The 2021 Salary Survey takes a look at the management and compensation trends on the horizon.

Image from Getty Images

In recent years, the jobs of health care facilities professionals have undoubtedly become more complex. 

Perhaps no more so than in the past year and a half as health care shifted toward handling the COVID-19 crisis, forcing facilities professionals to focus on emergency management and patient surge planning on top of daily responsibilities.

In the wake of COVID-19, health facilities professionals continue taking on multiple roles and more responsibility in addition to their core duties, according to the 2021 survey of management compensation conducted by Health Facilities Management with the American Society for Health Care Engineering (ASHE) and the Association for the Health Care Environment (AHE). 


Click image above to view survey data.

This year, 1,030 facilities, construction and environmental services (EVS) professionals responded to the 2021 biennial Salary Survey.

In the survey, the vast majority of respondents reported having at least three additional responsibilities in addition to their main job. They are spending close to half of their time on core duties and dividing the rest primarily between maintenance, construction, safety, materials management and EVS, the survey shows. More than 40% expect to take on more staff in the next year. 

Many are struggling to manage time, balance priorities and keep their teams fully staffed across multiple departments. “Many ASHE members feel stretched thin,” says Deanna Martin, MS, CAE, executive director for ASHE. “When they agree to take on additional roles, time management becomes critically important. There are only so many hours in the day, and each department has its own priorities and urgent needs.”

The 2021 survey, which shows EVS and construction managers are also taking on more roles and responsibilities, reports across-the-board pay increases for those in management positions. Roughly 33% said 2021 budgets did not change from the previous year.

Facilities managers received a 5% pay increase in 2021 for an average salary of $119,031 — a drop from the 9% increase they reported in the 2019 HFM survey. 

EVS managers received a 4% increase, on par with the 3% increase they reported in 2019. EVS managers have an average annual salary of $83,385, the survey shows.

Construction managers scored the biggest raise: In 2021, construction salaries increased by more than 10% to an average salary of $164,149, which was on par with their 2019 raise. 

But the question remains: Are health facilities professionals being fairly compensated for the ever-increasing workloads and responsibilities they have been handed? And what is the impact felt by managers wearing multiple hats and supervising more employees?

Challenges vs. benefits 

To gain further insight, HFM asked survey respondents for anonymous comments on both sides of the issue: challenges and benefits to handling multiple roles. 

In terms of challenges, the vast majority cited time limitations, balancing priorities, keeping fully staffed, lack of resources, burnout and “being tugged in multiple directions.” Many mentioned the challenge of giving 100% to each task considering their time limitations.

Likewise, handling multiple roles can have advantages. Benefits cited by survey respondents include coordinating needs between departments, improved communication, gaining experience and getting a big-picture look at the organization. 

In fact, Jonathan Flannery, MHSA, CHFM, FASHE, FACHE, senior associate director of advocacy at ASHE, says he cites managing multiple departments as a benefit to his career. 

“To me, handling multiple departments was a big advantage because it reduces the silos that limit interaction,” Flannery says. “When you bring various departments together under one manager, the silos disappear.”

Regardless of whether managers take a glass half-full or half-empty approach to their jobs, they all seek adequate compensation for their work. 

Overall, the survey shows that many health facilities professionals feel underpaid compared to their colleagues. Nearly 33% said they felt their salary is a little lower than their peers, while 22% feel their salary is much lower.

But the survey did show that some managers receive higher pay for taking on more tasks. For example, an EVS manager taking on three or more extra tasks has an average salary of $87,628.

Facilities salaries 

In terms of facilities managers, Shadie (Shay) R. Rankhorn Jr., SASHE, CHFM, CHC, ASHE president-elect and senior director of facilities management at Quorum Health, Brentwood, Tenn., says salaries are not “woefully inadequate,” but should be higher, even in a COVID-19 environment.


“In my opinion, 4.5% would not be in line with growing responsibilities considering that in a non-COVID-19 economy, the annual cost of living increase plus retention alone is normally around 3%-5%,” says Rankhorn. “Generally, a 15% pay increase is the minimum for taking on another department, especially if it is large and/or complex to handle.”

