Return on investment
The cost hospitals already carry
Annualized · Sourced

The vacancy is
already on your budget.

An open RN position doesn’t show up as its own line item on a budget, it shows up as overtime, agency premiums, and the slow erosion of unit quality. By the time a CFO asks why staffing costs are up, the gap has usually been open for months and the real cost has already been paid, just spread across categories that don’t say “vacancy” anywhere on them.
What the numbers actually say

Cost of not solving it.

Annualized cost per unfilled RN FTE
$175K to $500K+

Depending on specialty, overtime, and travel-nurse coverage.

Cost of turnover, per nurse who leaves
$60,090

NSI 2026 average per bedside RN, before the cost of refilling that role even begins.

Interactive · drag to size

The premium you are carrying, calculated live.

Pick the tier closest to your hospital, then correct any number with your own. The model prices the premium you are paying today, the travel and agency markup, the overtime on the seats they do not cover, and the churn on those seats, and shows what stops when a permanent nurse takes the seat instead.
Your hospital
Size tier

300 to 700 RN FTEs. Sets a conservative base case you can overwrite.

Budgeted RN FTEs500
RN vacancy rate8.6%

Budgeted positions unfilled by permanent staff. National average is 8.6% (NSI 2026).

Travel RN FTEs in use20
Agency / contract RN FTEs10
RN turnover rate17.6%

National average is 17.6%, ranging 5.6% to 40.0% by bed size (NSI 2026).

The placement
Direct-hire RNs placed20
Share replacing travel85%
Share replacing agency0%
Share filling open vacancies15%

The remainder, set automatically so the allocation always totals 100%. These are the seats currently covered by overtime.

Scenario

A global haircut on gross savings. Base is 1.00x.

Adjust the rate benchmarks
Travel RN bill rate$92/hr

All-in. Conservative against the ~$102 national average.

Agency bill rate$78/hr
Loaded cost, permanent RN$110,000

Wage plus about 28% benefits and differentials. Excluded as a program cost, since you pay it for any staff nurse in the seat.

Cost per RN turnover$60,090

NSI 2026 average per bedside RN, soft costs included.

Premium you stop paying, each year
$1,534,834

at full run-rate on 20 placements, counted from the day each nurse starts

Per nurse, per year
$76,742
Over three years
$4.60M
Seats converted
20
Where the annual saving comes from
Premium labor replaced$1,383,120
Overtime premium reduction$129,000
Turnover reduction$22,714
Cumulative gross savings$1.24M$2.49M$3.73M$4.97MYear 1Year 2Year 3$4.60M
The staffing gap you are covering todayFTEs
Vacant RN positions43
Covered by travel and agency30
Open gap absorbed by overtime13
Overtime premium spent on that gap, per year$559,000

These are gross savings: the premium spend that stops. They are shown before what the program costs you, because your investment depends on the roles, the timeline and the volume, and we would rather quote it than have you guess at it. Benchmarks come from the NSI 2026 National Health Care Retention Report and Nurse.org 2024, listed in full below. Each driver is scoped so nothing is counted twice: travel and agency seats are counted once as premium labor, while overtime and turnover apply only to the open vacancies your nurses fill. Send us your figures and we will run the net model, assumptions shown.

Why direct hire changes the math

Where the math actually changes.

01

Avoided turnover cost

Direct-hire nurses are not cycling through a contract and leaving at the end of it.
02

Reduced overtime & agency premiums

The position is filled permanently rather than patched temporarily.
03

Quality scores & shorter stays

Staffing continuity ties directly into reimbursement and accreditation metrics, not just staffing line items.
04

Sustained revenue

Units that are reliably staffed don't have to turn away admissions or close beds.
Proof, not projection: as placements at our contracted hospitals complete, this page will carry documented before and after cost data, covering vacancy rate, cost delta against travel nursing, and time to fill, so the pattern speaks for itself.
Talk to us about your numbers

Tell us a little about your hospital.

A real person follows up, not a sales queue.
The calculator above shows gross savings, the premium spend that stops. Send us your current agency spend and open requisition count and we will run it net of what the program costs you, with every assumption shown.Or compare direct hire against staffing agencies →

You are already paying for this.

The premium above is not a projection, it is spend that is already in your budget under other names. The only question is whether it keeps buying temporary coverage or buys a permanent nurse instead.

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