Out of 398 bonus-advertising hospital RN postings, 96,2% skip the patient ratio

Frame and timing. Collection ran from 2026-09-09T17:42:04.087Z to 2026-09-09T23:47:15.636Z. We selected accessible hospital-employer boards, not a random sample of US hospitals. Workday searches used “nurse,” without the earlier new-graduate-only filters; iCIMS used nurse searches, SmartRecruiters its public postings API, and Tenet its RN category. Provider search limits and title screening can omit vacancies. HCA’s search access was blocked and it is not represented. Small independent hospitals and some ownership types may be underrepresented.

Selection. Hospital clinical RN titles covering inpatient, intensive care, medical-surgical, telemetry, stepdown, emergency and maternity-related roles were screened. Managerial, advanced-practice and support titles were excluded. URLs were hash-ranked using a fixed seed, with a maximum of 50 ads per employer group, before bonus classification. Workday and Tenet descriptions were fetched after selection; earlier same-day iCIMS and SmartRecruiters collections were subsampled using the same cap. Additional scope exclusions were not replaced.

What counts as a bonus. The main denominator requires explicit recruitment-bonus language in the title or description, including sign-on, signing, hiring or employment bonuses and combined sign-on/relocation offers. Eligibility conditions do not guarantee a payout. Generic “if offered” wording is not an offer; 46 such eligibility-only records are excluded. Another 107 records contain ambiguous or unspecified bonus language and are excluded from the main denominator. Annual, referral, retention and assignment-completion bonuses alone do not qualify.

What counts as patient-load disclosure. Numeric patient-to-nurse ratios, ranges and equivalent assignment statements count, including written-out numbers. Bed totals, training ratios, patient identifiers and generic promises of favorable staffing do not. We inspected contextual passages for all 80 positive numeric matches and broader candidate wording. Additional negative-case passage checks helped identify missed bonus formulations. This is rule-based classification with contextual quality review, not an independently double-coded manual census of every description.

Employer concentration. Group weighting averages the non-disclosure rate across groups with at least one bonus ad. Leave-two-out checks remove every possible pair of contributing groups. Matching employer/title grouping conservatively counts a group as disclosing a load if any member does; 94.9% of the 293 groups still lack one. Repeated titles may represent different units or sites, so this is not an estimate of unique vacancies.

Geography and missing data. Identifiable locations span 39 states; 702 postings could not be assigned a state from captured location fields. Country checks retain US postings; Tenet’s accepted locations were inferred from a US state and ZIP because its structured country field was blank. Six selected Tenet records could not be geographically resolved and were not replaced. Source-level unavailable rows and retrieval counts are in the JSON. We make no regional estimates or geographic weighting claims.

Expanded employer coverage. Version 3 adds DCH Health System, Baptist Health Alabama (Orlando Health) and OSF HealthCare, contributing 102 postings. Admission required at least 50 non-managerial RN titles and 20 titles meeting the report’s narrower clinical criteria. These thresholds were revised after listing-only feasibility checks, before reviewing descriptions for bonuses or ratios. The same title rules and 50-posting cap apply. All qualifying employers in this expansion were retained, including Baptist Health Alabama, whose sample had no qualifying bonus offers.

Description completeness by platform. Numeric patient-load figures appeared in 13 of 333 bonus-advertising Workday postings and 2 of 43 iCIMS postings, with the latter coming from DCH and OSF. None were identified in the 5 SmartRecruiters or 17 Tenet bonus-advertising postings. Positive cases are no longer exclusive to Workday, but 13 of 15 still come from that source. The audit cannot establish whether platform differences reflect employer practices, generally more detailed descriptions or capture completeness. We cannot rule out that description completeness varies by platform, and these counts do not establish a platform effect. Employer weighting does not resolve this limitation.

Interpretation. Absence from a captured description does not establish understaffing, concealment, unsafe care or information withheld later in recruitment. The sensitivity checks assess the retained data; they do not resolve potential differences in description completeness across platforms or make the panel nationally representative. Neither the smaller subsamples nor the sensitivity ranges are confidence intervals for the US hospital sector.