{"name":"Rural Hospital and Critical Access Hospital Nurse Staffing Statistics (2026)","compiledBy":"SimpleScheduleAI","url":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics","updated":"2026-08-11","license":"https://creativecommons.org/licenses/by/4.0/","attribution":"Cite the primary source given for each figure, and link https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics as the collection.","sections":[{"id":"cah-landscape","heading":"Critical Access Hospital Landscape","takeaway":"Nearly every Critical Access Hospital CEO calls nursing staff hard to recruit (94%), and there are 1,388 of these hospitals across the country.","stats":[{"anchor":"us-cah-count","value":"1,388","label":"Certified Critical Access Hospitals in the U.S.","context":"Rural hospitals of 25 or fewer acute-care beds, as of July 2026.","source":"Flex Monitoring Team, Historical CAH Data","sourceUrl":"https://www.flexmonitoring.org/historical-cah-data-0","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#us-cah-count"},{"anchor":"rural-closures","value":"197","label":"Rural hospital closures and conversions since 2005","context":"109 fully closed and 88 converted to another care model; 154 of them since 2010.","source":"UNC Sheps Center Rural Hospital Closures Tracker","sourceUrl":"https://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures/","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#rural-closures"},{"anchor":"cah-ceo-recruiting","value":"94%","label":"CAH CEOs who found nursing staff hard to recruit","context":"86% also reported retention challenges (survey of 155 CAH CEOs, March–May 2022).","source":"Flex Monitoring Team policy brief, February 2023","sourceUrl":"https://www.flexmonitoring.org/sites/flexmonitoring.umn.edu/files/media/CAH_workforce_during_COVID_Barriers_and_facilitators_for_recruiting_and_retaining_staff_2025.pdf","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#cah-ceo-recruiting"}]},{"id":"national-staffing","heading":"National Nurse Staffing & Turnover","takeaway":"Each nurse who leaves a hospital costs about $60,090 to replace, and the average hospital is already short 43 of them.","stats":[{"anchor":"rn-turnover","value":"17.6%","label":"Average hospital RN turnover","context":"18.6% median, ranging from 5.6% to 40.0% depending on hospital size.","source":"2026 NSI National Health Care Retention & RN Staffing Report","sourceUrl":"https://www.nsinursingsolutions.com/documents/library/nsi_national_health_care_retention_report.pdf","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#rn-turnover"},{"anchor":"rn-vacancy","value":"8.6%","label":"National RN vacancy rate","context":"One in three hospitals (33.1%) reports an RN vacancy rate above 10%.","source":"2026 NSI National Health Care Retention & RN Staffing Report","sourceUrl":"https://www.nsinursingsolutions.com/documents/library/nsi_national_health_care_retention_report.pdf","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#rn-vacancy"},{"anchor":"cost-per-rn","value":"$60,090","label":"Cost of turning over one bedside RN","context":"The average hospital loses $4.2M–$6.2M a year to RN turnover; each 1% change is worth about $295,000 a year.","source":"2026 NSI National Health Care Retention & RN Staffing Report","sourceUrl":"https://www.nsinursingsolutions.com/documents/library/nsi_national_health_care_retention_report.pdf","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#cost-per-rn"},{"anchor":"rn-shortage","value":"158,600","label":"NSI-estimated national RN shortage","context":"About 43 unfilled RN positions at the average hospital; 78 days to recruit an experienced RN.","source":"2026 NSI National Health Care Retention & RN Staffing Report","sourceUrl":"https://www.nsinursingsolutions.com/documents/library/nsi_national_health_care_retention_report.pdf","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#rn-shortage"}]},{"id":"rural-access","heading":"Rural Access & Workforce Projections","takeaway":"A rural county has about two-thirds the nurse density of a city, and by 2038 the rural nurse shortage is projected to reach 11%, versus 2% in metro areas.","stats":[{"anchor":"rn-density","value":"65.1 vs 99.5","label":"RNs per 10,000 people, rural vs urban","context":"Rural areas have roughly two-thirds the RN density of urban areas (2024 BLS OES data).","source":"Rural Health Information Hub, Health Care Workforce","sourceUrl":"https://www.ruralhealthinfo.org/topics/health-care-workforce","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#rn-density"},{"anchor":"rn-projection-2038","value":"108,960","label":"Projected national RN FTE shortage by 2038","context":"The nonmetro RN shortage is projected at 