How much an ambulatory surgery center pays its employees depends on various factors, including center location and amount of revenue, presence of bonuses and incentives and movement of compensation across the industry. Here are five questions every ASC should ask to help determine appropriate employee salaries.
1. Where are you located?
Physical location and presence of competing facilities plays a large role in determining employee salaries at a surgery center. If a center is located in a community with several competing surgery centers, the ASC will likely have to set its wages at the same level as the other facilities to ensure robust recruitment and retention. If the ASC is located in the same community as a hospital, matching salaries may be more difficult. Most surgery centers would struggle to offer salaries that compete with a local hospital or health system, but ASCs that pay significantly less than the local hospital may risk losing staff members.
In situations where the ASC must compete with a hospital, many surgery center administrators advise touting the surgery center's other benefits in lieu of providing competitive salaries. ASC staff members have holidays and weekends off and generally leave the center in the afternoon, rather than working late hours and coming in on Saturdays. Surgery centers often provide a more tight-knit atmosphere and a less bureaucratic structure for employees with suggestions or requests.
Geographic location also plays a role in compensation, according to data from VMG Health's 2010 Multi-Specialty ASC Intellimarker. According to the survey, staff members in surgery centers in the Western United States (defined as California, Oregon, Washington, Idaho, Nevada, Montana, Wyoming, Utah and Arizona) make more than staff members in any other area of the country, at an average of $29.01 for all staff members. Here is a breakdown of nurse, tech and administrative staff salaries in different areas of the country:
Nurse staff
West: $35.33
Southwest: $31.34
Midwest: $27.51
Southeast: $29. 36
Northeast: $31.32
Tech staff
West: $22.24
Southwest: $19.33
Midwest: $18.38
Southeast: $18.84
Northeast: $20.34
Administrative staff
West: $24.21
Southwest: $21.30
Midwest: $21.62
Southeast: $22.96
Northeast: $24.15
2. Will you offer bonuses to employees?
Some surgery center administrators choose to offer bonuses to staff members to incentivize and reward hard work. According to the ASC Association's 2010 ASC Employee Salary & Benefits Survey, the majority of managers are eligible for bonuses:
• Administrators – 75 percent
• Business office managers – 63 percent
• Directors of nursing – 64 percent
• Materials managers – 53 percent
The way a bonus is determined will affect how much the employee is paid in total compensation. For example, some surgery centers choose to distribute bonuses based on a percentage of total profits at the end of the year, meaning employees benefit if the center succeeds financially. Others put a certain percentage of the manager or employee's salary "at risk," so total possible compensation is determined at the beginning of the year but only a certain amount is guaranteed unless goals are met. It makes sense to gauge how bonuses will affect an employee's total compensation to make sure your ASC is paying a competitive salary without going over budget on staffing costs.
3. How is industry-wide compensation changing over time?
Make sure your center keeps an eye on industry trends to make sure your salaries are still competitive. Average compensation for a nurse in 1999 is likely to be significantly different from compensation in 2010, so stay updated on current salary reports. For example, registered nurse salaries increased 1.1 percent in 2010 over 2009 to a median salary of $60,500, while salaries for business office managers, anesthesiologists, instrument technicians and operating room technicians stayed constant, according to the ASC Association salary survey.
For most ASC positions, 2009 salaries saw a jump from the previous year. Operating room technicians saw their salaries increase from an average of $38,230 annually to $40,000 annually, while licensed practice nurses increased from $37,958 to $39,500 and receptionists/admitting clerks increased from $27,560 to $28,662. The only salaries to decrease in 2010 were medical director salaries, which dropped four percent to a median salary of $28,800.
These changes — mostly ranging from 1-4 percent — may not seem significant, but they add up over time. In addition, a new nurse faced with a $2,000 higher salary at another facility is likely to choose employment elsewhere unless you can provide an outstanding rationale for your compensation decision.
