2009 Salary & Benefits Survey shows just how hard HME industry has been hit.

It's the classic good news-bad news situation for home medical
equipment providers: Salaries seem to be holding steady — but
that's for employees who have kept their jobs.

Over the past 12 months, nearly one in three HME providers (31
percent) participating in HomeCare's Salary & Benefits
Survey have had layoffs.

That stat and others across the survey show without a doubt that
the industry's tumultuous conditions, worsened by the nation's
sputtering economy, have extracted a heavy toll.

Take employee benefits, for example. Fifty-seven percent of
providers reported they had made changes to their company's health
care plans in the past year: 35 percent changed/modified plans to
save the company costs, 16 percent have done so to save employees
costs and 27 percent have increased employee premiums.

In a second telling example, 84 percent of providers in the
magazine's 2008 survey gave employees raises averaging 5 percent.
This year, the average raise was also 5 percent, but only 53
percent of providers handed them out.

Over the past 12 months for providers
in HomeCare's survey group
31% have laid off employees
38% have frozen salaries
33% have left positions vacant
57% have made changes to health benefits
14% have reduced employees' work hours
53% gave raises vs. 84% in 2008
29% have dropped bonuses
26% have reduced commissions

Thirty-eight percent of providers in the 2009 survey group have
frozen salaries, another 13 percent have reduced them and 14
percent have reduced the hours of some employees. Thirty-three
percent have left an open position vacant. Twenty-nine percent have
dropped bonuses for some (16 percent) or all (13 per-cent)
employees. Twenty-six percent have reduced commissions.

The reasons for all this are exactly what you might expect.
Here's a representative sample of answers providers gave when we
asked why they had laid off staff, cut back hours and/or reduced
salaries or commissions:

"Because Medicare allowables have been so cut and coverage items
have been deleted. Also, the new regulations for oxygen are killing
us."

  • "Because we are down 20 percent-plus on the year. The money has
    to come from somewhere."

  • "Faced with the competitive bid, we closed two branches and
    reduced staff. We also cut back hours in the warehouse and
    delivery."

  • "Shrinking profit margin and increased expenses, which include
    accreditation and increased length of time of collectibles."

  • "Due to the oxygen cut in January, we are unable to increase
    sales as fast as we are losing O2 revenue."

  • "The volume of work has remained the same although reimbursement
    has been reduced significantly. There is no money to pay these
    people."

    On the flip side of the survey, however, the news isn't all bad.
    Forty-eight percent of participating companies added staff in the
    past year, with most of those positions (46 percent) in sales.
    Almost a third (37 percent) created new job functions, and 46
    percent have hired to fill open positions. A smaller percentage has
    added benefits (11 percent) and bonuses for some (5 percent) or all
    (3 percent) employees.

    Moving to 2010, providers also remain somewhat optimistic. Only
    15 percent said they anticipate layoffs next year. If conditions
    don't improve, however, half (49 percent) said they are prepared to
    take further action concerning staffing or salaries. With any more
    cuts to oxygen or power wheelchairs, 44 percent said they would
    reduce or freeze salaries, 40 percent will lay off staff and 37
    percent will reduce benefits.

    For many, a lot hinges on the outcome of competitive bidding,
    they said.

    "We can't plan ahead," wrote one frustrated provider. "It's a
    problem … Health care reform can increase business, but
    competitive bidding can put me out of business."

    Another summed it up this way: "The question is not 'will we
    hire' in 2010. The question is 'will we remain in business.'"

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Survey Fast Stats

    About Salaries & Bonuses

    The average salary increase given by responding companies was 5
    percent.

  • Of surveyed companies, 53 percent said at least some employees
    received a raise in the past 12 months.

  • Salary increases are most frequently linked to merit/performance
    (72 percent).

  • Forty-two percent of respondents pay their sales staff on a
    salary + commission basis, while 46 percent pay straight
    salary.

  • Thirty-eight percent indicate they have frozen salaries in the
    past 12 months and 13 percent have reduced salaries in the past 12
    months.