Flannery agrees, saying, “It is a decent raise, but it really doesn’t keep up with the cost of inflation, especially considering the added roles facilities managers are taking on.”

Adequate compensation is critical considering that finding and keeping qualified candidates is an ongoing issue, especially because salaries in the private sector are generally higher. Salaries for facilities directors and managers are generally 10%-15% lower than their non-health care peers, says Rankhorn. 

“Facilities managers are being asked to take on more responsibilities for financial reasons, a lack of qualified candidates and their inherent problem-solving capabilities,” Rankhorn says.

In fact, their competency across the board — including their skilled handling of COVID-19 — may have led to additional responsibilities for facilities managers, he says. Others are handed additional departments by default. They might be asked to take over an open position during a candidate search and end up keeping it.

And though facilities managers have long taken on extra duties, the scope of those roles has been broadening in recent years, says Flannery.

“Now, we are seeing facilities managers expanding into different areas,” Flannery says. “Back in the day, facilities managers would take over environmental services or materials management departments, but now they are taking on departments like safety and security and even IT.”

EVS wears more hats

EVS managers also are supervising larger staffs over multiple departments across multiple campuses, particularly in areas such as laundry support services and hospitality, says Patti Costello, executive director for AHE. 

“Infection prevention and control is central to EVS work, so we don’t anticipate changes there,” Costello says. “However, as regional consolidations and mergers continue, we anticipate management of larger complements of staff to continue to increase.”

As in facilities management, more EVS managers are often being handed departments where they lack expertise, says Rock Jensen, CHESP, AHE president-elect and administrative director of support services at Yuma Regional Medical Center, Yuma, Ariz.

“We promote people up when we have a position to fill, but often that person doesn’t have the education or training they need,” Jensen says. “And it’s tough to interest younger people in these positions, both from the ASHE and AHE side.”

In terms of the average salary of $83,385 cited for EVS managers in the survey, Jensen says that pay rates are generally higher, particularly in bigger cities. “In the metropolitan area, EVS managers generally make six figures,” he says.

Overall, average salaries are stretched thin for EVS managers.

“While salaries have increased slightly since 2019, so has the cost of living, the responsibilities and the extra hats,” Costello says. “The market is tight and, if you have a strong EVS leader, do what you can to retain that person.”

While COVID-19 spotlighted the importance of the role EVS managers play, that recognition still hasn’t translated into significant pay increases. But it still could.

“For the first time in recent memory, these technicians and their managers garnered the recognition they have always deserved,” Costello says. “As the saying goes, ‘You are only as good as your last big success,’ so they need to remain active, visible and engaged.”

Jensen suggests pursuing and stacking certifications and certificates, including Certificate of Mastery in Infection Prevention (CMIP) and Trainer–Certified Surgical Cleaning Technician (T-CSCT), which are becoming more valuable to EVS professionals.

At Yuma Regional Medical Center, front-line staff and EVS management have been certified in T-CSCT and have since taken over the role from surgical techs — a career boost for both.

“Since COVID-19, every EVS leader should pursue the CMIP certificate, because it could put them on the path to become a director of infection prevention,” Jensen says.

Boomers retiring

While Jensen says that handing managers more departments stems from the “constant, never-ending drumbeat to do more with less,” both he and Rankhorn also attribute the shift to changing demographics in the industry.

A little over 26% of survey respondents have more than 25 years on the job in management positions and will be retiring in large numbers in coming years, leaving a glut of openings. Many facilities are already struggling to fill vacancies, lacking younger, qualified candidates. The survey shows that 4% of respondents have been managers for two years or less.

“The pool of candidates who are qualified to both manage and maintain our facilities is shrinking at an alarming rate,” Rankhorn says. “To add fuel to the fire, there are very few educational career paths to train future health care facility managers and technicians specifically to our field.”

Rankhorn says he knows one college — the Owensboro Community and Technical College, Owensboro Ky. — that offers an associate degree focused on health facilities management leadership. The program is led by Mike Canales, a former facilities director turned professor. 