4. How much revenue do you bring in?
When benchmarking your center against other centers across the country, make sure to look at centers with similar revenue streams. If your ASC has two operating rooms and net revenue of $4,000, you are unlikely to offer the same salaries as a seven-OR center with significantly higher revenue. According to VMG Health's survey, ASCs with more than $6.99 million in annual net revenue pay their employees an average of $26.60 per hour, compared to $25.81 per hour for ASCs with less than $4.5 million in net revenue. Nurses in ASCs with greater revenue make significantly more per hour than nurses in less profitable centers, at $31.65 per hour compared to $29.82 per hour.
No matter how your ASC compares to other centers across the country, your salary costs should always fit your budget. If your revenue is down, you may have to explain to employees that bonuses must be eliminated or salaries must be frozen while efforts are made to increase profits. If net revenue is down in your area because of decreased reimbursement or other issues, you may find that other local surgery centers are experiencing similar issues and are limiting their compensation as well.
5. How will you reward credentials?
It is important to establish how you intend to compensate employees for coming to the center with certain credentials. You want pay to be fair and equitable across the center, which means rewarding employees with similar education levels and credentialing in a similar manner. Some positions have various credentials and certifications associated with their roles that are compensated differently across the healthcare system. For example, registered nurses with critical care certifications can earn up to $32.88, while registered nurses with advanced cardiac life support certifications generally top out at $31.86 per hour, according to data from PayScale. Basic life support certification can earn nurses from $21.56-$29.56 per hour, while nurses with CPR certification can earn from $22.20-$30.76.
Coders are also compensated differently depending on credentials. The American Association of Professional Coders examined average coding salaries for 16 different coding credentials and found that salaries differed significantly based on credential. Statistics on salaries for employees with the job title "coder," divided by credential, are listed below:
CPC-A: $32,792
CPC: $39,953
CPC-H: $42,930
CPC-P: $45,750
CPC-1: $50,543
CASCC: $41,591
CANPC: $41,574
CCC: $40,250
CEDC: $50,000
CEMC: $45,000
CGSC: $42,500
CHONC: $35,357
COBGC: $43,690
COSC: $41,912
CIRCC: $45,595
CPMA: $42,937
The examples of registered nurses and coders indicate that different credentials demand different levels of compensation. Be aware that employees who come into the center with higher education, certification or credentialing may expect more than the industry average, and make sure your center pays consistently to avoid staff dissatisfaction and turnover.
Read more on VMG Health, the ASC Association and AAPC.
1. Where are you located?
Physical location and presence of competing facilities plays a large role in determining employee salaries at a surgery center. If a center is located in a community with several competing surgery centers, the ASC will likely have to set its wages at the same level as the other facilities to ensure robust recruitment and retention. If the ASC is located in the same community as a hospital, matching salaries may be more difficult. Most surgery centers would struggle to offer salaries that compete with a local hospital or health system, but ASCs that pay significantly less than the local hospital may risk losing staff members.
In situations where the ASC must compete with a hospital, many surgery center administrators advise touting the surgery center's other benefits in lieu of providing competitive salaries. ASC staff members have holidays and weekends off and generally leave the center in the afternoon, rather than working late hours and coming in on Saturdays. Surgery centers often provide a more tight-knit atmosphere and a less bureaucratic structure for employees with suggestions or requests.
Geographic location also plays a role in compensation, according to data from VMG Health's 2010 Multi-Specialty ASC Intellimarker. According to the survey, staff members in surgery centers in the Western United States (defined as California, Oregon, Washington, Idaho, Nevada, Montana, Wyoming, Utah and Arizona) make more than staff members in any other area of the country, at an average of $29.01 for all staff members. Here is a breakdown of nurse, tech and administrative staff salaries in different areas of the country:
Nurse staff
West: $35.33
Southwest: $31.34
Midwest: $27.51
Southeast: $29. 36
Northeast: $31.32
Tech staff
West: $22.24
Southwest: $19.33
Midwest: $18.38
Southeast: $18.84
Northeast: $20.34
Administrative staff
West: $24.21
Southwest: $21.30
Midwest: $21.62
Southeast: $22.96
Northeast: $24.15
2. Will you offer bonuses to employees?
Some surgery center administrators choose to offer bonuses to staff members to incentivize and reward hard work. According to the ASC Association's 2010 ASC Employee Salary & Benefits Survey, the majority of managers are eligible for bonuses:
• Administrators – 75 percent
• Business office managers – 63 percent
• Directors of nursing – 64 percent
• Materials managers – 53 percent
The way a bonus is determined will affect how much the employee is paid in total compensation. For example, some surgery centers choose to distribute bonuses based on a percentage of total profits at the end of the year, meaning employees benefit if the center succeeds financially. Others put a certain percentage of the manager or employee's salary "at risk," so total possible compensation is determined at the beginning of the year but only a certain amount is guaranteed unless goals are met. It makes sense to gauge how bonuses will affect an employee's total compensation to make sure your ASC is paying a competitive salary without going over budget on staffing costs.
