Employee turnover rates in Missouri’s hospital workforce increase slightly

JEFFERSON CITY, Mo. – Turnover rates for registered nurses, and in aggregate for 35 hospital- and clinic-based positions, increased slightly in 2025 — ending a downward trend seen since 2021. The uptick mirrors a small increase in all-profession hospital worker vacancies during the same period. According to MHA President and CEO Jon D. Doolittle, identifying these trends helps Missouri hospitals understand the local, regional and statewide talent environment to support their work in shaping individual and collective workforce investments.

“Missouri’s hospitals and their partners have built a strong system to identify, recruit and train tomorrow’s workers,” Doolittle said. “They also innovate within their organizations to ensure hospital careers remain a great choice for both entering and incumbent team members. Countless opportunities exist in health care for careers that provide personal and professional growth. They also bring the reward of contributing to healthier and stronger communities.”


According to Doolittle, hospitals have made significant progress in stabilizing the R.N. workforce, although work remains. He highlighted the nearly 50% decline in R.N. vacancy between 2021 and 2025, while signaling the significant work occurring to build strong cultures and flexible organizations to reduce R.N. turnover.

MHA’s workforce data collection focuses primarily on the influence of two components — vacancy (unfilled positions) and turnover (workers who leave the position or organization). Doolittle said both challenges can influence hospital operations and organizational morale.

“The relatively flat vacancy rates statewide indicate investments in work redesign and the workforce pipeline are delivering results,” Doolittle said. “Turnover often signals team members seeking opportunity within the same organization or elsewhere in the talent marketplace. Together, the data informs hospitals’ understanding of the competitive talent environment and helps them evaluate and invest in benefits, work designs and workplace cultures to remain employers of choice in the communities they serve.”

MHA’s 2026 Workforce Report

MHA Workforce_Report_FINAL_A

The 2025 data indicates vacancy rates are correlated with specialized, harder-to-fill clinical roles, rather than broadly distributed throughout the workforce. Turnover is highest among entry-level and support roles, which often serve as key entry points into the health care workforce. Several nurse and nurse support roles have both high vacancy and turnover.

The survey also found significant regional variation in the R.N. workforce, and in numerous other positions within the hospital workforce. Within the R.N. category, the South Central region includes the lowest levels of R.N. vacancy while the Southwest region has the lowest rate of R.N. turnover. Regionally, the highest vacancy rate is in the Kansas City region while the highest turnover is in the Central region.

Check out MHA’s new Workforce Data Dashboards
to explore statewide and regional data.

“Talent development and work redesign are moving forward with purpose,” Doolittle said. “Whether we’re educating or training future team members or upskilling tomorrow’s leaders, the state’s hospitals are deeply committed to investing in people to deliver the high-quality care Missourians need and deserve.”

The report includes statewide and regional data from 126 hospitals and vacancy and turnover rates for 35 hospital- and clinic-based positions. A comprehensive interactive dashboard of workforce data, trends and color-coded vacancy and turnover maps are available at MoHospitals.org.

Learn more about MHA’s workforce strategy here.

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The Missouri Hospital Association is a nonprofit association in Jefferson City that represents 135 Missouri hospitals. In addition to representation and advocacy on behalf of its membership, the association offers continuing education programs on current health care topics and seeks to educate the public about health care issues.