Compounding the issue, roughly 47% of survey respondents said they have no succession plan in place.

“There are very few people coming up to fill these jobs,” Jensen says. “It’s the single greatest challenge in our industry.”

Risk management issue

While handling multiple roles or filling slots with less qualified workers can be a challenge for managers, it also can create an enormous risk for the hospital.

As one anonymous survey respondent described it: “The breadth of facility management can bring multiple priorities, which can stretch beyond experience and capabilities.”

“Someone who doesn’t know the health care environment can easily miss critical things, or even simple things that can have serious repercussions,” says Chad Beebe, AIA, CHFM, CFPS, CBO, FASHE, deputy executive director for ASHE. “Having qualified people in place reduces risk dramatically.”

For example, there is a steep learning curve for the inexperienced in facilities management departments dealing with electrical safety, medical gases and complicated equipment. Something as basic as equipment maintenance can mean the difference between life and death. For instance, an HVAC leak of refrigerant — a noxious gas — can cause asphyxiation in a matter of minutes. 

“Without training about the dangers of refrigerant leaks in enclosed rooms and how to properly maintain refrigerant warning systems, there is potential for serious injury or death,” Rankhorn says.

Another potential for a dangerous incident is an arc flash — a short circuit through air that flashes over from one exposed live conductor to another conductor — that can result from the buildup of dust, corrosion, dropped tools or improper work procedures. The arc flash can result in shock, burns, shrapnel, blindness and a concussive blast that can cause serious injury or death in addition to loss of power and damage to critical equipment.

“All of these risks increase when people are not trained,” Rankhorn says. “Hiring untrained facility managers means no one is managing the risk. You can’t manage a risk you don’t know about.”

Resources to help

For health facilities professionals who are stretched too thin or feel they lack expertise, there are resources to help navigate new situations. 

ASHE offers numerous education programs and webinars, as well as My ASHE, an online community of 12,000 members who help each other through difficult situations, says Martin. 

“You can post a question, get answers, share resources and policies,” Martin says. “Someone new to a department can reach out for advice. It’s important for ASHE members to know they aren’t in this alone when they take on a new role.”

While busy facilities professionals might not feel as if they have time to attend an education program or develop their professional network, those activities can save them time and effort in the long run, says Martin.

In terms of salary increases, health facilities professionals should keep track of their contributions and make their value known to the C-suite. Martin suggests tying work not only to targets, but to big-picture goals that improve the hospital overall. Tangible improvements like cutting operational expenses and reducing infections should be tracked and shared with higher-ups.

“Managers need to discuss their accomplishments with leadership, or they could help to create an annual report that highlights their department’s accomplishments,” says Martin.

Says Costello: “As the workforce challenges continue for the next one to three years at least, a savvy EVS professional will seize every opportunity to prepare themselves and their teams for taking on those additional hats.”

AHE offers a full roster of training, tools and resources, says Costello.

Demonstrating value

Because COVID-19 demonstrated — on a very large scale — the importance of the jobs facilities and EVS managers do, that value may eventually be reflected in pay increases, leaders say.

Hospital leaders who consulted facilities and EVS managers at the height of COVID-19 are continuing to seek their input in the post-pandemic environment on everything from airflow/air exchanges and cleanliness to new products related to infection control. 

Keeping that momentum going is critical, says Costello.

“EVS cannot lose the ground gained by fading away due to stress, fatigue or burnout,” Costello says. “Take care of yourself and your team and be prepared to lead for the next department or project using the expertise everyone now knows you have.”

In fact, while health facilities professionals continue to face challenges related to wearing multiple hats and managing growing teams, there are also benefits and opportunities to gain more experience to demonstrate their value to the C-suite, this year’s survey shows. 

That value — so clearly evidenced during COVID-19 — could translate into higher salaries down the line. 

Beth Burmahl is a Carbon Cliff, Ill.-based contributor to Health Facilities Management and Jamie Morgan is editor.