How Much Does It Really Cost to Lose a Nurse? (2026 Data)

The Invoice That Changed the Conversation

The travel-nurse bill arrives on a Tuesday. The line items — agency fee, housing stipend, mileage, the overnight surge rate — total more than the nurse manager expected, and the CFO sends a one-line reply: How did we get here?

The honest answer, in most facilities, is incremental. One resignation in February that went unfilled for eleven weeks. A second in April during a difficult stretch on the med-surg unit. Each departure felt like a staffing problem. The invoice revealed it was also a financial one.

What makes the cost of nurse turnover difficult to confront in a budget meeting is that it rarely appears as a single line item. Recruitment advertising, agency placement fees, overtime paid to colleagues carrying extra load, the preceptor hours burned onboarding a replacement, the ramp time before a new hire reaches full productivity — each of these lives in a different cost center. Summed, they tell a story that spreadsheets rarely surface until the damage is done.

This article works through what the 2026 research actually shows, how the component costs accumulate, and how a nurse manager or Director of Nursing can build a working model of their facility's annualized cost of nurse turnover — so the next board conversation starts with a number, not a reaction.

What the 2026 NSI Data Shows

Every year, the NSI National Health Care Retention & RN Staffing Report surveys hospitals and calculates an evidence-based per-departure cost for staff RNs. The 2026 edition — drawn from 527 hospitals across 40 states, covering 965,886 healthcare workers including 262,405 RNs — puts that figure at $60,090 per RN departure (NSI 2026 National Health Care Retention & RN Staffing Report, via Becker's Hospital Review, 2026).

That is a slight improvement from the prior year's $61,110 (NSI 2025, via Becker's, 2025), which was itself an 8.6% year-over-year increase, with a range of $49,500–$72,700 depending on specialty, geography, and facility type. The downward movement between 2025 and 2026 is modest; the underlying cost structure has not materially changed.

Alongside the per-departure figure, the NSI 2026 report estimates the total annual RN-turnover loss per average hospital at $4.2M–$6.2M, with a mean of $5.19M (NSI 2026, via Becker's, 2026). A single percentage-point change in RN turnover rate carries an estimated $295,000 annual impact per hospital (NSI 2026, via Becker's, 2026).

"A single percentage-point change in RN turnover rate carries an estimated $295,000 annual impact per average hospital." — NSI 2026 National Health Care Retention & RN Staffing Report, via Becker's Hospital Review, 2026.

These are averages. A 100-bed community hospital will see different absolute totals than a 280-bed regional medical center, but the per-departure mechanics are broadly consistent. The NSI methodology is the most widely cited external benchmark for this calculation; it is the figure Nursing Workforce Planner uses as the default cost-per-departure assumption in its turnover cost model (configurable against a facility's own finance-team numbers).

Where the $60,090 Comes From: A Component View

The NSI figure is not a single line item — it is an aggregate of costs that typically span three or four departments. Understanding the components helps nurse managers articulate the number to administrators who haven't seen the research.

Recruitment and sourcing costs

Once a nurse resigns, the unit begins incurring costs before a replacement candidate is even identified. Job board postings, agency placement fees, recruiter time, and candidate screening all accumulate during what the NSI 2026 data describes as an average 78-day time-to-fill for an experienced RN (Recruitment Difficulty Index, NSI 2026 via Kahuna Workforce, 2026). Nearly three months of vacancy is not an outlier — it is the national average.

During that window, the unit typically absorbs the shortfall through some combination of colleague overtime, float pool coverage, and agency or travel-nurse fill. None of those options are cost-neutral.

Overtime and agency coverage

Overtime paid to colleagues covering an open position represents real incremental labor cost. Agency coverage is substantially more expensive than directly employed staff: the NSI 2026 data notes travel-nurse rates as high as $160/hr (NSI 2026 / Kahuna Workforce, 2026), and the PMC-published research benchmark places the agency RN median at $64.19/hr against a directly employed RN median of $41.99/hr (PMC peer-reviewed research, 2023) — a meaningful premium that compounds across every week a position stays open.

For a facility relying on agency coverage to fill a 36-hour-per-week RN FTE at elevated agency rates, the premium relative to employed-staff wages accumulates quickly over a 78-day vacancy window. The NSI 2026 report quantifies a related data point: replacing 20 travel nurses with employed staff is modeled to save approximately $1.32M (NSI 2026 / Kahuna Workforce, 2026). That figure is a modeled estimate — not every facility will match it — but it illustrates the order of magnitude of the travel-nurse premium at scale.

