Healthcare Staffing Shortage Statistics 2026

Healthcare staffing shortage statistics for 2026 describe several different problems. A vacancy rate measures open budgeted positions. Turnover measures departures during a defined period. A workforce projection compares modeled future supply with demand. None of these measures can be substituted for another.

The latest national evidence shows that hospital RN vacancy improved from pandemic-era highs but remained substantial. Turnover rose in 2025, hospitals still needed more than two months to recruit an experienced RN, and contract staffing remained a major expense. Longer-term federal projections show large geographic and occupational gaps even when national supply appears adequate for some roles.

This review keeps the source year, population, and definition beside each figure. It does not combine surveys into a single shortage percentage.

Healthcare staffing shortage statistics at a glance

Hospital vacancy rates remain uneven

NSI's 2026 report is based on responses from 527 acute care facilities. It puts the national RN vacancy rate at 8.6%. One-third of participating hospitals, 33.1%, reported an RN vacancy rate of 10% or more. The average hospital still had 43 unfilled RN full-time-equivalent positions after measures such as higher pay scales and sign-on bonuses. NSI published the survey scope and results in March 2026.

The 8.6% figure is a hospital RN vacancy benchmark, not a vacancy rate for the whole healthcare sector. It does not cover every physician practice, nursing home, home health agency, or outpatient clinic. It also describes open positions relative to budgeted RN positions, not the share of licensed nurses who are unemployed.

NSI estimated a national shortage of 158,600 RNs from its survey responses. That estimate and HRSA's workforce projections use different methods. NSI surveys hospitals about current staffing. HRSA models occupation-level supply and demand under stated assumptions. They should be reported separately.

Turnover rose for hospital employees and staff RNs

Participating hospitals reported 18.5% employee turnover for calendar year 2025, up from 18.3% in 2024. Staff RN turnover was 17.6%, up from 16.4%. NSI found the highest RN turnover in behavioral health, emergency services, and telemetry. Pediatrics, surgical services, and women's health had the lowest rates. The 2026 NSI report defines these as hospital and staff RN turnover measures.

A one-year turnover rate should not be read as the percentage of positions vacant on a given day. A hospital may refill a role during the year and still count the departure in turnover. This is why a 17.6% RN turnover rate can coexist with an 8.6% vacancy rate.

NSI calculated an average cost of $60,090 for one bedside RN turnover. It estimated that turnover cost the average hospital $4.2 million to $6.2 million a year. A one-percentage-point change in RN turnover was worth about $295,000 annually for the average participating hospital. These are survey benchmarks, not a guaranteed cost for every facility. Hospital size, orientation time, overtime, recruitment expense, and lost productivity all change the local amount. NSI reports the cost model with its 2026 turnover findings.

Time-to-fill keeps vacancies open for months

NSI's RN Recruitment Difficulty Index was 78 days in the 2026 report. The measure represents the average time needed to recruit an experienced RN, or a little over two and a half months. The report uses the 78-day index as its national experienced-RN hiring benchmark.

Time-to-fill is not the same as vacancy duration for every open requisition. An employer's clock may start at approval, posting, or recruiter intake and end at offer acceptance or start date. Healthcare leaders comparing sites should use one definition and report the median as well as the average when possible. A small number of very difficult hires can raise the average sharply.

The operating effect lasts beyond the recruitment period. A new employee may need credentialing, orientation, and supervised practice before reaching normal capacity. Facilities should therefore track approved-to-accept, accept-to-start, and start-to-independent-practice as separate intervals.

Contract labor expense remains above its earlier baseline

The American Hospital Association estimated that hospitals spent about $51.1 billion on contracted staff in 2023. Total hospital labor costs reached $839 billion and accounted for nearly 60% of average hospital expense. Labor in the AHA estimate includes purchased services and professional fees. AHA published these 2023 expense estimates in its 2024 Costs of Caring report.

The longer comparison shows how quickly temporary staffing costs changed. From 2019 to 2022, hospital contract labor expense rose 257.9%. Contract full-time equivalents rose 138.5%, while the rate paid to staffing firms increased 56.8%. AHA's 2023 report attributes the figures to data from more than 1,000 hospitals and health systems.

Those 2019-to-2022 increases describe the pandemic surge, not a continuing annual growth rate. AHA says contract labor spending moderated after the peak, although the 2023 dollar total remained elevated. The proper 2026 conclusion is that contract expense is still material, not that it is still rising at the 2022 pace.

Contract workers can preserve service capacity while a permanent position is open. The cost comparison should account for benefits, paid leave, training, overtime, and vacancy coverage on the employee side rather than comparing a contract bill rate with base pay alone.