  • Less than half of responding companies (47 percent) pay bonuses
    to all employees.

    About Benefits

    Fifty-three percent of respondents have changed benefits in some
    way in the past year. Twenty-seven percent have modified benefits,
    19 percent have reduced benefits and 11 percent have added
    benefits.

  • Fifty-seven percent have made changes to health care plans: 35
    percent have changed/modified plans to save the company costs, 16
    percent have done so to save employees costs and 27 percent have
    increased employee premiums.

    About Staffing

    Nearly one in three respondents (31 percent) had layoffs in the
    past 12 months at an average 13 percent of staff. Primarily
    full-time (99 percent), but also part-time employees (29 percent)
    were laid off. Fourteen percent have reduced the hours of some
    employees.

  • Positions most likely to have been laid off include
    administrative/clerical (50 percent), delivery (40 percent),
    billing/collections (40 percent) and sales (28 percent).

  • In the past year, 46 percent of respondents have hired to fill
    open positions, while 33 percent have left an open position
    vacant.

  • If conditions don't improve, 49 percent of respondents plan to
    take action concerning staffing or salaries.

  • For each staffing category, the majority indicate staffing
    levels wll remain the same in 2010. Only 15 percent of respondents
    anticipate layoffs in 2010 at an average 12 percent of staff.

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Benefits & Bonuses

    How have your benefits changed in the past 12 months?

    We have added benefits 11.4%
    We have modified existing benefits 27.0%
    We have reduced benefits 19.2%
    We have not changed our benefits 45.2%

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Benefits & Bonuses

    If you offer medical insurance, over the past 12 months, have
    you:

    Increased employee premiums 27.4%
    Changed/modified plans to save company costs 35.2%
    Changed/modified plans to save employee costs 15.7%
    Have not made any changes in the past 12
    months
    30.2%

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Benefits & Bonuses

    How has your bonus offering changed in the past 12 months?

    Maintained bonuses previously offered 40.2%
    Have added bonuses for all employees 3.2%
    Have added bonuses for some employees 5.0%
    Have dropped bonuses for some employees 16.4%
    Have dropped bonuses for all employees 12.8%
    Do not pay bonuses 23.5%

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Benefits & Bonuses

    What determines employee bonuses?

    Revenue goals 63.8%
    Performance goals 59.6%

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Benefits & Bonuses

    Do you pay bonuses to:

    All staff 46.5%
    Sales personnel 31.5%
    Managers 28.2%
    Billing/Collections personnel 17.8%
    CSRs/Clerical personnel 8.9%
    Clinicians 6.6%
    Delivery personnel 6.6%

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Benefits & Bonuses

    Common Employee Benefits

    HME companies in this year's survey group spend an average 13%
    of salary on employee benefits, and an average 34% of revenue on
    salaries, commissions and bonuses for employees.

    Vacation 86.5%
    Holidays, including floater(s) 77.9%
    Medical insurance 75.8%
    Sick leave 67.6%
    Cell phone 65.1%
    Bonuses 54.1%
    401 (k) plan 50.5%
    Personal time 49.5%
    Dental insurance 47.0%
    Trade show/convention/seminar expenses 44.8%
    Life insurance 44.1%
    Auto or auto allowance 37.4%
    Flexible work schedule 35.6%
    Vision insurance 26.7%
    Long-term disability plan 26.3%
    Short-term disability plan 25.6%
    Association memberships 23.5%
    Blackberry/PDA 21.7%
    Tuition reimbursement plan 21.0%
    Profit-sharing plan 11.4%
    Pension plan 9.3%
    Stock purchase plan/stock options 3.2%

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Raises & Reductions

    Over the past 12 months, has your company:

    Given raises to any employee(s) 53.0%
    Frozen salaries 38.1%
    Reduced the salary of any employee(s) 12.8%

    For companies giving raises:

    • 5% was the average raise.
    • On average, 68% of employees received raises.

    For companies that reduced salaries:

    • 15% was the average reduction.
    • On average, 35% of employees received pay cuts.
    • 22% reported pay cuts for all employees.

