Hospitals have long screened patients for housing, food and financial insecurity. A growing number are now running the same playbook on their own workforce, and they are building the infrastructure to fix it.
Pay raises alone have not closed the gap between what healthcare workers earn and what it costs to live near the hospitals that employ them. So systems are treating basic-needs security — housing, childcare, cash flow, a person to call in a crisis — as a retention and, increasingly, a clinical strategy.
A stark case is in Nantucket, Mass., where 70% of the staff at Nantucket Cottage Hospital experience housing insecurity on an island where the average home sells for $4.4 million. The 14-bed hospital, part of Somerville, Mass.-based Mass General Brigham, is raising nearly $70 million to build 48 furnished apartments for staff. About two years ago, the hospital hired a full-time housing coordinator, who last year helped roughly 120 employees navigate lottery-based housing and secure leases.
The strain of affordability falls hardest on the workers who keep hospitals running and sit lowest on the pay scale. Hospital housekeepers earned a median of $35,510 and nursing assistants $42,260 last year, according to May 2025 Bureau of Labor Statistics data — a fraction of the $97,550 median for registered nurses, the hospital workforce’s largest occupation, and far short of what it costs to rent, arrange childcare or buy groceries in many markets.
“We are the second largest employer on the island, and so it’s incredibly important that we have a workforce that can support the hospital,” Amy Lee, president and COO of Nantucket Cottage Hospital, told Becker’s in May.
Similar offerings have been running for more than a decade. San Diego-based Scripps Health created a dedicated “crisis concierge” employee in 2010 to walk workers through the paperwork and financial assistance that follow a death, a fire or a medical emergency, drawing on an employee-funded hardship pool. It is the same instinct behind Nantucket’s housing coordinator: someone whose full-time job is the parts of an employee’s life that happen outside the building.
Childcare is another established benefit. For example, Mass General Brigham runs childcare centers that offer in-home backup childcare, nanny services and tutoring. Meanwhile, HCA Healthcare built a $7 million childcare learning center for employees.
In February, Santa Barbara, Calif.-based Cottage Health achieved approval to expand its Orfalea Children’s Center, which carries a waitlist of more than 300 employees. The project would roughly double capacity to 160 children and grow the center’s staff from 28 to 50, with construction slated to begin in early 2027. Cottage is separately planning 204 below-market homes for employees to buy.
Other systems are handing over cash. Morgantown, W.Va.-based WVU Medicine gives aspiring nurses up to $25,000 upfront — money meant for life’s unexpected expenses, such as a flat tire, or expected costs like utility bills and groceries. The cash is in exchange for a three-year commitment to work at the 25-hospital system. As of late July, 985 students had enrolled and 338 had graduated into WVU Medicine jobs, with retention holding at 90% or higher.
“These are not people that would have gone to school, and it doesn’t make them less qualified,” according to Melanie Heuston, DNP, RN, the system’s chief nursing executive. In surveys, 80% of participants said they would not have applied to a nursing program without the support.
Another shift is happening on payday itself.
In October, Midland, Mich.-based MyMichigan Health began offering its roughly 10,000 employees earned wage access — the option to draw already-earned pay before payday through a vendor, free over one to three days or same-day for a small fee. Julie Ward, EdD, the system’s chief human resources officer, said the benefit was meant to help workers cover an unexpected bill and to nudge them to pick up open shifts when they know the money is available sooner.
It could be that housing, childcare and money for surprise expenses are not just perks but also recruitment and retention tools at health systems and hospitals — if they can afford them.
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