Either way, they'll have to work at it. The word from both consultants and successful firms is that talent doesn't just walk in the door (maybe it never did). Good employees are hard to find and hard to replace. Recruiting, in particular, demands real effort and creativity.

Crew, for instance, urges companies to do more “non-traditional advertising,” such as enlisting outside sales reps in the recruiting effort. “As long as they are prospecting for customers, they should be putting out feelers for potential employees,” he says.

As for retention, Crew says there's still no substitute for cash. “Where money's concerned, do the best you can whenever you can,” he advises. Even small amounts can help, Crew says: “A $50 or $100 bonus or gift certificate can go a long way.”

Dallas Jackson, owner of Vacaville, Calif.-based Jackson Medical Supply, says his firm tries every advertising and recruiting venue available — including five newspapers, online classified ads, a county jobs program and contacts at high schools — and he still has trouble finding people for entry-level jobs. Recently he was trying to fill two driver-tech positions and had “very few applicants,” he said, adding that he got more response when advertising for a management-level position.

The problem, as he sees it, is a labor pool divided between two groups actively looking for work — “virtually uneducated people and very highly educated people” — with no one in between. That middle group of less experienced but motivated people is a prime target for employers such as Jackson. He notes that he “would like to get someone young and hungry who would like to start a career, but we have trouble pulling such people in.”

Marnhout says he meets his recruiting challenge with word-of-mouth advertising and keeps an eye out for new college grads (his headquarters, Lexington, is the home of the University of Kentucky). But hiring talented up-and-comers has a cost. “They'll be here two or three years,” he says. “I know I'm going to lose them because they can't make the big bucks here.”

But even as ex-employees there is an upside, Marnhout concludes: “A lot of them stay in the state and say good things about Bluegrass Oxygen.”

About the Survey: Data for the Salary & Benefits Survey were collected June 23-Aug. 9. Percentages are based on responses from 246 companies. Of those reporting, 51 percent have one location, while 37 percent operate between two and nine locations, and 7 percent have 10 or more locations. The median revenue of respondents' companies is $2.3 million. Thirty percent reported revenues of $1 million or less, while 15 percent have revenues of $10 million or more. Not all respondents answered every question, and some totals may add to more than 100 percent due to multiple responses.

Did any of your employees receive a raise in the past 12 months?

On average, 76.8% of responding companies' employees received raises in the past 12 months.

5.6% was the average raise, and 4% was the median (the point at which half the raises reported were higher and half were lower).

Providers in this year's survey group spend an average of 31% of revenue on salaries, commissions and bonuses for company employees.

• The average salary increase given by responding companies was 5.6 percent.

• Of surveyed companies, 83 percent said that at least some employees received a raise in the past 12 months.

• Salary increases are most frequently linked to merit/performance (80 percent).

• Forty-four percent of respondents pay their sales staff straight salary only, while 44 percent pay on a salary-plus-commission basis. Less than 2 percent of respondents pay their sales staff commission only.

• More than half of responding companies that offer bonuses do so to all employees (59 percent). Forty percent offer bonuses to sales staff; 38 percent to delivery personnel; 37 percent to managers; and 36 percent to billing/back office employees.

• Providers responding to the survey spend an average of 13.1 percent of salary on employee benefits.

• Eighty-seven percent of respondents offer vacation time, while 77 percent offer medical insurance and 70 percent offer bonuses. Sixty-three percent offer cell phones, while 13 percent supply Blackberries/PDAs.

• Only 19 percent of respondents offer their employees a pension plan. Twenty-five percent offer a profit-sharing plan.

• The largest segment of companies reported that staffing will not change in 2007, but a significant percentage do plan increases in: outside sales, 40 percent; billing/collections personnel, 33 percent; showroom/CSRs, 30 percent; and service/repair staff, 20 percent.

• Companies that participate in competitive bidding but are not selected said they will likely lay off employees (46 percent); require employees to pay a larger share of health benefits (29 percent); and/or freeze salaries (28 percent).

What percentage of your employees fall into the following categories?

Full time	84%
Part time	16%
Management	28%
Non-management	72%

How will your staffing change in 2007?

Job Title	Increase	Decrease
Outside Sales	39.8%	2.8%
Delivery Personnel	36.6%	4.5%
Billing/Collections	32.9%	5.7%
Showroom/CSRs	29.7%	4.1%
Service/Repair Staff	19.5%	4.1%

How much does it cost to train a new employee?

