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Hospital occupational pay in 23 metropolitan areas.

Hospital occupational pay in 23 metropolitan areas

Occupational pay levels in hospitals spanned a broad range in August 1985, according to a Bureau of Labor Statistics wage survey.1 For each of the 23 metropolitan areas studied,2 earnings information was developed for full- and part-time workers in 47 occupations. These occupations accounted for one-half of the total non-Federal hospital employment in most of the areas and were selected from two major employee categories--professional or technical and nonprofessional.

Full-time general duly nurses typically averaged between $11 and $13 an hour, with the lowest average recorded in Buffalo ($10.11) and the highest in San Francisco ($15.52). General duty nurses typically averaged 30 to 40 percent more than licensed practical nurses and 60 to 75 percent more than nursing aides in the same area. However, head nurses usually averaged 20 to 30 percent more than general duty nurses in the same area, while the corresponding pay advantages for supervisors of nurses were usually 30 to 40 percent.

Area pay levels varied widely among the other jobs surveyed. Pharmacists, supervisors of physical therapists, medical record administrators, and supervisors of radiographers generally averaged between $13 and $16 an hour among the areas studied. Physical therapists, medical and psychiatric social workers, dietitians, librarians, electricians, engineers, and biomedical technicians typically averaged between $11 and $14 an hour. Other technicians (pharmacy, medical record, EKG), surgical technologists, licensed practical nurses, and clerical and service workers (such as laundry and kitchen employees) commonly recorded area averages below $8.50 an hour. (See table 1.)

The 58,000 nursing aides--largest of the nonprofessional group--averaged from $5.43 an hour in Dallas-Fort Worth to $9.76 in San Francisco. Psychiatric aides averaged more than nursing aides in 10 of the 12 areas where comparisons were made, but their hourly pay advantages were less than 10 percent.

Even within the same occupation and area, earnings of full-time workers spanned broad ranges. For example, in private hospitals, the differences between the highest and lowest paid employee frequently exceeded $4 an hour. This reflects differences in pay levels of individual hospitals in the same area as well as the range-of-rate pay systems employed by most hospitals. Also contributing to differences in occupational pay among hospitals in the same area were type of facility; pay differentials for licensed, certified, or registered employees; size of facility; and whether the workers were covered by collective bargaining agreements.

Where comparisons were possible, occupational pay levels were usually higher in private hospitals than in State and local government hospitals. This continued the reversal of pay relationships between these two types of hospitals, first noted in the Bureau's August 1981 survey.3 Examples of pay comparisons favoring private hospitals ranged from supervisors of nurses to ward clerks, with average differences usually falling below 10 percent. Areas where State and local government workers typically averaged more than their private counterparts included Buffalo, Denver, and Detroit.

All hospitals studied provided paid holidays. Private hospitals generally provided 8 to 12 days annually, compared with 10 to 13 days in non-Federal government hospitals. Paid vacations (after qualifying periods of service) also were provided by all hospitals covered by the survey. Typical provisions called for at least 2 weeks of vacation pay after 1 year of service, 3 weeks after 5 years, and at least 4 weeks after 15 years.

Life insurance and health plan coverage for employees, including hospitalization, surgical, medical, and major medical benefits, were nearly always provided by the hospitals studied. However, employees in private hospitals often received at least part of the health benefits package through direct care. For example, at least one-fifth of the employees in 10 metropolitan areas received full coverage through a combination of insurance and direct care. State and local government hospitals rarely dispensed care directly, relying almost exclusively on insurance coverage.

Retirement pension plans (in addition to Social Security) applied to virtually all private hospital employees in 14 areas. Coverage in the other locations was nine-tenths or more in six areas, approximately four-fifths in Miami and Los Angeles, and three-fifths in Dallas-Fort Worth. Some form of retirement plan was available to virtually all employees in the State and local government hospitals studied. Typically, a combination of an employer-sponsored pension plan and Social Security were provided.4 In Boston, Cleveland, and Detroit, however, all hospital workers were covered exclusively by pension plans not funded through Social Security.

