What you’ll learn in this article…
- The 2026-2027 HCS report covers 947 nursing homes and 126,050 employees.
- Nursing Home Administrator pay rose 3.71% among repeat participants.
- Sign-on bonus use fell to 54.38% in 2026 as turnover declined.
What Nurse Leaders Should Take From the New Nursing Home Pay Report
Turn the HCS findings into budget benchmarks, retention plans, and board-ready talking points
As turnover eases and sign-on bonus spending fades, budget season in long-term care now forces nurse administrators to justify pay adjustments with market data rather than anecdotes. The 49th annual Nursing Home Salary & Benefits Report from Hospital & Healthcare Compensation Service, supported by AHCA, gives you that data, effective as of March 2026.
Repeat participants reported a 3.71% compensation increase for Nursing Home Administrators. Sign-on bonus use slipped to 54.38%, down from 55.61% in 2025. That shift from recruiting gimmicks to retention math changes how you make the compensation case.
What the Report Covers and How Reliable It Is
What exactly is the 2026-2027 Nursing Home Salary & Benefits Report, and how much weight should nurse administrators put behind its numbers? It is a large, repeatable market scan, but like any self-reported survey, it is a benchmark, not a census.
What Is Actually in the Report
The report is the 49th annual national study published by Hospital & Healthcare Compensation Service (HCS), with support from AHCA. Data is effective as of March 2026. It draws on 947 nursing homes and compensation data for more than 126,050 employees, covering 47 management positions and 55 nonmanagement positions. The AHCA overview summarizes the findings.
How Reliable Is It?
Participating facilities self-report the data, so it reflects only organizations that chose to submit. The published materials do not provide a response rate or the number of facilities invited, so you cannot calculate a sample-to-population percentage. Use the breakouts as directional nurse administrator salary comparisons against your own market and peer group, not as a universal national fact.
How to Access It
Order the PDF or hard copy through the HCS website. Pricing varies by channel: - HCS participant: $200 - HCS nonparticipant: $400 - AHCA/NCAL member: $325 - Excel add-on: $325, not sold separately
The fringe benefit section is described as covering 18 or 19 categories depending on the source.
Key Compensation Findings for Nursing Home Leadership Roles
Among facilities that reported in both the current and prior-year studies, the report shows year-over-year pay movement for several key leadership roles. Repeat participants reported compensation increases of 3.71% for Nursing Home Administrators, 3.82% for Directors of Facilities/Plant Operations, and 3.66% for Directors of Social Services from 2025 to 2026.
Where the Highest Increases Landed
The highest-increase group also included CFO, HR Director, Director of Staff Development, and Life Enrichment Director. For nurse leaders, the Staff Development role matters directly because those professionals manage clinical competency, orientation, and compliance training across the nursing team, areas a nursing administration certificate often covers.
A Gap for Director of Nursing
The published raise percentages do not include a separate Director of Nursing figure. For context, the most recent national averages for nursing home Director of Nursing and Nursing Home Administrator roles were $117,000 and $145,790, respectively, according to Hospital & Healthcare Compensation Service data. Use those as directional benchmarks, not facility-specific targets.
Why Repeat Participants Matter
The 3.71%, 3.82%, and 3.66% increases reflect only homes that reported in both years. That means they track how pay moved for the same facilities over time, not what a new hire might command on the open market. When you bring this data to a budget conversation, frame it as internal wage growth for incumbent leaders, especially those with nurse executive certification. New-hire offers can run higher, especially in tight state or rural markets.
How Nursing Home Pay Compares With BLS Benchmarks for Nurse Leaders
The BLS Occupational Employment and Wage Statistics for 2025 provide outside context for nursing home leadership pay. Medical and health services managers, the federal category that most often includes nursing home administrators and directors of nursing, reported a national median of $123,860, with a 25th percentile of $94,700 and a 75th percentile of $166,100. Registered nurses had a median of $97,550, and chief executives a median of $213,990. These figures cover all industries, so they do not isolate nursing homes, and salary aggregators often publish different numbers because they use different job definitions, data years, and sample sources. Published nursing home comparisons show Directors of Nursing around $117,000 to $123,860, while acute care directors often fall between $130,000 and $170,000, suggesting hospital settings pay more for comparable leadership roles. Treat the 2025 BLS data as approximate when benchmarking 2026 nursing home compensation.
| Occupation | 25th Percentile | Median | 75th Percentile |
|---|---|---|---|
| Medical and Health Services Managers | $94,700 | $123,860 | $166,100 |
| Chief Executives | $129,540 | $213,990 | $356,200 |
| Registered Nurses | $80,330 | $97,550 | $112,350 |
Matching Your Facility to the Right Peer Group
Long-term care peer benchmarking no longer relies on one-size-fits-all national figures; the 2026-2027 HCS report gives nurse leaders the cut points to do it right. The report's data is effective as of March 2026 and includes breakouts by state, metro area, bed-size band, and profit type.
