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Facilities managers have always worked by the mantra, “Do more with less.” That trend appears to be deepening as more facilities managers are being asked to take on more roles and responsibilities along with their core duties.

And, while salaries are increasing, budgets remain relatively flat and most facilities managers don’t anticipate hiring new staff members to help offset their workloads anytime soon. Nevertheless, facilities managers who are certified are earning higher salaries and getting the necessary training to take on new roles where they might lack expertise.

Those are some of the key takeaways of the 2023 survey of management compensation conducted by the American Society for Health Care Engineering (ASHE) and its Health Facilities Management magazine. This year, 1,330 facilities, construction, environmental services (EVS), safety professionals and more responded to the 2023 Salary Survey, which is conducted biennially.

Other trends show that the field is attracting a small but growing number of new employees and managers, potentially creating a pipeline of candidates to fill vacancies in the wake of a wave of coming retirements. And more facilities managers say they are reporting directly to the C-suite compared to the last salary survey, conducted in 2021. 

Wearing many hats

In a post-COVID-19 world, health care is facing financial challenges like rising expenses, high inflation levels and critical workforce shortages, pushing budgets to the limit. Cutting staff and condensing management roles are quick ways to reduce the bottom line. 

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Click image to expand and view charts from the 2023 Salary Survey

But hospitals asking managers to wear more hats may end up paying in other ways, says ASHE President Gordon Howie, MSPM, CHFM, CHC, SASHE, regional director of facilities and construction services at Mayo Clinic Health System, Eau Claire, Wis.

“In some ways, assigning more duties to facilities managers is a shortsighted solution,” Howie says. “While managers are filling those roles, their own responsibilities don’t go away. This can translate into longer hours, burnout and job dissatisfaction. Or a manager with too much on his or her plate could miss or neglect something, creating a risk for the hospital.”

That cost-saving strategy has created another problem, says ASHE Advisory Board member Michael A. Hatton, MBA, CHFM, FASHE, vice president of facilities engineering and construction at Memorial Hermann Health System, Houston. “There is now a shortage of experienced junior-level management talent with trade-specific skills and competencies who have the ability to take on an expanded role today,” Hatton says.

Facilities managers received a 5% raise, which is in line with the increase reported in the last salary survey. The average salary for facilities managers is $125,246, the survey shows. In light of the mounting workload, time limitations, staff shortages and other challenges, ASHE leaders say facilities managers deserve a larger pay hike.

“I would say 5% is a good start, but I don’t think it is commensurate with additional duties that seem to fall outside of what facilities managers should be doing or the 24/7, year-round nature of their work,” says Howie. 

While that average is on par with smaller and acute care hospitals, the annual salary skews low for medium or larger hospitals, says ASHE President-elect Skanda V. Skandaverl, MBA, CHFM, CHC, FASHE, division director for facilities management, energy and infrastructure in the Midwest at CommonSpirit Health, Omaha, Neb. 

“Depending on location, I’m seeing hospitals with 200 to 250 beds paying between $130,000 to $160,000 a year,” he says. “In areas with a shortage of qualified candidates for facilities managers, candidates can often pick and choose where they want to go. Not only facilities managers but the whole technical staff.”

While salaries for construction managers dipped by 4.5% in 2023, they are still the highest paid management-level professionals in the survey. Construction managers earned an average salary of $156,813. 

EVS salaries jumped significantly, increasing by 14% to an average salary of $95,164 in 2023. “I can’t stress enough how important the environmental services staff is, especially for patient outcomes,” Howie says. “It is hard to attract qualified candidates, and they need to be trained and compensated to retain them.”

Included in the salary survey for the first time, the safety director is playing a growing role on the facilities management team, says Jonathan Flannery, MHSA, CHFM, FASHE, FACHE, senior associate director of advocacy at ASHE. Safety directors earned an average of $104,033, the survey shows.

“The safety manager is becoming recognized even more as a vital position,” Flannery says. “Along with keeping patients, employees and volunteers safe, the safety manager ensures compliance with codes and standards associated with accreditation, as well as standards from the Occupational Safety and Health Administration and the Environmental Protection Agency.”

Despite rising work levels, more than half of respondents said their employer doesn’t offer bonuses. But hospitals that do offer bonuses are paying well. Of those receiving bonuses, 38% are earning more than $10,000 each year. More hospitals are tying bonuses to incentives like employee retention and energy efficiency, the survey shows.

“Employee retention and satisfaction are critical in an industry that relies heavily on skilled professionals,” says Lindsey Brackett, CHC, CHFM, SASHE, chief empowerment officer at Legacy FM LLC, Little Rock, Ark., and ASHE Associate Member Advisory Board Representative. “Linking bonuses to employee retention rates can encourage facilities managers and construction personnel to invest in creating a positive work environment, which, in turn, fosters employee engagement and longevity.”

Facilities and construction managers taking on more duties are seeing a good deal of crossover in their roles. For example, nearly 80% of facilities managers have been assigned construction roles, while 58% of construction managers are handling facilities management. Maintenance is in the top three additional roles for both facilities and construction managers. 

Increasingly, construction managers are handling every aspect of a project, from the contracts to life safety and infection control, Howie says. “What I see is construction managers being asked to manage the entire process from conception to final delivery. Their roles are expanding far beyond managing construction.”

While energy has primarily been the domain of facilities managers, growing pressure to decarbonize the health care sector is increasing their sustainability-related duties, says Kara Brooks, MS, LEED AP BD+C, sustainability program manager at ASHE. Roughly 55% of facilities managers oversee energy management, the survey shows, a large jump from 30% in the 2021 survey.