The 1,225 hospitals covered by the survey employed 1.3 million workers in August 1985, or nearly two-fifths of the 3.4 million private and State and local government hospital workers in the Nation. Of the survey's total, private hospitals employed just over four-fifths of the workers. In most areas, nine-tenths or more of all private hospital workers were employed in short-term, general hospitals that did not specialize in a particular type of care. Most of the remaining private hospital workers were in psychiatric, children's, and orthopedic facilities. Not-for-profit, secular institutions accounted for nearly two-thirds of the private hospital employment.

State, county, and city government hospitals each accounted for about three-tenths of the 219,737 government hospital workers covered by the survey. Hospital districts and city-county hospitals employed the remainder. Of the total, general hospitals employed four-fifths of the workers; psychiatric hospitals (typically long-term hospitals run by State governments), one-seventh; and the remainder were employed in chronic or convalescent and orthopedic hospitals.

Regularly scheduled part-time employees accounted for one-fourth of the total hospital work force studied. Minneapolis reported the largest ratio of part-timers (about one-half) and New York, the lowest proportion (about one-seventh). The following occupations were staffed with part-time workers totaling 20 percent or more: nurse anesthetists and practitioners; general duty and licensed practical nurses; EKG and medical laboratory technicians; medical technologists; radiographers; occupational, physical, respiratory, and speech therapists; medical librarians; pharmacists and pharmacy technicians; nursing and psychiatric aides; ward clerks; food service helpers; and several clerical occupations.

Collective bargaining agreements generally applied to greater proportions of workers in State and local government hospitals than in private hospitals. The extent of coverage, however, varied among the metropolitan areas and by occupational group. Surveywide, collective bargaining contracts in government facilities covered two-thirds of the nurses, seven-tenths of the other professional or technical personnel, three-fourths of the office clerical workers, and just over four-fifths of the nonprofessionals. The corresponding proportions in private hospitals were nearly one-fourth of the registered professional nurses; approximately one-fifth each of the other professional or technical employees and office clerical workers; and nearly two-fifths of the other nonprofessional employees.

A comprehensive report on the survey findings, Industry Wage Survey: Hospitals, August 1985 (Bulletin 2273) may be purchased from the Superintendent of Documents, Washington, DC 20402, or from the Bureau of Labor Statistics, Publications Sales Center, P.O. Box 2145, Chicago, IL 60690. The bulletin provides additional information on occupational pay (including area earnings distributions and averages by type and size of facility and labor-management contract coverage); work schedules and hospital characteristics; and on the incidence of selected employee benefits for full-time workers.

1 The survey excluded all Federal Government facilities and hospitals with fewer than 100 workers. Earnings data exclude premium pay for overtime and for work on weekends, holidays, and late shifts, as well as the value of room, board, or other perquisites provided in addition to cash wages. Incentive payments, such as those resulting from piecework or production bonus systems, and cost-of-living pay increases (but not bonuses) were included as part of the worker's regular pay. Excluded are performance bonuses and lump-sum payments of the type negotiated in the auto and aerospace industries, as well as profit-sharing payments, attendance bonuses, Christmas or yearend bonuses, and other nonproduction bonuses.

2 Refers to Metropolitan Statistical Areas as defined by the U.S. Office of Management and Budget through June 1983.

3 For an account of the earlier study, see Industry Wage Survey: Hospitals, October 1981, Bulletin 2204 (Bureau of Labor Statistics, 1984).

4 According to a 1983 amendment to the Social Security Act, effective January 1984, nonprofit hospitals are required to make contributions to Social Security. However, State or local government hospitals are not legally required to make Social Security contributions, but may do so voluntarily. The amendment specifies that any State or local government hospital that provided Social Security before the amendment became effective cannot terminate such coverage.

Table: 1. Pay ranges for selected occupations in hospitals, selected areas, August 1985
COPYRIGHT 1987 U.S. Bureau of Labor Statistics
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Publication:Monthly Labor Review
Date:Oct 1, 1987
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