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Raises & Reductions

    Have you laid off staff in the past 12 months?

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    For companies reporting layoffs:

    • 13% of staff was the average layoff.
    • 99% reported layoffs of full-time employees.
    • 29% reported layoffs of part-time employees.

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Employees

    Have you added staff in the past 12 months?

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    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Employees

    If you have added staff, in what positions?

    Sales 45.9%
    Billing/Collections 31.9%
    Delivery 30.4%
    Administrative/Clerical 26.7%
    Clinicians/Therapists 26.7%
    CSRs 20.0%
    Managers 16.3%
    Warehouse 13.3%
    Service/Repair 10.4%

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Employees

    Which of these licensed/credentialed positions do you
    employ?

    Nurse (RN/LPN) 27.0%
    Pharmacist/Pharmacy technician (RPH) 18.9%
    Physical/Occupational therapist (PT, OT) 8.2%
    Respiratory therapist (RT, CRRT, RCP) 56.9%
    Rehab specialist (ATP/ATS) 17.4%
    None of these 19.2%

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Employees

    Which of these positions do you employ?

    Compliance officer 49.8%
    Dispatcher 17.1%
    Information technology specialist 25.6%
    Service/Repair personnel 56.2%
    None of these 21.7%

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Employees

    How many employees do you have?

    Annual Revenue Average Number
    of Employees
    Under $1 million 6
    $1 million to $3.5 million 26
    More than $3.5 million 56

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Employees

    If employees have left in the past year, have you:

    Hired to fill the open position 46.3%
    Left the position vacant 32.7%
    No employees have left in the past year 23.8%

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Employees

    If you have laid off staff, in what positions?

    Administrative/Clerical 50.0%
    Billing/Collections 39.5%
    Delivery 39.5%
    Sales 27.9%
    CSRs 22.1%
    Warehouse 22.1%
    Managers 29.1%
    Service/Repair 20.9%
    Clinicians/Therapists 17.4%

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Employees

    Do you link salary increases to:

    Merit/Performance 71.5%
    Years of service 35.2%
    Profit 26.3%
    Sales 23.1%

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Annual & Hourly Salaries

    Average annual salaries by job title*

    Job Title 2009 2008
    Median ($) Mean ($) Median ($) Mean ($)
    Accounts receivable manager 45,000 47,907 42,000 44,179
    Billing clerk 30,000 30,158 28,150 29,115
    Bookkeeper/Asst. controller 35,000 45,788 40,000 36,578
    CEO/President 120,000 129,482 80,000 82,253
    Clerical/Administrative support 25,000 26,437 25,000 24,430
    Compliance officer 50,000 56,233 50,000 51,635
    Controller/VP finance 80,000 98,742 61,500 61,713
    Customer service rep 30,000 28,208 30,000 29,463
    Customer Svc. Mgr./Supervisor 42,000 41,160 41,000 40,952
    Delivery technician 30,000 29,368 25,250 26,954
    Information technology** 54,000 53,000 55,000 54,761
    Nurse (RN/LPN) 52,500 51,073 45,000 48,688
    Operations manager 40,000 47,275 49,500 48,773
    Outside sales/Marketing rep 50,000 50,121 50,000 49,606
    Rehab technician** 50,000 54,183 N/A N/A
    Respiratory therapist 45,000 47,284 49,000 48,705
    Sales manager/VP sales 70,000 76,226 60,000 65,150
    Service/Repair personnel 30,000 32,626 31,250 30,308
    Store/Branch manager 49,000 51,548 50,000 51,143
    Warehouse manager 41,000 41,359 40,000 39,324

    *The mean, or average,
    figures presented refer to the statistical mean, which is defined
    as "the value obtained by adding all the numeric answers given for
    a particular question and then dividing by the total number of
    respondents answering the question." The median is defined as the
    value that is exactly in the middle of all answers, or the point
    where half of the responses lie above and half of the responses lie
    below the value.

