The facilities, construction and environmental services (EVS) professionals who responded to this year’s Health Facilities Management (HFM) biennial Salary Survey reported a strong interest in improving their professional prospects by utilizing the wide variety of career development tools being offered by professional societies and others serving the health facility operations and construction fields.
When asked how often they think about taking actions to develop a successful career, for instance, 69% of respondents stated “often” or “always.”
Moreover, when asked what actions they had taken in the previous two years to develop their careers, 70% had attended a conference, 64% had taken on additional responsibility, 57% had joined or renewed membership in a professional organization, and 57% had taken an online or in-person training course.
Additional steps launched by approximately one-third of respondents included obtaining certificates or designations specific to their field (35%) and applying for new positions (32%). More than one in 10 respondents became career mentors, attended school for education or taught courses specific to their fields.
Finally, nearly six times as many respondents (65%) indicated they intended to take career development action in the next year as did not (12%).
These are among the findings of the 2019 survey on management compensation of more than 1,600 respondents undertaken by HFM in collaboration with the American Society for Health Care Engineering (ASHE) and the Association for the Health Care Environment (AHE).
Overall, facilities managers received a 9% salary hike over 2017, to an average of $113,937. Jack Gosselin, founding partner of Gosselin Martin Associates of Mystic, Conn., and chair of ASHE’s Career Development Committee, believes that increase is recognition of the growing criticality of facilities managers’ roles. “We have positioned ourselves as very valuable assets,” he says. “The onstage work we do these days has a lot to do with salaries becoming more commensurate with contributions.”
Construction managers won a 15% hike from 2017 to $148,385. The labor shortage in construction and health care’s need to compete with other fields both factor in that large increase, Gosselin says. A considerable amount of construction was delayed for years due to financial constraints, he notes. The growing formation of hospital systems results in additional funds flowing into the systems, permitting more construction projects to be undertaken. “It’s also a more competitive market among hospitals,” he adds. “Patients have choices, and they want to go to attractive, highly functional contemporary facilities.”
Meanwhile, 3% salary hikes over 2017 levels were reported by EVS managers, who averaged $80,296.
Asked if that indicated EVS leaders are undervalued compared to facilities and construction managers, AHE Executive Director Patti Costello, MT-CHEST, MT-CSCT, states that, given the laser focus and mounting research evidence on the role of the environment as a vector for the transmission of pathogenic organisms, a competent leader directing a quality environmental hygiene program has to be valued if quality outcomes, patient experience and safety are the goals. It’s merely taking time for the salaries to align with the evidence.
“We believe, over time, EVS managers’ salaries will increase and catch up due to the emphasis and focus on infection prevention,” Costello says. “Additionally, the required competencies, training, education and credentialing offered for professionals provide the perfect pathway for higher compensation.
“Assimilating a comprehensive EVS program into a culture of safety while combining ongoing education and credentialing, EVS leaders have higher earning power than over the last 10 years,” Costello adds. “EVS leaders direct programs that are implemented on the front line of infection prevention and need to be able to succinctly articulate the value of the EVS program and its strategic value, both short and long term, to an organization versus alternative models.”
Pam Toppel, CHESP, MT-CHEST, T-CSCT, who is president of AHE and environmental services regional manager at Peoria, Ill.-based OSF HealthCare, says the role of professionals like herself isn’t the same as it was 10 years ago.
“EVS is much more complex,” she says. “EVS management competencies have expanded, and the front line needs base technical skills and knowledge of infection prevention and microbiology. Ten years ago, that was unheard of. As EVS leaders, it’s our responsibility to ensure the entire team is competent if the EVS program is going to be successful and engrained into the culture of an organization. Make no mistake, a high-quality EVS program can’t be developed by just anyone, and if you believe it can, there are rough times ahead related to safety, patient experience and infection rates.”
For respondents who received a bonus in 2018, 86% say it was tied to performance. Gosselin says variable income incentive programs have existed for some time in management and executive ranks. As facilities management becomes more appreciated, it is appearing there, too.
