Texas Nurse Turnover & Wage Landscape: A 2026 Guide

Why Wage and Turnover Tracking Matter More in a Market This Large

The resignation letter arrives on a Tuesday. By Friday, the charge nurse is running the math on travel-nurse coverage, the Director of Nursing is fielding calls about open shifts, and someone is pulling up a spreadsheet that was already three months out of date.

That sequence plays out in every state. But in Texas — with its sprawling metro labor markets, rapid hospital and SNF growth, and significant variation in wages between a major academic medical center corridor and a rural border-region facility — the gap between what a spreadsheet can track and what a nurse leader actually needs to know is especially wide.

The state's sheer scale means that a Director of Nursing in a 150-bed San Antonio community hospital and a CNO at a Dallas-Fort Worth system hospital are operating in meaningfully different wage environments, even though both are "in Texas." Knowing which metro benchmark applies to your unit — and whether your current pay band sits above or below it — is the foundation of any credible retention conversation.

This guide pulls together what the national data can tell Texas nurse leaders about the broader context for texas nurse turnover and wages, explains where Texas-specific figures need to be verified against the BLS release directly, and describes a practical approach to turning that data into something actionable.

The National Turnover Picture as Context for Texas

There is no Texas-specific turnover rate published in the major public benchmarking sources available at the time of writing. What exists is a national figure with a wide range, and understanding that range is the starting point for any Texas facility benchmarking its own performance.

The 2026 NSI National Health Care Retention & RN Staffing Report placed the national staff RN turnover rate at 17.6% for 2025, an increase of 1.2 percentage points from the prior year and a reversal of the decline recorded in 2024 (NSI 2026, via Becker's Hospital Review, 2026). That single number, however, conceals a range of 5.6% to 40.0% across hospitals sorted by bed count (NSI 2026, via Becker's, 2026). A 100-bed community hospital and a 600-bed regional medical center are not operating in the same turnover environment, even within the same metro.

For context on what that turnover costs, the same NSI report puts the average cost per RN departure at $60,090 (NSI 2026, via Becker's, 2026). At the hospital level, the annualized cost of RN turnover averages $4.2M–$6.2M per year, with a mean of $5.19M — and each additional percentage point of turnover carries an average cost of $295,000 per year per hospital (NSI 2026, via Becker's, 2026).

For a Texas nurse leader trying to contextualize their own facility's numbers, the practical question is not just "how do we compare to 17.6%?" but "what is the trend on our unit, and is our wage position contributing to it?" The national range suggests that turnover at smaller Texas facilities could easily sit well above the national average, while a well-resourced system hospital might run below it.

"Each one-percentage-point increase in RN turnover costs the average hospital approximately $295,000 per year." — NSI 2026 National Health Care Retention & RN Staffing Report, via Becker's Hospital Review, 2026.

RN Wages in Texas: National Benchmarks and What to Verify Locally

The BLS Occupational Employment and Wage Statistics program publishes wages for Registered Nurses (SOC 29-1141) at the national, state, and metropolitan-area levels each May. These are the authoritative public figures for external wage benchmarking.

At the national level, the BLS May 2024 OES release placed the median annual RN wage at $93,600, with the 10th percentile below $66,030 and the 90th percentile above $135,320 (BLS Occupational Outlook Handbook, Registered Nurses, May 2024). Those percentile anchors matter: a facility paying near the 10th percentile in its metro is not competing on wages with most of its peers, regardless of what its HR policy says.

Texas is a large state with substantial wage variation across its metros. The BLS OEWS May 2024 state and metro-level data for Texas RNs (SOC 29-1141) — including figures for Houston, Dallas-Fort Worth, San Antonio, Austin, and El Paso — are not reproduced in this guide because they were not available in the verified source library at time of writing. Before using any Texas-specific wage figure for internal pay-band decisions, verify the current numbers directly from the BLS OEWS State and Metro Area release at bls.gov/oes.

For comparison: California is currently the highest-paying state for RNs, with a mean annual wage of approximately $148,330 (BLS OEWS May 2024, via Sunbelt Staffing analysis, May 2024). Texas wages — while not at that level — vary considerably by metro, and the gap between a high-demand urban corridor and a rural or border-region market can be substantial. A CNO benchmarking pay bands against a statewide Texas average rather than the relevant metro figure may be drawing the wrong conclusion entirely.

Our guide to state vs. metro wage benchmarking covers why metro-level BLS data generally produces more accurate pay-band comparisons than state-level averages, particularly in geographically and economically diverse states like Texas.

LPN/LVN Wages in Texas: The Same Verification Logic Applies

Licensed Practical and Vocational Nurses (SOC 29-2061) are the backbone of many Texas SNF and LTC staffing models. At the national level, the BLS May 2024 OES release places the LPN/LVN median annual wage at $62,340 ($29.97/hr), with the 10th percentile below $47,960 and the 90th percentile above $80,510 (BLS OOH, LPN/LVN, May 2024).

As with RNs, Texas metro-level LPN/LVN wages are not reproduced here — those figures must be verified against the BLS OEWS May 2024 state and metro release before they are used in pay-band decisions or cited in board presentations. The same metro-level logic applies: what LPNs earn in a Houston skilled nursing facility may be meaningfully different from what they earn in a rural West Texas market, and blending those figures produces benchmarks that are accurate for neither.