11%, versus 2% in metro areas.","source":"HRSA / National Center for Health Workforce Analysis (December 2025)","sourceUrl":"https://bhw.hrsa.gov/data-research/projecting-health-workforce-supply-demand","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#rn-projection-2038"}]},{"id":"nurse-wages","heading":"Registered Nurse Wages","takeaway":"The median American nurse earns $97,550 a year ($95,970 in Texas), the wage base that every overtime hour is charged against.","stats":[{"anchor":"rn-wage-national","value":"$97,550","label":"Median RN annual wage, national","context":"About $46.90 per hour (BLS May 2025 OEWS wage data, via O*NET).","source":"O*NET OnLine, 29-1141.00 (BLS May 2025 OEWS)","sourceUrl":"https://www.onetonline.org/link/localwages/29-1141.00?st=TX","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#rn-wage-national"},{"anchor":"rn-wage-texas","value":"$95,970","label":"Median RN annual wage, Texas","context":"About $46.14 per hour (BLS May 2025 OEWS wage data, via O*NET).","source":"O*NET OnLine, 29-1141.00 (BLS May 2025 OEWS)","sourceUrl":"https://www.onetonline.org/link/localwages/29-1141.00?st=TX","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#rn-wage-texas"}]},{"id":"texas-cah","heading":"The Texas Critical Access Hospital Picture","takeaway":"Texas Critical Access Hospitals fill their nursing jobs better than any other hospital type in the state, then lose those nurses faster than any of them.","stats":[{"anchor":"texas-cah-count","value":"86","label":"Texas CAHs in the 2024 DSHS study frame","context":"The 2024 state survey counted 86 CAHs across 78 counties, of which 50 responded. The current federal count is 93 (Rural Health Information Hub, 2026).","source":"Texas DSHS 2024 Hospital Nurse Staffing Study, Rural/CAH factsheet","sourceUrl":"https://www.dshs.texas.gov/sites/default/files/chs/cnws/HNSS/2024/2024_HNSS_RuralCAH_accessible.pdf","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#texas-cah-count"},{"anchor":"texas-cah-vacancy","value":"11.6%","label":"Texas CAH RN vacancy rate","context":"Lower than rural non-CAH hospitals (14.3%) and non-rural hospitals (16.5%).","source":"Texas DSHS 2024 Hospital Nurse Staffing Study, Rural/CAH factsheet","sourceUrl":"https://www.dshs.texas.gov/sites/default/files/chs/cnws/HNSS/2024/2024_HNSS_RuralCAH_accessible.pdf","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#texas-cah-vacancy"},{"anchor":"texas-cah-turnover","value":"18.2%","label":"Texas CAH RN median turnover","context":"The highest of the three groups (rural non-CAH 15.4%, non-rural 17.4%).","source":"Texas DSHS 2024 Hospital Nurse Staffing Study, Rural/CAH factsheet","sourceUrl":"https://www.dshs.texas.gov/sites/default/files/chs/cnws/HNSS/2024/2024_HNSS_RuralCAH_accessible.pdf","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#texas-cah-turnover"},{"anchor":"texas-cah-rn-mix","value":"61%","label":"Share of Texas CAH nursing staff who are RNs","context":"Versus 80.5% at non-rural hospitals; LVNs make up 16.4% of CAH nursing staff (vs 3.6%).","source":"Texas DSHS 2024 Hospital Nurse Staffing Study, Rural/CAH factsheet","sourceUrl":"https://www.dshs.texas.gov/sites/default/files/chs/cnws/HNSS/2024/2024_HNSS_RuralCAH_accessible.pdf","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#texas-cah-rn-mix"},{"anchor":"texas-cah-fte","value":"74%","label":"Texas CAHs reporting no change in budgeted RN FTEs","context":"Only 24% increased their budgeted RN FTEs, versus 36.3% no-change at non-rural hospitals.","source":"Texas DSHS 2024 Hospital Nurse Staffing Study, Rural/CAH factsheet","sourceUrl":"https://www.dshs.texas.gov/sites/default/files/chs/cnws/HNSS/2024/2024_HNSS_RuralCAH_accessible.pdf","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#texas-cah-fte"},{"anchor":"texas-statewide-vacancy","value":"16.4%","label":"Texas statewide hospital RN vacancy (2024)","context":"Down from 17.6% in 2022; 8,575 of 52,369.8 RN FTEs statewide were vacant.","source":"Texas DSHS 2024 Hospital Nurse Staffing Study, Highlights factsheet","sourceUrl":"https://www.dshs.texas.gov/sites/default/files/chs/cnws/HNSS/2024/2024_HNSS_Highlights_accessible.pdf","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#texas-statewide-vacancy"},{"anchor":"texas-statewide-turnover","value":"23.2%","label":"Texas statewide RN median facility turnover (2024)","context":"Down from 28.3% in 2022.","source":"Texas DSHS 2024 Hospital Nurse Staffing Study, Highlights factsheet","sourceUrl":"https://www.dshs.texas.gov/sites/default/files/chs/cnws/HNSS/2024/2024_HNSS_Highlights_accessible.pdf","permalink":"https://simplescheduleai.com/rural-hospital-nurse-staffing-statistics#texas-statewide-turnover"}]}]}