Less than $1,000	14.6%
$2,000 - $2,999	21.5%
$3,000 - $4,999	12.6%
$5,000 or more	15.9%
Average training cost: $3129

Which of these positions do you employ?

EMT/Paramedic	2.8%
Nurse (RN/LPN)	24.0%
Pharmacy Technician	25.2%
RPH	19.9%
RT/CRTT/RCP	57.7%
Rehab Technology Supplier (RTS/CRTS)	21.1%
Information Technology Specialist	18.7%

If you participate in competitive bidding but are not selected as a winner, will you:

Lay off employees	45.9%
Require employees to pay a larger share of health benefits	28.5%
Freeze salaries	28.0%
Shorten employee hours	24.8%
Drop some health benefits	13.0%
Drop some non-health benefits	11.8%
Other employee-related action	7.7%

COMMON EMPLOYEE BENEFITS

Vacation	87.0%
Holidays, including floater(s)	81.3%
Medical insurance	76.8%
Bonuses	69.5%
Sick leave	68.7%
Cellular airtime/usage	63.0%
Personal time	54.9%
401(k) plan	53.7%
Flexible work schedule	52.8%
Trade show/convention/seminar expenses	50.0%
Dental insurance	47.2%
Life insurance	47.2%
Auto or auto allowance	43.5%
Long-term disability plan	34.6%
Short-term disability plan	33.7%
Tuition reimbursement plan	30.9%
Association memberships	28.0%
Vision insurance	27.6%
Profit-sharing plan	24.8%
Pension plan	19.1%
Blackberry/PDA	12.6%
Stock purchase plan/stock options	7.7%
HME companies spend an average of 13.1% of salary on employee benefits.

What do you link salary increases to?

Merit/performance	79.7%
Profit	31.3%
Years of service	29.7%
Sales	22.4%

How do you pay your sales staff?

Salary plus commission	44.3%
Straight salary only	43.5%
Commission only	1.6%

If you pay salary plus commission for your sales staff, what is the average guaranteed base salary on a percentage basis?

25% or less	11.0%
26% to 50%	21.1%
51% to 75%	25.7%
More than 75%	23.9%

Who do you pay bonuses to?

All staff	59.1%
Sales personnel	40.4%
Delivery personnel	38.0%
Managers	36.8%
Billing/Collections personnel	35.7%
CSRs/Clerical support personnel	25.7%
Clinicians	22.2%

What determines employee bonuses?

Revenue goals	68.4%
Performance goals	64.3%

Do you pay higher salaries to credentialed personnel?

Yes	76.8%
No	13.4%

AVERAGE ANNUAL SALARIES BY JOB TITLE*

Job Title	Median ($)	Mean ($)
Accounts Receivable Manager	40,000	41,260
Billing Clerk	28,000	30,465
Bookkeeper/Asst. Controller	40,000	42,033
President/CEO	100,000	134,621
Clerical/Administrative Support	25,000	27,030
Controller/VP Finance	75,000	93,716
Customer Svc./Inside Sales Rep	27,750	30,325
Customer Svc. Mgr./Supervisor	40,000	41,657
Delivery Technician	25,000	26,981
Operations/Warehouse Manager	41,000	45,690
Outside Sales/Marketing Rep	42,500	51,570
Pharmacist	95,000	94,352
Respiratory Therapist	45,000	46,039
Sales Manager/VP Sales	75,000	80,841
Store/Branch Manager	50,000	52,752
Warehouse Manager	40,000	38,119

AVERAGE HOURLY WAGE BY JOB TITLE*

Job Title	Median ($)	Mean ($)
Accounts Receivable Manager	14.25	14.40
Billing Clerk	12.13	12.47
Bookkeeper/Asst. Controller	13.00	13.98
Clerical/Administrative Support	10.58	11.14
Customer Svc./Inside Sales Rep	12.00	12.07
Customer Svc. Mgr./Supervisor	15.00	15.32
Delivery Technician	12.00	12.35
Dispatcher**	14.00	13.85
Nurse (RN/LPN)	20.00	19.51
Operations/Warehouse Manager	15.00	14.94
Respiratory Therapist	20.00	20.78
Service/Repair Personnel	11.75	11.81
Store/Branch Manager	18.50	19.01
Warehouse Manager	14.21	14.40

*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 they employed dispatchers. Of those that did, most were paid hourly. The maximum salary reported was $20 per hour; the minimum reported was $9 per hour.