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Executive pay is rising faster than bedside pay, and the coverage says nothing about your DON
The Hospital & Healthcare Compensation Service (HCS) published its 2026-2027 Nursing Home Salary & Benefits Report in August 2026, produced with LeadingAge and supported by the American Health Care Association. Skilled Nursing News reported the results. Among positions tracked in both the 2025 and 2026 studies, MDS coordinators saw the biggest average raise, 4.25%, to $92,666. Executive directors/CEOs rose 4.08% to $173,884, and nursing home administrators rose 3.71% to $139,630. CFOs remain the best paid at $198,264, up 3.50%. The sample is about 950 nursing homes and more than 126,050 employees, with data effective March 2026.
Is leadership pay really outrunning nursing wages?
Yes, on these averages. Executive directors got 4.08% and administrators 3.71%, while RNs rose roughly 3%, LPNs 3.15% and CNAs 2.68%, so leadership raises exceeded every bedside role listed.
Skilled Nursing News said growth was concentrated among "core administrative and operational leaders", a group that included HR, staff development, life enrichment, social services and plant operations directors. Hourly RN pay moved from $40.68 to $41.90, LPN pay reached $33.19 and CNA pay reached $20.77. If you are defending a nursing retention budget, the gap helps your argument. It also means your nurses can read the same trade press and compare it with their own raise.
Can I benchmark my Director of Nursing from this?
Not from the published coverage. Skilled Nursing News gave no Director of Nursing or assistant director figures, so you would need the full report's position tables.
The omission may be an editorial choice, since the report covers many management roles and DON data may well be in it. But the one nursing-adjacent number we do have is the MDS coordinator average of $92,666, which rose 4.25%. Check whether the gap between your DON's pay and your MDS coordinator's has narrowed. Do the same for your ADONs. Compression like that tends to show up in resignations before it shows up in a survey.
How far should I trust an average from about 950 homes?
Treat it as a directional benchmark, not a market price. Participating homes supplied the data, the coverage reports averages rather than ranges, and the figures are effective March 2026.
Three questions are open. Skilled Nursing News doesn't say whether the same facilities answered in both years, and the year-on-year percentages depend on that. The sample leans not-for-profit, at 58.50% against 41.50% for-profit, which may not match your competitors. And the data comes from employers describing what they pay, not from what candidates accepted. The report is cut by revenue, profit type, bed size, region, state and CBSA, so ask for your own cut. A national average will mislead you in a tight local market.
Does falling turnover mean hiring has eased?
Partly. Turnover has declined since peaking in 2022 and fewer homes now pay sign-on bonuses, but bonus use barely changed in the latest year, so the market is not obviously loose.
Bonus use was 65.44% of respondents in 2024, 55.61% in 2025 and 54.38% in 2026. Most of the decline came earlier. RNs, LPNs and CNAs are still the main recipients. The article gives no turnover rates by role, which is where a DON would want detail. The report reportedly includes turnover and vacancy rates and projected 2026 to 2027 raises by department, and those are the figures to use when you build next year's budget.
Frequently asked questions
Which role had the largest raise?
MDS coordinators, at 4.25%, to an average of $92,666, among positions tracked in both the 2025 and 2026 studies.
What did nurse hourly pay do?
Staff RNs rose from $40.68 to $41.90 an hour. LPNs rose 3.15% to $33.19 and CNAs rose 2.68% to $20.77.
What should I ask whoever supplies my pay benchmarks?
Ask for the sample size in your state and CBSA, whether figures are means or medians, whether the panel of facilities was the same year to year, and what DON and ADON pay looks like.
Sources: Skilled Nursing News, "Nursing Home Executive Salaries Rise in 2026, With Executive Directors/CEOs Seeing a 4.08% Increase."