New York City Health and Hospitals Corporation - Management and Control of Overtime Costs [Issued 5/7/12] [NY]

New York City Health and Hospitals Corporation


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NYS Comptroller


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New York City Health and Hospitals Corporation
Management and Control of Overtime Costs

Issued: May 7, 2012
Link to full audit report 2009-N-15
Link to the 90-day response

To determine whether the New York City Health and Hospitals Corporation (HHC) has effectively managed and controlled its employee overtime costs. The audit covers the period January 1, 2006 through December 31, 2009.

HHC, the largest municipal hospital and health care system in the United States, serves about 1.3 million patients annually. HHC provides comprehensive medical and mental health services through its eleven acute care hospitals, four skilled nursing facilities, six diagnostic and treatment centers, a home health care agency, and more than eighty community-based clinics. In addition, HHC provides medical services to New York City's correctional facilities and operates a managed care health plan. HHC incurred $126 million in overtime cost in 2011.

Key Findings

  • We analyzed overtime payments incurred throughout all HHC facilities and found that many employees are being paid significant amounts of overtime, as their annual overtime pay often exceeds their annual salaries. For example, the overtime earnings for 54 employees totaled $3.1 million in 2009 and their overtime pay totaled at least 50 percent and as much as 183 percent of their annual base salaries. (See Exhibit A).
  • We reviewed the overtime records for 40 employees at two facilities and found many are working considerable overtime, including more than three overtime shifts in a one or two week period and/or ten or more consecutive days without a day off. As a result, there may be increased risks to patient care posed by staff who may not be performing at their optimal level due to fatigue or inattentiveness.

Key Recommendations

  • Explore, implement and manage ways to reduce overtime costs. Adopt the best practices of other HHC facilities when deciding to use overtime.
  • Establish and implement controls to prevent employees from working excessive overtime shifts and consecutive days.
  • Set specific dollar or percentage overtime reduction goals for the facilities and monitor performance in achieving these goals.

Other Related Audits/Reports of Interest

Metropolitan Transportation Authority: Management and Control of Employee Overtime Costs Report 2009-S-88
Port Authority of New York and New Jersey: Management and Control of Employee Overtime Costs Report 2009-S-87

State Government Accountability Contact Information:
Audit Director: John Buyce
Phone:(518) 474-3271; Email:
Address: Office of the State Comptroller; Division of State Government Accountability; 110 State Street, 11th Floor; Albany, NY 12236