Gentiva has 232 hospices and 103 employees on the clinical ladder. That's less than half an employee at each site receiving extra pay for their clinical skills and education. Roughly one third are nurses, a third social workers and a third bereavement coordinators/chaplains.
0.14 nurse per site on clinical ladder
0.15 social worker per hospice are ladder approved
0.16 chaplain/bereavement person per site on clinical ladder
It takes employees over 40 hours to compile information required for the clinical ladder. Given management requires employees to do their voluminous work without overtime (causing many employees to donate their time - a fact shared with human resources numerous times), I expect few dedicated clinicians to apply. Those that do have roughly a 50% chance of being approved.
I predict the company would expressly refuse to pay employees for the over 40 hours required to complete the application. That's based on my prior experiences with Gentiva's Human Abuse department.
The other odd thing about the ladder is the reward for being at the top rung is dependent on the route taken. Those with years of experience and proficiency in their work can take the leap in one giant step, only the reward is a fraction of that from progressing through each rung.
To sum up, employees are responsible for ensuring they are paid fairly based on their skills, education and experience. The reward is not for possessing a certain skill set, but for going through the ladder steps in sequential order.
i believe the clinical ladder was intended to be a relief valve for Gentiva leadership. Unhappy with your pay? Clinical ladder. Feeling unappreciated for your skill set? Clinical ladder. Mad that your pay hasn't kept up with inflation for years? Clinical ladder.
Gentiva CEO Tony Strange told J.P. Morgan investors the company has not experienced wage pressures due to the poor economy. The company's clinical ladder has been a tool for senior leaders to bleed off wage pressures. It dangles like the pot of gold at the end of a rainbow, but it evaporates prior to impacting actual paychecks. It looks more like clinical blather. Does Generic Hospice have such a program in their Human Abuse department?
P.S. - Some of the regional committees entertaining clinical ladder applications found themselves with few applicants in Spring 2014. This drives home my assertion the clinical ladder is for show.