieved – – 47.3%47.3%Clinical outcomesClinical outcomes – – 45.5%45.5%

OtherOther – – 36.4%36.4%Physician saPhysician satisfaction scorestisfaction scores – – 29.1%29.1%

Case volumeCase volume – – 25.5%25.5%Case costsCase costs – – 20.0%20.0%

On What Were Bonuses to HOPD Administrators Based?

(n=55; respondents could check all that applied)

what they do,” says Ms. Klein. When owners sharethe wealth of the facility, it also helps eliminatethe resentment that comes when administratorssee physicians lining their own pockets whileslashing staff salaries and bonuses.

• Benefits are a big plus. Satisfied surveyrespondents frequently touted the added perksthey receive, like generous health benefits, over-

time pay, vacation time and401(k) plans (“The match isincredible,” raved one adminis-trator). While Ms. Hausteenlaments not being eligible forextra pay when she takes call ather hospital, she says she’sthankful her employers let hertake comp time to make up forthe extra hours she works.Several dissatisfied respon-

dents, on the other hand, said they weren’t ade-quately compensated for the time they spent fillingin for staff when needed, attending conferencesand training sessions, and even lobbying lawmak-ers on behalf of the industry.

• A little appreciation goes a long way. ASCadministrators, in particular, cited pleasant work-ing conditions and appreciative physician-owners


Project6 6/17/09 10:40 AM Page 1


ASC profitsASC profits – – 60.8%60.8%FFinancial benchmarks achievedinancial benchmarks achieved – – 44.0%44.0%

PPaatient satient satisfaction scorestisfaction scores – – 35.4%35.4%Physician saPhysician satisfaction scorestisfaction scores – – 32.5%32.5%

OtherOther – – 29.7%29.7%Clinical outcomesClinical outcomes – – 28.2%28.2%

Case volumeCase volume – – 28.2%28.2%Case costsCase costs – – 26.3%26.3%

On What Were Bonuses to ASC Administrators Based?

(n=209; respondents could check all that applied)

TH ANNUAL SALARY SURVEY Are You Overworked and … · (includes any bonus and overtime pay) (income...

Documents

Transcript of TH ANNUAL SALARY SURVEY Are You Overworked and … · (includes any bonus and overtime pay) (income...