Erlanger Managers Deserve The Bonus - And Response (5)

  • Sunday, December 14, 2014

I was greatly offended by a comment in this weekend's paper by being referred to as one of Spiegel's "gang of 99".  I have been a manager at Erlanger for 16 1/2 years.   I have worked extremely hard often giving 12-16 hour days, sometimes seven days a week as well as being available almost 24/7.

 I do it as a member of management and often trying to help our bottom line.  Most hourly employees work their day shift and leave and go home to their families.   If they work more they are paid for this time.   I, on the other hand, am paid a salary, which is also well below market.   Many years ago we were given performance-based incentives with a part of our salary at risk.   These performance-based incentives were based on measurable metric, which consisted not just financial but also tied primarily to patient safety.   This year was the first year in many years we have met our metrics.   As an organization management, which included myself and many others, have worked extremely hard to increase those positions which were dramatically under market.  In the past six months we have increased bedside RN's and LPN's, and they will receive another increase in July 2015.   We are also looking at other clinical positions that are under market.

I in no way feel this is a "bonus".   It is added compensation for those that have been a part of getting our ship back on course.   Some of us did the math and what we are to receive is about 1/2 of the hours we've worked above and beyond our normal salary.

I find it offensive to be referred to a gang.

I also find it does more to hurt the morale all of the hard-working people within our organization.   We should be focusing on patient care of improving areas in need of improvement rather than constantly defending ourselves against the overwhelming negativity that's always in front of us in the media.   They never seem to bring out all the good we do for our community such as providing $86 million in uncompensated care, free local health fairs, a clinic for prisoners, and a place for sexually/physically abused children.  I could go on and not even scratch the surface of what we all do to give back to the community.  Shame on those who criticize, often without even asking the right questions.

Cathy Swafford, Director
Pikeville, Tn. 

* * *  

Ms. Swafford is correct.  Salaried workers get no overtime pay or time and a half pay the way hourly workers do, no matter how many hours they work. Salaried workers can be on call 24/7 and must be prepared to return to work on a moments notice even if they've just finished working a 24 hour shift. When payday comes around the check is going to be the same no matter how many hours they worked over. In fact, when it's broken down by the hour, many salaried workers earned far less than the hourly workers they sometimes supervise or manage. 

Been there/done that.

Brenda Washington 

* * *  

Cathy, 

As someone who does not work for Erlanger nor have a vested interest,  I can agree wholeheartedly with your points on how you deserve that bonus.   I would also add that as a public hospital, you are generally at a significant disadvantage to some of the private hospital corporations such as HCA or CHI, who operate Parkridge and Memorial respectively.  As private companies, they can pay their managers in a competitive manner without all of the scrutiny.   If Erlanger wants the best managers, they should compensate them.  It just makes good business sense. 

Also, if as you posted, you live in Pikeville,  I would imagine you have a bear of a commute every day to work those long hours, so for someone to begrudge your bonus simply because they are envious, likely because they didn't bother getting an education or bettering their own career, is ridiculous.    I say they should give you the bonus.  You earned it.  It's really odd that for all of the talk of living in "the Bible Belt" people forget that one commandment about not coveting your neighbors wife, ox, or in this case, salary and bonus.   

I do want to throw out a couple of qualifiers to my statements.   Firstly, as a publicly funded hospital, all of the good that is done within the community is a responsibility, don't you think?  It's not really a gift from Erlanger. The taxpayers pay for it, and I'm not sure Erlanger deserves to be patted on the back for fulfilling its role as a publicly funded hospital. 

Secondly, ever so often I see a number for "uncompensated care" thrown out to try to spin a positive light on a hospital as being a generous organization.  The public should understand that "uncompensated care" includes but does not equal "charity care."  I would love to know how much of that $86 million was true charity out of the kindness of Erlanger's heart versus all of the uncollected bad debt from which the hospital likely sent patients through the ringer with a collection agency who ultimately was unable to collect any more blood out of those turnips.  And of the charity care, how much of that was a write off for someone you were legally obligated to treat?  In my opinion, true charity is giving to someone when you don't have to give at all.  