The reason for incentive compensation programs is the need to retain employees in a competitive market for talent, says Tim Adams, FASHE, CHFM, CHC, the former director of leadership development for ASHE who recently left the association to take a position with a health care system.
In the past, incentives tied to organizational performance were less common in health care than in other fields, Adams says. “But I’m hearing more and more health care organizations are using incentive programs based on personal and also organizational performance.”
Across all areas of facilities, more people earn in excess of $120,000 than before.
That applies as well to EVS, where it is a reflection of greater responsibility and accountability. “As health care consolidation increases, along with the emphasis on an EVS culture of safety, opportunities are going to be there,” Costello says. “But professionals have to make the business case for themselves and for the program they are leading.”
In addition, more people are starting at higher salaries. Toppel notes people entering the profession will earn significantly more than she did when she entered management 19 years ago. On top of this consideration, she says, is the fact that the health care sector needs to compete with many other fields for top talent in a tight labor market.
Wholesale changes in the health care field are impacting remuneration of facilities, construction and EVS professionals.
For instance, the 2019 Salary Survey found salaries for people working in behavioral health, long-term care, health care systems, medical office buildings and satellite clinics increased. That is because health care is increasingly taken to the patient rather than vice versa, Gosselin says. Along with the growing sophistication of satellite health care facilities comes the need for high competency levels — and higher salaries — for those filling roles there, he adds.
Some of those facilities have grown very complex, and some offer the same services as hospitals, Adams adds. “They often have similar accreditation and code requirements and inspections as hospitals,” he says. “You need to have people managing those buildings who understand the codes and standards and ensure the facility meets those standards.”
Where staffs are increasing, the reason could be either consolidation or expansion, Adams says. “As we take health care to people, my sense is there are more facilities in neighborhoods where it is convenient and available,” he adds. “There are just a lot more facilities. Not more hospitals, but more facilities.”
Of note was growth of $10 million-plus budgets. This is a reflection of the systemization of health care, Gosselin believes. Increasingly, corporate offices oversee local facilities, with local managers accessing expertise from above. “You used to have high-, middle- and low-level compensation in the same freestanding hospital. Now that’s not the case,” he says.
The Salary Survey also included respondents’ open-ended comments. A common thread among respondents who stated their salary is lower than their peers was a belief that executive management does not grasp the critical role of managers.
For instance, one survey respondent argued the EVS and linen departments are regarded as non-revenue-generating, rather than as an essential part of an organization’s overall mission and vision. Costello disagrees with this thinking, asserting that EVS can be a revenue-generating discipline.
“As care shifts to satellite facilities, someone has to maintain those care environments and ensure the EVS program is as effective as the acute care setting. Organizations have to pay someone to perform the work; why not create an internal outsource service with EVS being paid to perform the work?” Costello asks. “EVS leaders could be looking to scale the business model with an eye toward standardization, cost savings across the continuum and the organization’s desired outcomes.” She suggests writing the business plan to fill those gaps, asserting the financial rewards will be there.
Education and certification
Lifelong learning contributes to higher salaries. Continuing one’s education in pursuit of certifications and other credentials is a way to earn more. It is soft rather than hard skills that contribute to differences in salaries, Gosselin has come to believe. Those soft skills include communication and collaboration, strategic and critical thinking, and team building. “ASHE is a great source of continuing education, and local professional chapters are a great way of networking,” he adds.
Turning to certifications in EVS, Toppel notes there are health care systems that may not compensate for professional certifications. “But AHE and I still believe there is great value in acquiring certifications in terms of demonstrating your expertise in the field and having pride in the profession,” she says. “AHE offers the training and preparatory materials for technical training and soft skills development. Professionals in possession of the credentials are demonstrating the value of the knowledge and skills required to perform the work at all levels, as well as pride in the work being performed. Credentials speak volumes to that value.”
