Chief Human Resources Officer / Europe
Decisions that closed beds to keep staff
- Group revenue
- €318m
- 2025; rehabilitation clinics in Austria and Bavaria
- Employees
- 3,420
- 2,210 in Tyrol and Salzburg, 1,210 in Upper Bavaria
- Clinics and day centres
- 11
- Nine rehabilitation clinics and two geriatric day-rehabilitation centres
Decisions & consequences
01Paying for every cancelled day off and closing beds to build a float pool
In 2021 our nurses and therapists were called in from rostered days off an average of 3.8 times a quarter. Nursing sickness absence had reached 9.1 per cent, voluntary nurse turnover 15.2 per cent, and we spent €4.9 million on agency and temporary staff. Exit interviews named one cause repeatedly: nobody could plan a weekend. Ward managers were not careless. With no reserve, they had only the telephone.
In early 2022 I proposed rosters fixed six weeks ahead, a €60 premium plus a replacement day for every call-in from a day off, and a float pool of 58 posts serving neighbouring clinics at a nine per cent allowance. The full cost was €2.4 million a year. To staff the pool quickly, I also proposed closing 26 neurological rehabilitation beds at our clinic near Rosenheim for seven months, forgoing about €1.5 million of revenue.
The finance director opposed the closure and preferred to keep paying agencies while the pool grew slowly. The Bavarian works council first rejected the pool, fearing that members would be sent anywhere at short notice. We agreed that pool staff would keep a home clinic, work at no more than two others within a 45-minute radius, and count travel as working time. Our Austrian works agreement adopted the same terms. The management board accepted the bed closure on condition that I reported the call-in rate monthly.
By the end of 2024, call-ins had fallen to 1.1 a quarter, nursing sickness absence to 7.5 per cent and voluntary nurse turnover to 10.6 per cent. Agency spending was €1.6 million. I do not credit all of that to the roster; increases under both collective agreements helped as well.
What I would do differently: the pool attracted experienced nurses from our strongest wards, which struggled for a year. I would cap how many staff any ward could release at the start, and I would involve the therapists' professional leads before signing the agreement rather than afterwards.
Ending an overseas recruitment contract and paying our own staff to qualify as nurses
In 2022 we contracted Carovant, a recruitment agency, to bring 40 registered nurses from outside the EU to our neurological and geriatric clinics over eighteen months. Fourteen had arrived by May 2023. That month, one of them told her works council representative that she owed about €5,500 to a partner agency in her home country, repayable if she left us within three years. Our review found similar debts for the others, and showed that the agency had begun sourcing in a country on the World Health Organization's safeguards list.
I recommended ending the contract. Severin Pfeifhofer, our medical director for neurology and geriatrics, disagreed firmly: eighteen geriatric beds were already closed for lack of nurses, and he saw no other supply within a year. The chief executive shared his concern. We paid the agency's fees for the fourteen arrivals and a €70,000 termination charge, and we settled the nurses' debts directly at a cost of €77,000, so that none of them owed anything for coming to work for us.
The alternative was already inside our clinics. Forty-nine employees working as care assistants, cleaners or kitchen staff held nursing degrees from twelve countries but had never completed recognition. We offered each of them paid language tuition to B2 level, eight hours of paid study a week, adaptation placements and examination preparation through Achenreith Nursing Academy, with a mentor on their ward. The programme cost €1.3 million over two years.
By September 2025, 31 of the 49 had been recognised as registered nurses, ten were still in the process and eight had withdrawn. Thirteen of the fourteen arrivals remain with us. The cost was real: the geriatric beds stayed closed eleven months longer than the recruitment plan had assumed, and Severin's department carried most of that loss.
What I would do differently: I would interview candidates privately about fees before signing any agency contract, and I would have started the recognition programme years earlier. The qualified people had been working for us all along.
Raising therapists' grades after a job evaluation placed them below comparable technicians
Preparing for the EU pay-transparency directive in 2024, we evaluated 146 job profiles across both countries against one set of criteria. The results were uncomfortable. Physiotherapists, occupational therapists and speech therapists, 84 per cent of them women, earned on average 8.7 per cent less base pay than medical-technical and building-services technicians, 81 per cent of them men, whose roles scored in the same evaluation band. The difference came from twenty years of local market supplements granted when technicians received outside offers. We also had 41 therapist vacancies.
I proposed moving therapists up one grade in two steps, in January 2025 and January 2026, at a full cost of €1.8 million a year. To fund part of it, I recommended no above-agreement increase for management grades in 2025 and a one-year delay to a planned replacement of our human resources software.
The minority investor's representative on the supervisory board asked us to wait until Austria and Germany had finalised their transposition laws. The Bavarian works council supported the therapists but argued that care assistants deserved the same increase. Technicians' representatives worried that their work had been judged less valuable. We reduced nobody's pay, showed the technicians that the evaluation placed them in the same band, and agreed to evaluate care-assistant roles in a second round during 2026. The supervisory board approved the plan in November 2024.
By mid-2026, after both steps, the gap within that band was 1.6 per cent and therapist vacancies had fallen to 17. Two senior managers mentioned the pay freeze when they resigned, and the software delay has kept some payroll work manual for longer than our payroll team would like.
What I would do differently: I would publish the evaluation criteria to all employees before the results, not alongside them. Managers spent weeks answering questions about the method that a clear explanation at the outset would have prevented, and some therapists first heard of the review through rumour.