While I am willing to acknowledge that you deserve your bonus, I'm not going to sing the praises of an organization just for fulfilling its obligation to the public in exchange to tax dollars received to operate, and I'm not going to acknowledge uncompensated care as generosity, when it is often just a bad debt write off that all businesses have to endure as a cost of doing business.    (Those statements are the products of a good PR team, who also have done well, and deserve their bonuses, too.) 

Best wishes to you to receive your fair pay.   I'm glad we have Erlanger here, and I hope things continue in a good direction.    

Mark Lawrence 

* * * 

I can see how someone might be offended by being called a gang member. I might also understand how it could anger someone to have a cushy bonus delayed. 

From what I understand, there was not any money to give away until a recent windfall of federal cash.  Two percent seems to be good enough for all the others. Why not just make it fair and give everyone the same raise? A nonprofit government supported entity should not work on a class system. Good talent is needed to be compensated fairly at every level.  

Chris Pell 

* * * 

We very much appreciate Mr. Lawrence’s positive comments about Erlanger, which enables us to correct a common misconception regarding “uncompensated care.” Here are the facts: 

The State of Tennessee specifically defines what constitutes free care costs in order to ensure comparable reporting by all Tennessee hospitals.  Free care costs provided by hospitals include three elements: (1) patient treatment costs for Medicaid patients in which reimbursement from the Medicaid program does not cover the cost of treatment; (2) patient treatment costs for charity patients who meet specific poverty level guidelines, and (3) patient treatment costs for self-pay patients unable to pay based on their assets and credit report review. 

For Erlanger, the total amount of free (uncompensated) care costs last year was $86.1 million.  This $86.1 million includes $27.6 million for unpaid Medicaid costs, $33.4 million in charity care costs, and $25.1 million for bad debt cost.  

In response to the claim that Erlanger is publicly funded, Erlanger receives only $1.5 million from Hamilton County, or local taxpayers, every year.  To put this into perspective, that $1.5 million represents less than one day's cost to run Erlanger. 

Erlanger's cost to treat Hamilton County prisoners last year alone was $1.4 million.  Only $100,000 from local taxes went to help fund the mission of Erlanger last year.  According to the national organization America's Essential Hospitals, Erlanger is “the least financially supported public health system in the nation.” Hamilton County residents have a great deal, particularly compared to those living in Davidson and Shelby Counties – where residents are taxed more than $65 million annually for their public hospitals. 

Erlanger is the one system of hospitals, doctors and services that the people of Hamilton County and surrounding counties cannot do without. As the region’s only essential safety net health system, Erlanger has already provided more than $28.6 million in uncompensated care to this community the first four months of this fiscal year. We are on track to provide more than $85 million in uncompensated care to this community this year - which no one else will or can do.  Name one other organization which begins its fiscal year knowing that it faces, and must overcome, an $85 million deficit in order to continue its mission to serve the community. 

Despite this daunting challenge, Erlanger’s team embraces its mission, is passionate about providing these services and achieving financial sustainability to ensure Erlanger’s future.   

Pat Charles
Erlanger Health System     

* * *  

Thank you Erlanger employees for all that you do and have done in the past. Many have hung in there during tough times, stayed and tried to make a difference.

I’ve heard great things about Mr. Spiegel from friends that still work there.  The employees have confidence and respect for him which is something that they haven’t had in a long time…not in Skip Reeder's, or Dennis Pettigrew's or Jim Brexler's days.  I worked there under two of those and know that morale has not always good.  

The employees deserve most of the praise.  They’re on the frontline treating patients and making it all happen. It’s a great place to work, they do a wonderful job and show pride in all that they do.

Bonuses for the managers? Yes!  Raises for the hourly employees? Yes!  They’ve earned it. 

Ken Snyder
Ooltewah 

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