    **Use these figures with
    caution, as fewer than 30 companies reported salaries for
    dispatchers, IT personnel and rehab technicians.

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    Annual & Hourly Salaries

    Average hourly wage by job title*

    Job Title 2009 2008
    Median ($) Mean ($) Median ($) Mean ($)
    Accounts receivable manager 16.50 17.18 16.50 16.55
    Billing clerk 14.00 14.01 13.60 13.71
    Bookkeeper/Asst. controller 16.00 17.83 14.00 13.75
    Clerical/Administrative support 12.00 13.25 11.00 12.17
    Customer service rep 12.60 13.24 13.00 13.43
    Customer Svc. Mgr./Supervisor 17.00 16.18 16.00 16.41
    Delivery technician 13.00 13.22 13.00 13.01
    Dispatcher** 13.00 13.84 13.64 13.31
    Nurse (RN/LPN) 20.50 25.53 24.00 25.47
    Operations manager 16.00 16.39 16.00 16.53
    Respiratory therapist 22.00 23.16 22.00 22.40
    Service/Repair personnel 14.00 13.54 14.00 13.48
    Store/Branch manager 18.00 19.08 19.50 21.39
    Warehouse manager 16.00 15.74 13.75 14.85

    *The mean, or average,
    figures presented refer to the statistical mean, which is defined
    as "the value obtained by adding all the numeric answers given for
    a particular question and then dividing by the total number of
    respondents answering the question." The median is defined as the
    value that is exactly in the middle of all answers, or the point
    where half of the responses lie above and half of the responses lie
    below the value.

    **Use these figures with
    caution, as fewer than 30 companies reported salaries for
    dispatchers, IT personnel and rehab technicians.

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    About 2010

    Do you anticipate layoffs in 2010?

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    Providers who think they will lay off employees next year
    anticipate laying off an average of 12% of staff.

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    About 2010

    How will your staffing change in 2010?

      Increase Decrease No Change
    Billing/Collections 24.6% 7.5% 59.8%
    Clinicians/Therapists 16.7% 5.3% 64.1%
    CSRs/Intake 21.7% 6.0% 60.9%
    Delivery Personnel 27.0% 6.8% 55.9%
    Outside Sales 27.8% 6.0% 55.9%
    Service/Repair staff 11.4% 3.9% 72.6%
    Warehouse 8.9% 4.6% 72.2%

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    About 2010

    When economic/industry conditions improve, will you:

    Refill all positions that have been
    eliminated
    5.3%
    Refill only some of the positions that have been
    eliminated
    8.5%
    We have "right-sized" our company and plan to keep
    it that way
    23.5%
    We need to see what the outcome of competitive
    bidding (or other reimbursement cuts) will be before making
    staffing decisions
    43.8%
    Unsure 16.1%
    No Answer 2.8%

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

    About This Survey

    Data for HomeCare's Salary & Benefits Survey were
    collected July 16 through Aug. 20, 2009. Of 281 qualified
    responses, 83 percent are from home medical equipment providers
    with other respondents from pharmacies/chain drug stores with HME,
    home health agencies with HME or other specialty segments. Just
    over half of the respondents (52 percent) operate one location,
    while 30 percent operate between two and four locations and 16
    percent have five or more locations.

    Forty-one percent of the companies participating in this year's
    survey operate primarily in DME MAC Jurisdiction C, with 19 percent
    operating in Jurisdiction D, 18 percent in Jurisdiction B and 14
    percent in Jurisdiction A. Six percent of participating companies
    report nationwide operations. While 27 percent of respondents
    indicate annual revenues under $1 million, 13 percent have revenues
    of $10 million or more.

    Figures presented are national means and medians across
    companies of all sizes. Not all respondents answered every
    question, and some totals may add to more than 100 percent due to
    multiple responses.

    Survey methodology conforms to accepted marketing research
    methods, practices and procedures.

    2009 Salary & Benefits Survey Questions

    Benefits & Bonuses

    Raises & Reductions

    Employees

    Annual & Hourly Salaries

    About 2010

    Other Information

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