Texas LPN wages are particularly relevant in the SNF and LTC context. The national picture for that sector is sobering: 94% of nursing homes report difficulty recruiting staff, and 90% raised wages within the prior six months (AHCA 2024 State of the Sector Report, March 2024). By 2024, 46% of SNFs nationally were limiting admissions and 20% had closed entire units due to staffing constraints (PMC peer-reviewed research, 2026). These are national figures, but Texas SNF operators tracking texas nurse staffing pressures will recognize the pattern.

Texas Nursing Workforce: Scale and Structural Context

Texas's hospital base is large and growing. Nationally, there are approximately 6,120 hospitals with 916,752 staffed beds (AHA Fast Facts, FY2022 data, 2024 edition), and Texas accounts for a substantial share of both. The state's population growth, combined with a hospital development pipeline that has outpaced many other states, means that nurse demand is not easing.

On the supply side, the national picture for RN workforce size is more stable than the shortage narrative sometimes implies: total FTE RNs rebounded to 3.35 million in 2022–23, 6% above 2019's 3.16 million, with projections of approximately 4.56 million by 2035 (Auerbach et al., via PMC/HealthExec, 2024). BLS projects RN employment to grow 5% nationally between 2024 and 2034, generating approximately 189,100 annual openings — a large share of which reflect replacement demand rather than net new positions (BLS OOH, Registered Nurses, 2024–2034 projection).

For Texas, the practical implication is a continued competition for experienced RNs, particularly in high-acuity specialties. The NSI data shows that certain units face structurally elevated turnover: step-down, telemetry, and emergency services saw 113%–121% cumulative five-year turnover nationally (NSI 2025, via Becker's, 2025). Texas facilities staffing those units should not expect those pressures to ease through market normalization alone.

The HRSA workforce projection adds a long-run dimension: while a national 8% RN shortage is projected for 2028, the agency projects that shortage narrowing to approximately 3% (108,960 FTE) by 2038 — but with an 11% nonmetro shortage persisting at that point (HRSA Nurse Workforce Projections 2023–2038 Factsheet, 2024). Rural and border-region Texas facilities are likely to feel that nonmetro pressure more acutely than urban metros.

Turning Texas Wage Data Into a Retention Conversation

Understanding where your pay bands sit relative to the BLS metro median is the first step. But a wage benchmarking exercise that lives in a spreadsheet and gets revisited once a year is not the same as a retention-monitoring practice.

The underlying mechanics are straightforward — and worth making explicit. A rolling 12-month turnover rate calculated separately for each unit and role gives a nurse leader a current, comparable figure rather than a lagging annual snapshot. Paired with BLS OES wage benchmarking at the metro level, it answers two questions simultaneously: how often are nurses leaving, and is our pay position creating pressure that explains part of the answer?

For a concrete sense of what those numbers mean, consider the labeled model: a 120-bed Texas community hospital with 80 RN FTEs and a 20% annual turnover rate would see approximately 16 departures per year. At the NSI 2026 per-departure cost of $60,090, that is roughly $961,440 in annualized turnover cost — before any travel-nurse premium to cover vacancies. The NSI data puts the average time-to-fill for an experienced RN at 78 days (NSI 2026, via Kahuna Workforce, 2026), meaning each vacancy is a prolonged staffing gap, not a short-term inconvenience. This is a modeled illustration using NSI and BLS inputs — actual costs will vary by facility and should be verified against internal data.

That is the ROI logic behind treating wage benchmarking and turnover tracking as continuous operational metrics rather than annual exercises. Our BLS nurse wage benchmarking guide walks through the mechanics of pulling and applying metro-level OES data in detail.

What Texas Nurse Leaders Should Do Next

The immediate, practical step is pulling the BLS OEWS May 2024 metro-level data for your specific Texas market — Houston-The Woodlands-Sugar Land, Dallas-Fort Worth-Arlington, San Antonio-New Braunfels, Austin-Round Rock-Georgetown, or whichever metro applies — and comparing it against your current pay bands for RN (SOC 29-1141) and LPN/LVN (SOC 29-2061). That comparison tells you whether your wages are positioned to retain staff or to accelerate turnover.

The second step is making that comparison continuous rather than periodic. A pay band that sat at the 55th metro percentile in May 2024 may sit meaningfully lower by mid-2026 if wages have moved and your bands have not. That drift is rarely visible until a resignation conversation confirms it.

For Texas nurse managers and DONs who want to understand how analytics can make this monitoring systematic, our nursing workforce analytics guide covers the core metrics — rolling turnover rate, FTE-weighted headcount, wage-gap flags, retention risk scoring — in plain terms. The features overview and pricing page describe how Nursing Workforce Planner structures those metrics for mid-size facilities.

Stay current on Texas nursing workforce data. Subscribe to our newsletter for updates when new BLS wage releases, NSI benchmarks, or Texas-specific workforce data become available — we summarize what changed and what it means for mid-size facility planning, without the noise.

Wage and turnover figures cited from BLS OES are public domain; cite by source and release year. For Texas-specific metro wage data, always verify against the current BLS OEWS State and Metro Area release at bls.gov/oes. For nurse-to-patient ratio requirements and staffing regulations, consult the Texas Board of Nursing and the Texas Legislature directly. For SNF/LTC minimum staffing requirements and their current legal status, consult CMS.