“Local and state jurisdictions often have energy targets that hospitals need to meet as they work toward decarbonization,” Brooks says. “Facilities managers are playing a larger role in helping hospitals reach these goals.”

Gradually, the role may shift away from facilities management as more hospitals are hiring executive-level managers to oversee sustainability, Brooks says.

Increasingly, facilities managers are taking over EVS duties that could range from patient discharge to lending a hand in nutrition services, Skandaverl says. “This is becoming very common in smaller, critical access hospitals as a cost-saver. Because there are often staff shortages in EVS, extra duties can get elevated to a supervisor.”

Professional development

Building on years of ASHE advocacy, professional certification is taking a stronger hold in the field as hospital leaders recognize its value in building a highly qualified team of facilities professionals. 

For managers, certification can improve their professional value and increase their salaries — often significantly. Salaries for facilities managers with a Certified Healthcare Facility Manager (CHFM) designation were 20% higher than salaries of those without the designation, the survey shows. 

Asked to rate the personal value of certification, roughly 77% said having the designation was of moderate or major professional value (see sidebar at right).

Respondents asked to comment anonymously about certification praised its value. Said one: “Having the Certified Healthcare Constructor (CHC) designation has given me a broader overall understanding of health facility project types and how compliance is affected. Keeping up with the training and compliance requirements keeps adding value to my role on the team.”

As they take on more duties, certification gives managers the training and knowledge to succeed in new areas and provides vital training in health care for new hires coming from outside industries. 

“Health care is a very unique environment with serious implications if something is done wrong,” says Chad Beebe, AIA, CHFM, CFPS, CBO, FASHE, ASHE’s deputy executive director. “ASHE believes certification helps reduce the risk of making a mistake and reduces the burden on hospitals to set up programs to train managers taking on new responsibilities. We firmly believe that everyone who works in the health care physical environment should have some type of health care certification.”

In terms of adding new employees, the survey numbers are encouraging. This year, nearly 13% of respondents have between zero and five years of experience working in a health care setting, up slightly from 2021. The largest number — 26% — have more than 25 years of experience working in a health care setting. 

With a wave of retirements expected, facilities departments need to ramp up efforts to attract even more new employees and put succession plans in place immediately. 

“As the current leadership structure ‘grays out’ and retires, we quickly need to identify, recruit, retain and educate the next generation of facilities management and engineering/construction leadership to take on the ever-expanding role of today’s health care facilities manager,” Hatton says.

Challenges include higher pay in other industries and few educational career paths specific to health facilities management. However, more than 30% of those surveyed have a bachelor’s degree, and more are earning vocational or trade degrees, data show.

Demonstrating value

While salary increases are determined by a complex mix of factors, demonstrating value to higher-ups is key to career advancement, which could lead to bigger paychecks.

As incoming 2024 ASHE President, Skandaverl says one of his key goals is to elevate the profession of health facilities management to the level of strategic planning to ensure managers have a voice in decision-making. Having a seat at that table also creates a stronger connection with CEOs, he says.

“Facilities managers have many critical responsibilities that the C-suite doesn’t even know about. We want hospital administrators to understand their value within the organization, including their impact on patient care,” Skandaverl says. 

In the fight for health care resources, ASHE leaders stress the importance of communicating with the CEO, or learning “CEO-speak.” This year’s survey shows that more managers — roughly 37% — are reporting to the CEO, up from 30% in 2021. 

“It is extremely important for facilities managers to understand how to speak to the C-suite, whether they report directly or indirectly,” says ASHE Advisory Board member Danielle Gathje, vice president of hospital operations at St. John’s Hospital, part of M Health Fairview, in Maplewood, Minn. “The C-suite makes operational decisions that affect facilities managers every day. Facilities managers should communicate needs and impacts along with demonstrating how they can be a great partner. This is crucial to success within operating budgets, capital planning and operational support.”

Facilities professionals need to fight for a seat at the table during strategic planning, Hatton says. “We owe our C-suites information — capital planning, staffing support data and regulatory awareness. And not just today or from the rearview mirror, but two, five and 10 years into the future.”

While many hospitals are more likely to invest in a new MRI machine than a new boiler, deferring maintenance can be very costly. Input from facilities managers can save hospitals thousands of dollars in the long run.

“There are two hospitals in our system with broken boilers,” says Skandaverl. “One hospital is paying $20,000 a month to rent just one boiler. These boilers were giving facilities managers headaches, but it didn’t become a pressing issue to the hospital until they broke.”

Preventing such scenarios takes planning. “Develop your facility-specific five-year ‘look-ahead’ plan for behind-the-scenes deferred maintenance and infrastructure capital that all facilities require as they age,” Hatton says.

When speaking to CEOs, Gathje says it’s critical that managers understand return on investment and how facilities contribute directly and indirectly. She suggests communicating needs through the “bottom-line up front” method of putting conclusions and recommendations at the beginning of a document to get the CEO’s attention.

Moving forward

Ultimately, managers who want to advance their careers and increase their salaries need to keep moving forward, Howie says. This requires a combination of experience, education, certification and ongoing learning. 

“To advance your career, you must continue to learn, adapt and evolve with the changing environment,” Howie says. “ASHE is with facilities and construction managers every step of the way.” 

Beth Burmahl is a Carbon Cliff, Ill.-based freelance writer and Jamie Morgan is editor of Health Facilities Management.