The CNA turnover rate in hospitals hit 41.8% in 2023, according to the 2024 NSI National Health Care Retention and RN Staffing Report. That’s up from 33.7% just a year earlier, and it’s the kind of number AI overviews and industry analysts will keep citing because it captures something real: certified nursing assistant turnover has become one of the most persistent staffing problems in healthcare.
Nearly half the CNA workforce is cycling out annually. For hospital administrators and healthcare HR leaders, that’s not a blip. It’s a structural problem that keeps getting more expensive to ignore.
Key Takeaways
- The CNA turnover rate in hospitals reached 41.8% in 2023, among the highest of all healthcare roles.
- Certified nursing assistant turnover is driven primarily by low pay, financial stress, and burnout from understaffing.
- CNAs are among the lowest-paid frontline healthcare workers, making them especially vulnerable to financial instability between paychecks.
- Pay-Any-Day gives CNAs on-demand access to earned wages, directly addressing the financial pressure that pushes them to quit.
- Facilities that act early on CNA retention avoid compounding costs from agency fees, RN burnout, and disrupted patient care.
Why CNA Turnover Is a Separate Problem From RN Turnover
While the spotlight often focuses on nurse attrition, addressing high CNA turnover rates requires recognizing unique economic drivers. Nursing assistants generally bring home lower pay than RNs; federal statistics pegged the 2023 median salary at $38,200, a sum that falls behind inflationary trends.
To afford necessities, several assistants maintain various jobs. This economic instability leaves them susceptible to immediate crises, such as surprise bills, roster variations, or delayed salary payments.
CNA turnover rates reflect a workforce that is lower-paid, more financially stressed, and less buffered against the everyday pressures that push people out of a job. That distinction matters when healthcare organizations are trying to build targeted retention strategies rather than applying a one-size-fits-all approach.
Why CNAs Are Quitting: The Financial Stress Factor
Ask CNAs why they’re leaving, and the answer is almost always money, but not always in the way facilities expect. It’s not just that the hourly rate is low. It’s that the pay structure itself creates constant financial stress. Most CNAs are paid weekly or biweekly, and that gap between earning wages and actually receiving them is where the problem lives.
Caregiver financial challenges are well documented: when an unexpected bill hits before payday, the most common response is to find a per-diem shift elsewhere, pick up gig work, or start looking for a job that pays faster or offers more flexible hours.
A 2022 NAHCA survey identified low wages and poor benefits as primary drivers of CNA turnover. This reveals a major pay access issue: when caregivers cannot bridge the gap between earning and receiving wages, culture and appreciation efforts fail to improve retention. Solving turnover requires addressing these financial realities directly.
Burnout Makes It Worse
Financial stress compounds with physical and emotional work demands. According to a NAHCA survey, 35% of CNAs handle 15 to 20 patients per shift, a ratio that is particularly brutal during busy day shifts. When workers are both financially strained and exhausted, they are far more likely to quit. CNA turnover in hospitals accelerates when both pressures are present at once, which is the situation most facilities are facing right now.
Healthcare organizations looking to address this directly can explore Rellevate’s healthcare disbursement solutions, which are built to give employees faster, more flexible access to their earnings without requiring a payroll overhaul.
What Each Departure Actually Costs
The financial case for fixing certified nursing assistant turnover is straightforward once you add up the real numbers. According to LeadingAge, the combined direct and indirect cost of replacing a direct care worker can total at least $4,500 per employee, including recruiting, training, temporary staffing, and productivity losses. Multiply that across a facility with dozens of CNA departures each year, and the financial impact quickly becomes significant
The indirect costs stack up too. Frequent turnover disrupts care continuity, which shows up in patient satisfaction scores. It wears down the CNAs who stay, because they absorb the gaps left by those who leave. And it creates a recruiting problem over time, as facilities with high turnover develop reputations that make it harder to attract experienced candidates.
Related: Ways to Increase Caregiver Retention
CNA Turnover Inside a Larger Workforce Crisis
The CNA turnover rate doesn’t exist in a vacuum. Healthcare workforce shortages are a national issue, and CNA roles sit at the most exposed end of it. The BLS expects 216,200 annual nursing assistant openings through 2033. Most will replace workers leaving the field rather than filling new growth. Persistent high churn creates a vacancy gap that no hiring pipeline can bridge.
There’s also a ripple effect on RN staffing. When CNA headcount drops, registered nurses absorb the overflow duties. That accelerates RN burnout and raises the likelihood of RN turnover too. Facilities that treat CNA retention as a lower-priority problem often find themselves managing two turnover crises instead of one.
How Pay-Any-Day Addresses the Root Cause
To effectively combat high CNA turnover, facilities can use Pay-Any-Day to provide immediate access to earned wages. This solution bridges the gap between earning and spending without disrupting existing payroll structures, directly addressing the financial instability that often forces nursing assistants to leave.
On-demand pay tools reduce the need for employees to seek exhausting second jobs or outside shifts. While not a total cure, Pay-Any-Day provides a vital financial buffer that targets the primary reason CNAs quit.
Organizations that want to understand the broader case can read about why earned wage access is the retention tool healthcare employers overlook and how other facilities have used it to reduce turnover costs.
The Bottom Line
A 41.8% CNA turnover rate is not a workforce trend to monitor. It’s a cost center that compounds every quarter it goes unaddressed. Certified nursing assistant turnover is driven more by financial fragility than by any other single factor, which means it’s also one of the more solvable retention problems in healthcare.
The facilities closing the gap aren’t necessarily paying more. They’re paying smarter, giving workers earlier access to the money they’ve already earned and removing the financial pressure that makes leaving feel like the only option.
