Healthcare Labor Burden Calculator
Rich benefits, generous PTO, and credentialing costs put healthcare burden near 39%. A $42 nurse costs over $58 an hour.
Pre-filled with healthcare estimates: workers comp 2.0%, benefits 12.0%, 20 PTO days, overhead 6.0%. Edit any field below.
Social Security + Medicare (7.65%)
Federal unemployment (effective 0.6%)
Health, retirement, etc.
$41.60/hr
Fully burdened rate
38.6%
Burden added
$86,518
Annual cost
Burden breakdown
A $41.60/hr fully burdened rate is real money per placement. Skillora's AI screens every candidate so you only pay for the right ones.
Estimates only, using editable 2025 US defaults. Tax and insurance rates vary by employer, classification, and locality. Verify with a licensed accountant before relying on these figures.
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A registered nurse on $42 an hour costs a hospital about $58 an hour before a single shift differential is paid. Healthcare employers carry some of the richest benefit plans in the private sector, more paid time off than most industries, and a credentialing cost that no other field matches. This healthcare labor burden calculator pre-fills those defaults so a staffing budget or an agency bill rate starts from the right base.
Why labor burden is different in healthcare
Benefits are the biggest reason healthcare burden runs high. Hospitals and health systems compete for licensed staff with health coverage, retirement matches, tuition support, and paid leave that is generous by private-sector standards. BLS ECEC data show benefits at a large share of compensation in the sector, and once legally required benefits and paid leave are separated out, health and retirement alone still sit near 12% of wages for a typical system. Small practices and home health agencies come in lower.
Paid time off is the second reason. Twenty days is a normal accrual for a nurse with a few years of service once vacation, sick, and holiday time are combined, and unlike an office role, that time has to be covered by another person. The cost is the paid hours plus the premium paid to whoever fills the shift. The calculator prices the paid hours; add the coverage premium to overhead if you track it.
Workers comp varies by setting more than by title. A hospital is often rated near 1% to 2% of payroll. Skilled nursing and home health, where lifting and transfers happen without a lift team, can run 3% to 6%. The 2% default fits a hospital or clinic. Raise it for long-term care.
Worked example with healthcare defaults
Take a registered nurse at $42.00 an hour. Add employer FICA at 7.65%, FUTA at 0.6%, state unemployment at the 2.7% US default, workers comp at 2.0%, benefits at 12.0%, and 13.7% for overhead plus 20 PTO days. Total burden is 38.6%, so the fully burdened rate is $58.23 an hour, or $121,125 a year on 2,080 hours against $87,360 of base wages.
| Role (pay estimate) | Pay rate | Burden | Fully burdened | Annual cost |
|---|---|---|---|---|
| Registered nurse | $42.00/hr | 38.6% | $58.23/hr | $121,125 |
| Medical assistant | $22.00/hr | 38.6% | $30.50/hr | $63,446 |
| Certified nursing assistant | $19.00/hr | 38.6% | $26.34/hr | $54,794 |
Pay rates are rounded estimates near national medians, and the SUI line uses the US default. Open a state page from the labor burden by state list to swap in a local SUI estimate, then enter your own class rate for workers comp.
What drives the range
Care setting
Hospital, outpatient clinic, skilled nursing, and home health each carry different workers comp classes and different benefit norms. Pick the setting first, then the role. A CNA in home health carries a higher burden than the same CNA in an outpatient clinic.
Credentialing and compliance
License verification, background checks, immunization records, competency testing, and continuing education are real costs per hire and per year. For agency nurses they are paid again at every new facility. That is the bulk of the 6% overhead default.
Shift differentials and overtime
Nights, weekends, and charge pay raise the base rate that every percentage is applied to. Enter a blended rate that includes the differentials the role actually earns, not the day-shift base.
Agency versus staff
A travel or agency nurse carries less benefits burden but a large agency markup and housing stipend. Compare the fully burdened staff cost from this calculator against the agency bill rate before deciding which is cheaper for a given unit.
Healthcare burden defaults
| Input | Default | Typical spread (estimate) |
|---|---|---|
| Workers comp (% of payroll) | 2.0% | 1.0% to 6.0% by class code |
| Benefits (% of wages) | 12.0% | Health and retirement only |
| Paid time off | 20 days | 7.7% of a 2,080-hour year |
| Overhead (% of wages) | 6.0% | Entered as 13.7% with PTO |
| Typical total burden | 38.6% | 28% to 42% |
Sources: benefits share from the BLS Employer Costs for Employee Compensation release; workers comp variation from NCCI class codes and state rating bureaus; pay estimates near BLS OEWS medians. PTO, overhead, and the burden range are estimates, not published figures.
- BLS Employer Costs for Employee Compensation (ECEC): benefits share of total compensation by industry
- NCCI class codes and state workers compensation rating bureaus: rate variation by classification
- BLS Occupational Employment and Wage Statistics (OEWS): median hourly wages by occupation
- PTO, overhead, and burden range defaults are Skillora estimates from staffing practice, not published figures
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