Salary surveys have, over time, confirmed the value of continuing education, Adams says. Working on a degree, preparing for certification, taking classes, and conducting one’s own “gap analysis” of competencies, ability and knowledge all play a role. Gap analyses allow individuals to fill the gaps through conference attendance, networking events, e-learning, and opportunities to read monographs and books.
“Another great source of career development is through local ASHE chapters that give you opportunities to network with colleagues, pursue education and get to know people in your area dealing with the same codes and standards,” Adams says.
It is essential for those working in EVS to demonstrate they are willing and able to remain at the top of their field, Costello says. Education should be a lifelong learning process that keeps professionals on the cutting edge of change and innovation in health care.
“It’s critical to demonstrate you are the respected, recognized authority,” Costello says. “If not, someone else will claim that authority. There are numerous tools, including certification, to help professionals stand out and be recognized. If we’re not recognizing ourselves and our competence through certifications, why would anyone else?
“Certifications demonstrate baseline competencies to perform the duties of the job and lead the department,” Costello adds. “Demonstrating you’re qualified through credentialing is a key first step indicative of the quality we can deliver. We can expect the pay scale to change, but we need to step up and just do it.”
Indeed, according to the survey data, those who “stepped up” were rewarded. Respondents who reported having an AHE Certified Health Care Environmental Services Professional (CHESP) designation made 28% more than their peers; those who had an ASHE Certified Health Care Facility Manager (CHFM) designation reported making 21% more than their peers; and respondents who had an ASHE Certified Health Care Constructor (CHC) designation made 3% more than their peers.
The 2017 Salary Survey reported that the aging of the baby boomer cohort made succession planning increasingly crucial, and that message has apparently become common wisdom. Specifically, respondents claiming to have succession plans have risen over the past two years from 12% to 20%.
Facilities departments are scrutinizing their leadership ranks to determine who can and wants to advance. Formalized succession planning efforts are critical to pinpointing the education and credentials required of those who seek advancement, Gosselin says.
Succession planning is steadily rising to the top of many organizations’ agendas, Adams agrees. “They’re aware they’re going to lose a substantial amount of their talent in the very near future,” he says. “It’s become something that’s more on people’s minds.”
Organizations are seeking talent both from inside and out, the latter including university programs that teach students about the health care environment. For instance, at Indiana’s Purdue University, students can specialize in health care construction, learning about infection prevention, life safety, and code and standards compliance, Adams says.
Succession plans must be very purposeful, he adds. Plans must identify those who will fill the positions of employees who move up to take leadership roles. “You have to build relationships with community colleges and other training grounds of new employees to fill gaps,” Adams says. “If it’s a trade, let people come in and do tours.”
He adds those convinced they lack resources and tools to groom a new crop of leaders should look at ASHE online learning courses, which can be accessed at www.ashe.org/ondemand.
Toppel reports she and her direct reports have had succession plans in place for five years. Based on what she has seen in the training and the annual AHE Exchange conference, the tide is shifting to the next generation of EVS leadership.
“It’s likely 85% of EVS leaders have succession plans in place,” she says. “We’re always trying to groom someone to take our place. There’s nothing wrong with grooming and mentoring several people at a time to spark healthy competition.”
However, current EVS leadership needs to ensure executive management recognition of the fact that EVS cannot be led or managed by just anyone.
As a means to promote the value of all levels of EVS and the certifications that accompany the roles, AHE rewrote all the EVS position descriptions for the American Society for Health Care Human Resources Administration. “We hope to release all of them before year end, if not early in 2020,” Toppel says.
“AHE also aligned the position descriptions to AHE-led role delineation core competencies and developed the educational pathway for the profession to ensure national consistency of environmental services programs,” she says. “These additional tools will be released very early in 2020. Quality health care requires competent professionals at all levels regardless of the role.”
This year’s Salary Survey demonstrates that education and training are top priorities for many health facilities professionals. Moreover, those making the effort to advance their learning, training and experience often are finding a commensurate improvement in their compensation packages as well.
Article by Jeffrey Steele , and data by Jamie Morgan.