Salary Survey
Modest salary increases continue for rehab professionals
Outpatient facilities moving toward flexible schedules
As any physical therapist can tell you, these are not the halcyon days of high salaries, sign-on bonuses, and other perks known in the 1990s.
While salaries remain high for rehab administrators and directors, who are the main reader respondents to Rehab Continuum Report’s 2000 salary survey, industry experts predict salaries will level out in coming years. (See annual gross income chart.)
Annual Gross Income
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"At the managerial level in the hospital, traditionally they don’t cut people’s salaries, they freeze them," says Nancy Beckley, MS, MBA, president of Bloomingdale Consulting Group, a health consulting firm in Valrico, FL.
The Rehab Continuum Report salary survey indicates that salaries have mostly increased for respondents. Only 2.9% reported a salary decrease, and 14.7% reported no change in salary. The majority, 41.2%, said their salary increased between 4% and 6% in the past 12 months. (See chart on salary changes.)
How Has Your Salary Changed in the Past Year?
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Beckley says that even hospitals that gave staff hearty raises in the past year probably were making up for a couple of years in which salaries remained flat.
Also, hospitals have found other ways to cut costs, including tightening or eliminating budgets for business travel and discontinuing education expenses and seminars. In a recent study Beckley did of attendees at her company’s educational seminars, called Rehabilitation Seminars of Tampa, FL, she found that 95% of attendees paid by personal check or credit card, whereas five years ago, 85% were sent by their company.
To save money, some facilities are having staff earn their continuing education units through tele-classes or home study courses. Even so, hospitals are in a better position to withstand all of the changes the Balanced Budget Act (BBA) of 1997 forced on rehab and other industries.
Outpatient and freestanding rehab facilities have had more difficulty. These businesses have had to cut staff and in some cases salaries, Beckley says. They might make these changes by redefining certain positions and turning full-time therapy jobs into as-needed positions.
"In outpatient rehab there are more people working on a per diem basis or some type of flexible hourly schedule," Beckley says. "So if there are only 25 hours of therapy scheduled that week, they’ll provide only 25 hours of therapy."
Further, the therapy professions are only now beginning to rebound from the job losses and salary cuts put into motion by the BBA. "When the BBA came into effect it sent the rehab world into a tizzy, especially in skilled nursing facilities," recalls Bill Munley, MHSA, CRA, administrator of rehab/neuro/ortho services for Bon Secours St. Francis Health System in Greenville, SC.
"Many companies were laying off physical therapists and physical therapy assistants, which before that was unheard of," Munley says. "Then all of a sudden there was a glut of therapists out there, whereas in the past we couldn’t even get them without using agencies and sign-on bonuses."
Munley speculates that nursing facility, rehab, and other businesses probably laid off too many PTs, and now the demand has returned as nursing facilities are again hiring PTs.
Bon Secours St. Francis handled the salary issue differently than some rehab facilities, which simply cut PT wages. "Instead of taking a therapist making $22 per hour and saying, You now make $18 an hour,’ what we did was lower the range," Munley explains. "A therapist out of school may come in at $17 per hour instead of $18, and the cap might be $25 per hour instead of $26 per hour."
The rehab facility wanted to reward therapists who were loyal and stayed with the hospital when they could have chosen a higher-paying job, he adds.
The salary survey suggests that while the rehab industry has continued to cut jobs fairly significantly, there is an even bigger trend of adding new positions. (See chart on how the number of employees has changed in the past year.)
How Has Your Staff Size Changed?
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Rehab facilities are being affected by the nationwide nursing shortage, which is another indication that times are changing.
"I think it goes in cycles where every five years we either have a glut of nurses or we can’t find a nurse," Munley says. "But this is the worse shortage I’ve seen since I’ve been in the health care field."
The Greenville area has 1.5% unemployment, which particularly hurts a rehab facility’s ability to hire nursing assistants, he adds. "Anybody can stand behind the counter of a department store and say, "Do you like this perfume?’ and make 50% more than a nursing assistant."
The Greenville facility has begun to hire more LPNs, with wages in the $11-$12 range, since RNs, starting at $15/hour, are so difficult to find.
The challenge many rehab facilities are facing is to maintain the same level of quality that skilled RNs bring to patients when reimbursement issues and recruitment problems make it difficult to staff a facility adequately. "Patients still expect the same level of service as 15 years ago, and it just doesn’t happen because the nursing-to-patient ratio has deteriorated," Munley notes. "Nurses are frazzled, and nursing assistants you can’t get because you can’t pay them enough."
Support staff also have been cut in many rehab facilities and hospitals, although the solution to preventing these cutbacks is simple, Munley says. "My philosophy is that the best way to cut costs is to increase volume, the more volume you do the more you’re just using incremental costs and you’ll not have to cut support staff."
Another area that hospital-based rehab facilities have been cutting back is in marketing, Beckley says. The hospitals are either cutting the rehab marketing altogether or combining it with the hospital’s own marketing department, she adds.
How Many Beds Does Your Facility Have?
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