3. How is industry-wide compensation changing over time?
Make sure your center keeps an eye on industry trends to make sure your salaries are still competitive. Average compensation for a nurse in 1999 is likely to be significantly different from compensation in 2010, so stay updated on current salary reports. For example, registered nurse salaries increased 1.1 percent in 2010 over 2009 to a median salary of $60,500, while salaries for business office managers, anesthesiologists, instrument technicians and operating room technicians stayed constant, according to the ASC Association salary survey.
For most ASC positions, 2009 salaries saw a jump from the previous year. Operating room technicians saw their salaries increase from an average of $38,230 annually to $40,000 annually, while licensed practice nurses increased from $37,958 to $39,500 and receptionists/admitting clerks increased from $27,560 to $28,662. The only salaries to decrease in 2010 were medical director salaries, which dropped four percent to a median salary of $28,800.
These changes — mostly ranging from 1-4 percent — may not seem significant, but they add up over time. In addition, a new nurse faced with a $2,000 higher salary at another facility is likely to choose employment elsewhere unless you can provide an outstanding rationale for your compensation decision.
4. How much revenue do you bring in?
When benchmarking your center against other centers across the country, make sure to look at centers with similar revenue streams. If your ASC has two operating rooms and net revenue of $4,000, you are unlikely to offer the same salaries as a seven-OR center with significantly higher revenue. According to VMG Health's survey, ASCs with more than $6.99 million in annual net revenue pay their employees an average of $26.60 per hour, compared to $25.81 per hour for ASCs with less than $4.5 million in net revenue. Nurses in ASCs with greater revenue make significantly more per hour than nurses in less profitable centers, at $31.65 per hour compared to $29.82 per hour.
No matter how your ASC compares to other centers across the country, your salary costs should always fit your budget. If your revenue is down, you may have to explain to employees that bonuses must be eliminated or salaries must be frozen while efforts are made to increase profits. If net revenue is down in your area because of decreased reimbursement or other issues, you may find that other local surgery centers are experiencing similar issues and are limiting their compensation as well.
5. How will you reward credentials?
It is important to establish how you intend to compensate employees for coming to the center with certain credentials. You want pay to be fair and equitable across the center, which means rewarding employees with similar education levels and credentialing in a similar manner. Some positions have various credentials and certifications associated with their roles that are compensated differently across the healthcare system. For example, registered nurses with critical care certifications can earn up to $32.88, while registered nurses with advanced cardiac life support certifications generally top out at $31.86 per hour, according to data from PayScale. Basic life support certification can earn nurses from $21.56-$29.56 per hour, while nurses with CPR certification can earn from $22.20-$30.76.
Coders are also compensated differently depending on credentials. The American Association of Professional Coders examined average coding salaries for 16 different coding credentials and found that salaries differed significantly based on credential. Statistics on salaries for employees with the job title "coder," divided by credential, are listed below:
CPC-A: $32,792
CPC: $39,953
CPC-H: $42,930
CPC-P: $45,750
CPC-1: $50,543
CASCC: $41,591
CANPC: $41,574
CCC: $40,250
CEDC: $50,000
CEMC: $45,000
CGSC: $42,500
CHONC: $35,357
COBGC: $43,690
COSC: $41,912
CIRCC: $45,595
CPMA: $42,937
The examples of registered nurses and coders indicate that different credentials demand different levels of compensation. Be aware that employees who come into the center with higher education, certification or credentialing may expect more than the industry average, and make sure your center pays consistently to avoid staff dissatisfaction and turnover.
Read more on VMG Health, the ASC Association and AAPC.