Burnout and intent to leave remain retention risks

The 2024 National Nursing Workforce Study surveyed 744,714 RNs and 137,902 LPN/VNs through mail, email, and Nursys e-Notify samples across US jurisdictions. The National Council of State Boards of Nursing applied weights for state, age, and gender after a nonresponse analysis. NCSBN describes the study design and collection period of March 25 through December 31, 2024.

The study found that 39.9% of RNs and 41.3% of LPN/VNs intended to leave nursing or retire within five years. Among respondents who intended to leave, excluding retirement, about 41.5% selected stress and burnout as the reason. Workload, understaffing, and inadequate salary followed. More than 138,000 nurses had left the workforce since 2022. NCSBN released these findings in April 2025.

Intent is a warning indicator, not a forecast that 39.9% of RNs will leave. Plans can change, and the measure includes retirement. Even so, the scale matters because staffing shortages and workload can reinforce each other: vacancies increase workload, and workload is one reason nurses consider leaving.

Projected gaps differ by role and location

HRSA's December 2025 workforce brief projects a shortage of 141,160 physician FTEs in 2038 under its status quo supply and demand assumptions. The total includes 70,610 primary care physicians, 10,660 anesthesiologists, 7,660 obstetrician-gynecologists, and 7,270 cardiologists. Thirty of the 35 physician specialties modeled show a shortage. HRSA publishes the specialty breakdown and model horizon on its projections page.

Geography is as important as the national total. HRSA projects a 58% physician shortage in nonmetro areas in 2038, compared with 5% in metro areas. The percentages express projected supply adequacy against modeled demand within those areas. They are not the share of residents without a physician.

Nursing also varies widely by state. HRSA's 2023-to-2038 projections range from a 22% RN shortage in California to a 79% projected surplus in Wyoming. A national balance can therefore coexist with severe local deficits. The HRSA nurse projections fact sheet reports the state range.

BLS offers a different view of future hiring pressure. It projects about 1.9 million openings per year across healthcare occupations from 2025 to 2035. That total includes openings caused by employment growth and the need to replace people who permanently leave an occupation. It is not a shortage estimate. BLS states the projection period and definition in its Healthcare Occupations outlook.

A practical workforce scorecard

Healthcare organizations can keep these measures distinct in a monthly staffing review:

Administrative workload belongs in the same review because it affects clinical time. Scheduling, referral follow-up, inbox management, and records work do not require a licensed clinician in every case. Our overview of the healthcare virtual assistant role explains common administrative assignments. Organizations evaluating managed support can also review healthcare virtual assistant services. Task delegation should follow privacy, security, credentialing, and clinical-scope requirements.

Frequently asked questions

What is the RN vacancy rate in 2026?

The 2026 NSI survey reported an 8.6% national RN vacancy rate among participating acute care hospitals. It also found that 33.1% of hospitals had an RN vacancy rate of at least 10%. This is a hospital survey benchmark, not a rate for every healthcare setting.

What is the hospital nurse turnover rate?

Staff RN turnover was 17.6% for calendar year 2025 in NSI's 2026 report. Overall hospital employee turnover was 18.5%. Turnover counts departures over a period and should not be confused with the point-in-time vacancy rate.

How long does it take to hire an experienced RN?

NSI's 2026 RN Recruitment Difficulty Index was 78 days. Employer definitions differ, so organizations should document when their hiring clock starts and stops.

How much do hospitals spend on contract staff?

The American Hospital Association estimated that US hospitals spent approximately $51.1 billion on contracted staff in 2023. The figure remained elevated after pandemic peaks but should not be treated as a 2026 spending estimate.

How many healthcare workers will be needed in the future?

BLS projects about 1.9 million healthcare occupation openings each year from 2025 to 2035, including growth and replacement openings. HRSA separately projects a shortage of 141,160 physician FTEs in 2038. The two numbers answer different questions and should not be added together.

Sources and methodology

This review uses sources available through September 2, 2026. It prioritizes federal workforce projections, occupational projections, a national nursing regulatory survey, a national hospital retention survey, and American Hospital Association expense reporting. The main publication dates are March 2026 for NSI, December 2025 for HRSA, April 2025 for NCSBN, and May 2024 for the AHA contract staffing total.

Vacancy, turnover, time-to-fill, contract expense, intent to leave, annual openings, and projected supply gaps remain separate measures throughout the article. Survey results describe their participating populations. Modeled projections depend on their stated assumptions and should not be read as current headcounts.