Onboarding and orientation

A replacement hire does not reach full clinical productivity on their first day. Preceptor time, unit orientation, electronic health record training, and the learning curve on unit-specific protocols all carry a cost. The preceptor who is walking a new hire through procedures is not simultaneously carrying their own full patient assignment; that reduced capacity is a real cost to the unit even if it never appears as a budget line.

Specialty units tend to carry higher onboarding costs because the learning curve is longer and the preceptor investment is greater. The NSI 2025 report documented 113%–121% cumulative five-year turnover in step-down, telemetry, and emergency services (NSI 2025, via Becker's, 2025), compared with 77.2% in pediatrics and 77.1% in surgical — a signal that facilities relying heavily on high-acuity nursing roles experience the compounding effect of onboarding costs more frequently.

Productivity ramp

Even after orientation ends, a new RN typically operates at reduced throughput for months. Patient assignment complexity may be managed carefully during the ramp period; charge nurses spend additional time supporting the new hire. This soft productivity loss is real cost even when it is invisible to a cost-center report.

What the Turnover Rate Looks Like in 2026

The per-departure cost is one variable. The other is how frequently departures occur.

The NSI 2026 report puts the national staff RN turnover rate at 17.6% for 2025, up 1.2 percentage points from 16.4% in 2024 — reversing the prior year's decline (NSI 2026, via Becker's, 2026). That upward movement is worth monitoring, particularly because the 2024 figure had been read by many facilities as a stabilization signal.

The range across hospitals tells a more useful story than the average: 5.6%–40.0% depending on hospital bed count (NSI 2026, via Becker's, 2026). A facility sitting at 25% turnover is not experiencing an unusual aberration — it is within the documented range. What distinguishes it from a facility at 12% is not category, it is measurement and intervention.

The vacancy rate sits at 8.6% nationally (2025), with an average of 43 unfilled RN FTEs per hospital; one in three hospitals (33.1%) is carrying a vacancy rate at or above 10% (NSI 2026, via Becker's, 2026). Open positions and turnover interact: a facility with a high vacancy rate has fewer employed nurses to absorb the load when another resignation arrives, which accelerates the agency dependency cycle.

For context on the broader labor market: the BLS projects RN employment to grow approximately 5% from 2024 to 2034, with roughly 189,100 annual job openings (BLS Occupational Outlook Handbook, 2024–2034 projection). Annual openings account for both growth and replacement demand; a meaningful share reflects nurses leaving the profession or retiring rather than moving between employers. That structural demand is the backdrop against which every facility's 78-day average time-to-fill sits.

Building Your Facility's Annualized Cost of Nurse Turnover

The NSI per-departure figure is a national average. Your facility's actual number depends on your headcount, your turnover rate, and your cost structure. The following is a worked example — a method demonstration, not a projection for any specific facility — anchored on NSI and BLS inputs.

Example inputs (round numbers for clarity):

Variable	Example value	Source
Employed RN FTEs	80	Facility input
Rolling 12-month RN turnover rate	20%	Facility input
Estimated departures per year	16 (80 × 20%)	Calculated
Cost per departure	$60,090	NSI 2026
Annualized turnover cost (modeled)	$961,440	Calculated

At 20% turnover across 80 RN FTEs, a facility is looking at a modeled cost approaching $1M per year — before any adjustment for specialty-unit premium, above-average time-to-fill, or heavy travel-nurse reliance. Change the turnover rate to 25% (still well within the NSI-documented range), and the modeled figure rises to approximately $1.2M.

The $295,000-per-percentage-point figure from NSI 2026 is a population-average sensitivity. For smaller facilities, the per-point impact is lower in absolute dollars but often larger as a share of operating margin.

The variables in this model — FTE headcount, rolling 12-month turnover rate, and cost per departure — are exactly what a rolling 12-month turnover rate calculation surfaces. If your facility is currently tracking departures in a spreadsheet, the RN Turnover Tracker template provides a structured starting point: a pre-built Excel workbook designed to calculate rolling 12-month RN turnover by unit and apply the NSI per-departure cost to model annualized attrition cost. You can run the numbers for your own headcount and rate in the ROI calculator as well.

For a step-by-step explanation of how the underlying rate is calculated — and why the rolling 12-month method is more reliable than a calendar-year snapshot — see the companion article on how to calculate your nurse turnover rate.

The Compounding Effect: When High Turnover Feeds Itself

One feature of nurse turnover that is easy to underestimate is its self-reinforcing character. A unit carrying a persistently open position puts additional load on the nurses who remain. That load is a known driver of intent to leave. If the additional load is covered by agency staff who rotate in and out, continuity suffers — another factor that experienced nurses cite when weighing whether to stay.

