Page 31 - FY 2025 NRR Annual Report

31
THE FINANCIAL AND OPERATIONAL IMPACT OF RN TURNOVER:

INSIGHTS FROM THE 2025 NSI NATIONAL REPORT

The 2025 NSI National Health Care Retention & RN Staffing Report features input from 450 acute care hospitals
across the country on registered nurse turnover, retention initiatives, vacancy rates, recruitment metrics, and staffing
strategies. The survey covers 844,205 healthcare workers and 218,626 RNs.

Key Findings from the 2025 NSI Report

Financial Impact of Turnover

The cost per bedside RN turnover (now $61,110) rose 8.6% over
the previous year.
The average hospital loses between $3.9 million and $5.78
million annually due to RN turnover.
Each percent change in RN turnover represents an additional
$289,000 in costs or savings per hospital per year.

RN Turnover & Vacancy Rates

The 2024 RN turnover rate fell to 16.4% nationally—a 2.4%
decrease.
9.6% of RN positions remain unfilled nationally.
41.4% of hospitals have RN vacancy rates above 10%.
20.2% report vacancy rates below 5%.

Recruitment & Staffing Challenges

Average time to fill a vacancy is 83 days (three days faster than
2023), ranging from 62 to 103 days.
Labor and Delivery is the only specialty with an increased time-
to-fill (up 7 days).
Replacing 20 travel RNs with permanent staff saves an average
of $1.58 million; every RN hired saves $79,000.

Regional Differences
Turnover rates vary regionally:
Northeast: Lowest turnover, largest year-over-year decrease.
South-Central and Southeast: Remain above national average.
North-Central and West: Below national average.

Departmental Mobility & Stability

Highest Turnover rates are in Step-down (120.8%), telemetry (117.6%), emergency services (112.9%)
departments—meaning the entire RN staff could potentially turn over within 4.5 years.
Lowest Turnover rates are in Pediatrics (77.2%) and surgical services (77.1%).

Quality and Labor Costs
High RN turnover and vacancy lead to:
Increased overtime and critical staffing pay
More spending on salary increases, travel/agency staff
Direct negative impact on patient safety, clinical outcomes, and experience

Reducing RN turnover can produce tangible cost savings (every 1% drop saves ~$289,000/year). Recruitment
times, especially in critical care and labor/delivery, remain a bottleneck.

Source: 2025 NSI National Health Care Retention & RN Staffing Report (PDF)