Dwindling Salaries

Tim,  I am a COTA with 30 years experience.  I have gone for periods of three to four years gone without a salary increase over the past 10 years... people don't know what to do with me because of my years of experienc.  I am currently at the end of my pay scale at my current job, so they gave me a bonus instead, of which almost half went for taxes!  Some bonus.  I have been noting that there has become a shortage of therapists in this area.  I am wondering if this will push the salaries upward as it has in the past.  What are your views on this?

Those salaries are very low I think for COTA's. Hopefully it's just the OH area because I have worked in IL,MO, and KY for no less than $25 per hour (oftentimes much more than that). Travel therapy is the best way to go. One could make up to $34 an hour travelling.

As a prior regional manager with a national contract agency, I have altered my name.

It is standard practice for companies to offer all levels of management (facility based up through VP) financial incentives to exceed revenue expectations.  Many formulas are based on % over target for % of one's annual salary.  It is a method they usually refer to as a way to 'reward' efficiency.

Unfortunately, it appears that these incentives become the motivating and guiding factor in management practice for many companies.  My philosophy of management was not congruent with this philosophy, so I left.  My guiding force was quality patient care, not to get a big bonus nor help my boss get a big bonus.

Although Medicare is lowering reimbursement, For Med. B, a unit of ADL will be $26.91/unit,  ther ex 25.07, neuro 26.23, ther activity 26.55.

So, if one was to take the span of salary you have identified, and just use the high end, of $18/hr plus 30% overhead to cover insurance, upper level management costs etc,  the hourly cost of that most expensive COTA is $23.40/hr.   Based upon the 2008 Medicare fee screen, even if a COTA only provided 15 min of patient care per hour for any of the above treatments, the employer would show a profit.  For those in contract therapy, many contracts recieve a cut or percentage of the fee screen, so to be more than fair - lets say it would take 2 units of treatment/hr to show a profit to agency and host facility (and this is at the high end salary range you have identified....)

When I hear about expectations of concurrent treatment required through the day, 600 minutes... the amount of profit on a weekly and monthly or annual basis for a number of contracts is huge!  The question then becomes, who are these managers?  what are their ethics? and how is it that people in the field will support this type of management by following requests to practice in a way they are deeming to be unethical and not appropriate for their patients?

There is only one agency I am aware of which had employees say 'no more' and they lost staff.  To this day, they continue to have a bad reputation and are unable to recruit therapists with good reputations in the community.

Likewise, I do believe it is wrong to hold an employer and blackmail for salary and rates that are far beyond the norm.

Truth of the matter is, ask the right questions when you interview, and stick to what you feel is right.  I took pride in making sure those facilities and therapists who were in my area had exceptional clinical programs and remained in the black.  I would never expect them to work at a level that I wouldnt do myself.