Build the Peer Filter in Order
Start by narrowing in this order: state or region, then core-based statistical area (CBSA), then bed-size band, then profit type (for-profit, nonprofit, government). For a Director of Staff Development, pull the same sequence from the management-position tables so you are comparing against facilities with similar market pressure and staffing scale, not just similar title. Use the same filter for Directors of Nursing and other nursing-line managers, because their market references should match the facility, not just the national database. Resist the urge to compare a rural 60-bed nonprofit with a metro chain-owned facility. Those two facilities are not peers even if both employ a Director of Staff Development; their wage competition, payer mix, and recruitment radius differ sharply. The HCS breakouts let you isolate each dimension before layering them together.
Check the State Breakout
For state-level planning, use the matching state breakout. If you operate in California, query the California section rather than leaning on a Pacific region or national median. Then place your figure next to BLS state and metro data for the same role as a sanity check, because BLS occupational wage estimates use different samples and time periods. Note the HCS effective date of March 2026 when presenting, and do not mix it with older BLS releases without flagging the date difference.
Always benchmark against your state, bed-size, and profit-type peer group. A national average hides the cost and competition differences that actually drive what your market pays, and it may not reflect the facilities you compete with for nurse leaders. Pull the local breakouts before you present a number.
Turnover Is Falling and Sign-On Bonuses Are Fading
Sign-on bonus use among nursing homes slipped to 54.38% in 2026, down from 55.61% in 2025 and 65.44% in 2024. That decline lines up with a longer downward trend in turnover that began after the 2022 peak, though the exact rates still depend heavily on the survey and sample.
Who Still Gets a Sign-On Bonus
Registered Nurses, LPNs, and CNAs remain the primary recipients of sign-on incentives. Fewer facilities reported offering bonuses to Medication Techs, Resident Assistants, or Dining and Kitchen staff in 2026. If your building is still paying broad sign-on bonuses across non-nursing roles, that money may be following an old playbook.
Turnover in Context
Recent role-level turnover figures remain wide: the 2025 HCS/AHCA nursing home report put RN turnover at 36.53%, LPN at 35.29%, and CNA at 42.34%, while a separate 2026 State of the Senior Living & Care Workforce reported RN at 40.8%, LPN at 31.6%, and CNA at 39.0%. Top-level executives were lower at 22.12% in 2025. Position-level vacancy rates are collected in the full report but are not consistently published in public summaries, so avoid using one national vacancy number as a fixed benchmark. The 2026-2027 report includes projected salary increases by department; use those figures internally rather than treating any single turnover percentage as the whole story.
Shift Dollars From Recruiting to Retention
As sign-on bonuses fade, nursing administration leaders control retention levers more directly, career ladders, shift differentials, and improved onboarding. Reallocate a portion of recruitment budget to these controls before turnover tightens again. Just be careful not to claim bonuses caused turnover to fall; the report shows association, not causation, and broader labor market relief likely played a role.
Benefits and Total Compensation: Looking Beyond Base Pay
Why Base Pay Alone Undervalues the Offer
Base salary is only one lever. A total-rewards comparison should weigh shift differentials, sign-on or retention bonuses, health insurance, retirement match, paid time off, and tuition support for a DNP in nursing administration. For a Director of Nursing or Staff Development role, a $5,000 base gap can disappear when a facility offers a stronger retirement match, lower health premiums, or a tuition benefit.
What the 2026-2027 Report Tells You
The AHCA/NCAL Nursing Home Salary & Benefits Report tracks fringe benefits and shift differentials alongside pay.1 The national summary does not publish every benefit prevalence rate, so treat the figures that circulate as directional until you check the full PDF tables. Cross-industry 2025 data puts median weekday second-shift differentials around $1.00 per hour and third-shift around $1.50 per hour, but those are not nursing-home-specific.2 Some nursing facility job ads show night differentials commonly in the $1 to $3 range, again not from the HCS survey. Once you have the full report tables, use the shift differential breakouts to see whether your second- and third-shift premiums sit near the market for your state, profit type, and bed size.
Build a One-Page Total Compensation Sheet
Line up cash compensation (base, differentials, bonuses) on one side and benefits on the other. Annualize what you can: employer health insurance contributions, the retirement match applied to salary, PTO days converted to a daily rate, and any tuition reimbursement cap. Then compare total cash plus benefits across facilities. When an offer looks low on base, show the combined value.