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August 6, 2007

Fat checks for hospital execs

UMass leads the pack; nurses say CEO O'Brien's $1.3M is too much

Among nonprofit hospital executives in central Massachusetts, John O'Brien, president and CEO of UMass Memorial Health Care, is clearly the king of the hill.

In 2005, the most recent year for which the hospital has filed financial papers with the state Attorney General's office, O'Brien received $905,880 in cash, plus $372,574 in benefits and deferred compensation.

Other leaders within the UMass system also made out well. Executive Vice President Wendy Warring's total compensation was almost $700,000, and five other top executives - including UMass Medical Center President Walter Ettinger - got more than $500,000. Leaders of other Central Massachusetts nonprofit hospitals generally received compensation in the $200,000 to $400,000 range. Information on compensation was not available for the CEOs of several local hospitals, including St. Vincent Hospital in Worcester and MetroWest Medical Center in Framingham, because they are for-profit and do not have to file reports with the state.

"For-profit in general will probably pay a little bit higher," said Audrey Brava, senior Vice President of Healthcare for the Boston Group, a franchise of the MRINetwork executive staffing firm. "I think in general there's more money, there's just a difference in responsibilities."

Fair comparison


According to UMass Memorial spokeswoman Nicole Soucy, the UMass system uses an outside consultant to determine fair and competitive wages. Soucy wrote in an e-mail to the Worcester Business Journal that it makes little sense to compare O'Brien's pay to that of the CEOs of individual hospitals in the area because the system is far larger than any other in Central Massachusetts and includes multiple hospitals and other facilities.

John O∀ˆ™Brien, president and CEO of UMass Memorial Health Care.
"There are not really any other health care systems similar to UMMHC in Central Massachusetts so a comparison of salaries simply by region is just not useful," she wrote.

But to the Massachusetts Nurses Association, which represents a majority of RNs at hospitals in the state, executive pay in general is out of line with their performance. David Schildmeier, a spokesman for the MNA, points to a 2006 study by the health care ratings company HealthGrades that ranked Massachusetts 22nd in the nation in patient safety.

"We don't think [executives have] earned their keep, and they're not investing their earnings appropriately to do what they're supposed to do," he said.

Schildmeier said hospitals argue against safety measures like mandated nurse-patient ratios because of their cost while running surpluses and paying high salaries to top employees.

"A hospital's business is to provide first-rate, safe patient care," he said. "That's where the resources should go."

But Brava said the pay of top hospital executives is similar to that in other industries. In contrast, she said, mid-level hospital managers tend to make more than their counterparts in different fields.

"I think there's a shortage of people, and competition is a lot stronger," she said.

Bleeding middle managers


Brava said many of the people who are qualified to take on the middle-management positions, such as experienced nurses, are hesitant to do so because they are already making good money. With RNs' pay sometimes as high as six figures, she said, hospitals have to offer significant rewards to entice nurses to take on more work and responsibility as middle managers.

Because of the high demand for their services, Brava said pay for hospital workers, almost across the board, is higher than that of people with similar education levels in other fields.

"They're making excellent salaries," she said, "Even just starting graduates in rehab and physical therapy."

Like most employees, Brava said, hospital executives in Central Massachusetts do not make as much as those in the Boston area, but she called their compensation "very competitive with other parts of the country."

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