Nursing Staff at continuing care retirement communities continue to enjoy significant pay increases and sign-on bonuses in 2024 — though a slight cooling of pay increases has carried over from 2023, according to a new report from the Hospital & Healthcare Compensation Service.

Pay rates for registered nurses, licensed practical nurses and certified nursing assistants increased by 5.04% overall in 2024, down from 7.04% in 2023 and 8.87% in 2022. 

The decreases have largely been driven by stabilizing CNA salaries, the 2024-2025 CCRC Salary & Benefits Report made clear. CNA pay rose by more than 11% in 2022, but was up only 5% in 2024 — putting it closely on par with the rate of LPN and RN pay increases.

While less than in prior years, the 5% overall increase still outstripped the pace of inflation in the US. The nation’s consumer price index rose by 3.4% in 2023.

CNAs now can expect to make $19.81 per hour on average in CCRCs, compared to $31.04 for LPNs and $39.29 for RNs.

Nursing home administrators, meanwhile, made $139,999 on average, which was a 6.4% increase from 2023. A CCRC’s director of nurses now makes $120,157 on average — a 6.7% increase from 2023.

The annual HCS report, made in partnership with LeadingAge, is among the most comprehensive and detailed looks at CCRC salaries and benefits and has been running since 1971. The 271-page report is available for purchase. 

The 2024 report surveyed 510 CCRCs and life plan communities nationwide, with more than 80,000 employees. Among the respondents, 57% provided some type of skilled nursing and 81% were nonprofit providers. 

Attracting and retaining staff

Faced with ongoing employee retention woes, many providers have attempted to attract more workers using sign-on bonuses. That number decreased between 2023 (64%) and 2024 (57%), however.

The small majority of CCRCs still using sign-on bonuses broadly increased the size of those bonuses for RNs (by 12%) and LPNs (by 17%) but slightly reduced bonuses for CNAs from $2,247 in 2023 to $2,107 in 2024 — a roughly 7% decrease.

The more modest bonuses for CNAs matched the smaller overall pay increases CNAs received in 2024.

Despite pay increases and bonuses, CCRCs continued to deal with extremely high turnover rates among nursing staff: 38% for RNs, 37% for LPNs and 43% for CNAs nationwide.

CNAs and dining service staff once again had the highest levels of turnover overall. CNA turnover was higher than 50% in the East North Central and West North Central regions, which included 12 Midwest and Great Plains states from the Dakotas to as far south as Kansas and as far east as Ohio. 

Sector experts and recent state programs across the nation have frequently targeted building a pipeline of new CNAs into long-term care and other senior care facilities, in response to this concerning turnover rate.

Turnover rates for top provider executives were also relatively high, sitting at 18% in the current report, with 13.6% of respondents citing a vacancy at that level.