The NCSBN 2022 National Nursing Workforce Study estimated that 610,388 RNs — nearly one in five — intended to leave their current position by 2027, including approximately 200,000 under the age of 40 (NCSBN 2022 National Nursing Workforce Study, 2023). Intent to leave is not the same as a submitted resignation, but it is a leading indicator. A facility with no systematic way to track unit-level turnover trends will typically learn about elevated intent through exit interviews — which arrive after the departure, not before.

The cost of nurse turnover is, in part, a cost of late detection. By the time a resignation letter is on the nurse manager's desk, the recruitment clock has already started, the agency call is already queued, and the financial impact is already locked in. The question that precedes all cost discussion is whether the facility had any signal in the months before the letter arrived.

That is what retention risk scoring and vacancy forecasting tools are designed to surface — but the prerequisite is having clean, unit-level turnover data in the first place. The nursing workforce analytics guide covers how that data infrastructure is typically built.

Why $60,090 Is a Floor, Not a Ceiling

The NSI per-departure figure is a national average built from broad survey data. Several factors push actual per-departure costs above it for specific facilities and roles.

Specialty premium. High-acuity units — ICU, ED, step-down, OR — carry longer orientation periods, higher preceptor ratios, and greater recruitment difficulty. The NSI 2025 documentation of 113%–121% cumulative five-year turnover in step-down, telemetry, and emergency services reflects the frequency with which these costs recur; it is not a direct specialty cost multiplier, but it signals where the turnover economics are most punishing.

Geography. The BLS May 2024 data puts the national RN median annual wage at $93,600, with a 10th-percentile floor below $66,030 and a 90th-percentile ceiling above $135,320 (BLS Occupational Outlook Handbook, May 2024). In states where the prevailing wage is substantially above the national median — California's mean annual RN wage was approximately $148,330 as of BLS OEWS May 2024 — replacement costs scale accordingly, because signing bonuses, competitive starting salaries, and travel-nurse fill all reference the local market.

Facility size. The NSI-documented turnover range of 5.6%–40.0% by bed count implies that smaller facilities can sit at the high end of that range. A 60-bed hospital with 35 RN FTEs experiencing 30% turnover is managing 10–11 departures per year. At the NSI per-departure figure, that is a $600,000–$660,000 annual exposure. For a facility of that size, the cost of turnover as a share of nursing labor budget is substantial — and almost certainly not visible as a single consolidated number anywhere in the current reporting structure.

LPN/LVN turnover costs. The NSI figure applies to RNs. LPN/LVN departures carry different cost dynamics: the BLS May 2024 median annual LPN/LVN wage is $62,340 ($29.97/hr), with 651,400 LPN/LVN jobs nationally and approximately 54,400 annual openings (BLS OOH, LPN/LVN, May 2024). Replacement cost for LPN/LVN roles is generally lower in absolute dollar terms but remains meaningful — particularly in SNF and LTC settings where LPN/LVN staffing ratios are load-bearing and AHCA survey data shows 94% of nursing homes find recruiting difficult, with 72% still below pre-pandemic staffing levels (AHCA 2024 State of the Sector Report, March 2024).

From a Number to a Dashboard Metric

Knowing that the cost of nurse turnover is approximately $60,090 per RN departure is a useful benchmark. What makes it actionable is applying it to your specific headcount, your actual rolling turnover rate, and your unit-level vacancy data — on an ongoing basis rather than once per year during budget season.

The annualized turnover cost calculator on this site walks through the arithmetic in detail. For facilities ready to move beyond a spreadsheet, Nursing Workforce Planner's dashboard automates the cost model: it calculates rolling 12-month turnover by unit and role, applies the NSI per-departure figure (or a custom value from your finance team), and keeps the annualized cost exposure current without manual data entry.

The ROI framing is straightforward: at $60,090 per RN departure (NSI 2026), preventing a single departure covers multiple years of the Professional tier ($3,490/year). That is not a marketing claim — it is labeled arithmetic on the NSI figure, which your CFO can verify directly from the source.

The more useful question, though, is not whether the product pays for itself. It is whether your facility currently has a number — a rolling, unit-level, cost-weighted view of RN turnover — that it could put in front of the board today. If the answer is "not without building it in a spreadsheet first," the RN Turnover Tracker is a practical starting point: a structured Excel template built around the same NSI per-departure anchor, ready to populate with your own headcount and departure data.

The cost of losing a nurse is not a mystery. In 2026, it has a name — $60,090 — and a method. What it needs, in most facilities, is a place to live in the reporting structure.

Explore the nurse turnover resource hub for the full library of turnover measurement guides, cost models, and benchmarking references, or review the travel-nurse-versus-staff-cost comparison to see how the vacancy premium maps onto the per-departure figure.