Vacancy and turnover rates have decreased in some key healthcare professions in North Carolina, and the state’s health education programs are producing more new professionals than a year ago. However, the supply of newly trained workers still falls well short of annual demand. The state also continues to face challenges with adequate workforce distribution in rural areas and worker retention, according to new North Carolina health workforce data released today.

The third annual Health Talent Alliance (HTA) report, produced by the NC Center on the Workforce for Health in partnership with NC AHEC and the NC Chamber Foundation, tracks changes in both supply and demand for health professionals while identifying strategies to better meet statewide and regional needs.

“NC Health Talent Alliance focuses on defining employer needs and mobilizing action region by region,” said Andy MacCracken, director of the NC Center on the Workforce for Health. “This year’s analysis provides state and regional partners greater depth of information to drive meaningful action.”

The analysis is designed to inform action across the nine NC AHEC regions, which convene employer-ed collaboratives that use the data to prioritize action around shared workforce pain points. More than 150 employers—representing a wide range of care settings—are engaged in HTA through those regional collaboratives alongside regional education and workforce partners to coordinate action and implement regionally tailored interventions.

“This progress reflects the hard work and collaboration of employers and educators across North Carolina, and they deserve enormous credit,” said Vincent Ginski, senior director of workforce competitiveness at the NC Chamber Foundation. “But we cannot take our foot off the gas. Retaining the professionals we have, bringing back those who have left, and continuing to invest in our schools, colleges and universities will be critical to closing workforce gaps and meeting North Carolina’s growing healthcare needs.”

Results of the 2026 Health Talent Alliance Data Analysis

North Carolina’s demographic shifts are creating both opportunities and challenges for its healthcare workforce. A fast-growing and aging population is driving increased demand for healthcare services. Major investments in health education programs and migration into the state are helping to expand the pool of available healthcare professionals. Increasing the number of graduates from health education and training programs alone will not address current and projected workforce shortages. Retaining existing healthcare workers is also essential to meeting growing demand.

Nursing supply saw modest improvements, but workforce gaps remain

• Nursing, where the state has the most comprehensive data, offers the clearest example of progress on the supply side. Data from the NC Board of Nursing shows North Carolina’s nursing programs produced approximately 4,670 newly licensed RNs in 2025, up from 4,543 in 2024, a gain of just under 3 percent. The growth is promising but slower than prior year’s year-over-year RN growth. LPN output grew far faster, rising from 913 to 1,078, an 18 percent year-over-year increase.
• Annual supply for RNs and LPNs is not meeting annual replacement demand. The supply of locally trained workers is not keeping pace with annual replacement needs for key positions like RNs and LPNs. Labor market projections for 2026 through 2029 show North Carolina needs an average of about 6,930 new RNs and 1,520 new LPNs entering the workforce each year to keep pace with those exiting the profession and new jobs being created. At 2025 output, the state’s nursing programs cover roughly two-thirds of annual RN openings and about 70 percent of annual LPN openings, leaving a shortfall of about 2,260 RNs and 440 LPNs a year. Sustained growth in program output, alongside better retention, is what will ultimately close that gap.

Workforce stability shows progress, but challenges continue

• Vacancy and turnover rates declined over the past year for registered nurses (RNs), licensed practical nurses (LPNs), certified nursing assistants (CNAs), and medical assistants (MAs) but remain above national and recommended levels. Workforce shortages and turnover continue to create significant costs for healthcare employers and affect their ability to deliver patient care given the size of these professions.
• Only 4% of hiring represents new jobs whereas all other positions are being replaced after being vacated. As such, retaining existing health professionals is crucial to stabilizing this workforce.
• Emergency management and behavioral health jobs take a long time to fill, and employees are moving through organizations (high turnover and churn) quickly.
• CNAs and LPNs metrics show workers coming and going from organizations quickly, meaning employers spend a lot of time staffing these positions.

Health workers are unevenly distributed across facility types and geographies

• NC continues to struggle with the distribution of its health workforce by geography. Rural areas had higher levels of vacancy, turnover, and churn than suburban or urban areas on average for the professions of interest combined. However, urban areas still struggle with attracting and retaining talent due to the volume of choice for employees in those areas and the reliance on out of state supply to meet employer demand.
• The state also struggles with distribution of health workforce by facility. Behavioral health, long-term services and supports, and public settings (i.e. health departments, correctional facilities and veterans’ affairs clinics) have higher levels of vacancy and employee turnover and churn than health and hospital settings, public, and other settings for the professions of interest.

About the Annual Health Talent Alliance Data Analysis

The NC Health Talent Alliance (HTA) leverages an employer-demand survey and other sources to provide insights into the specific challenges facing the healthcare workforce. This year’s analysis includes data on more than 102,200 positions submitted by employers across more than 1,700 facilities in North Carolina. The data collection effort was executed in spring 2026 and collected employer data on hires, separations, and total positions (headcount) for all of 2025 and January 2026.

HTA also conducted analyses of secondary data from Lightcast, the NC Health Professions Data System run by the UNC Cecil G. Sheps Center for Health Services Research, the NC Board of Nursing, the Integrated Postsecondary Education Data System, the NC Community College System, the UNC System Office, the NC Department of Commerce and other relevant sources. Nursing education output figures cited in this release reflect 2025 NC Board of Nursing data on newly licensed RNs and LPNs.

HTA data collection over the past two years focused on RNs, LPNs, CNAs, and MAs. This year the scope of the survey expanded to additional professions: social workers, mental health counselors, community health workers, EMTs/paramedics, and radiology technologists. The findings provide concrete data on the current state of North Carolina’s health workforce and the progress being made to address shortages.

Healthcare professionals in behavioral health, direct care, and other areas of shortage do not have the same level of data available as RNs and LPNs, meaning more research is needed to fully understand supply and demand challenges.

To read the full report, visit: NC Center on the Workforce for Health

About the NC Health Talent Alliance

The NC Chamber Foundation and the NC Center on the Workforce for Health formally launched the landmark NC Health Talent Alliance public-private partnership in 2023 to aggressively address the state’s critical health care workforce shortages, and it conducts an annual survey of health employers and educational organizations. By leveraging the U.S. Chamber Foundation’s proven Talent Pipeline Management® (TPM) framework, the Health Talent Alliance works to fill critical health sector roles by building robust talent pipelines aligned with industry demand. NC AHEC regions are implementation partners, hiring regional staff to coordinate action with regional employers, educators and workforce entities. For more information, visit workforceforhealth.org/hta.