Long-Term Care Exec Pay Keeps Rising — But the Era of Big Raises Is Over

Long-term care executives are still getting raises — just not the kind they saw a few years ago.

A new industry compensation report shows that executives managing multi-site long-term care organizations received average salary increases of 3.36% in 2025, marking the second consecutive year of cooling pay growth. The figures come from the 2025-2026 Multi-Facility Corporate Compensation Report released by Hospital & Healthcare Compensation Service (HCS), which analyzed pay trends across 47 large long-term care organizations.

A Deliberate Slowdown

The 3.36% average is down from 3.52% in 2024 and 3.69% in 2023. That may sound like a minor shift, but it reflects a calculated strategy that’s been playing out across the sector since the COVID-19 crisis.

“After several years where many executives forewent significant increases to fund frontline raises, we are seeing a cautious restoration of executive pay growth, though it remains conservative,” HCS Director of Reports Rosanne Zabka said. “The pace of wage growth has continued to decelerate across all HCS studies, but the ‘cooling’ we’re seeing is more of a sequential stabilization than a simple drop-off.”

During 2021 and 2022, the biggest raises went to direct care staff — particularly front-facing healthcare workers — as operators scrambled to combat record turnover rates. Now, with some of that urgency faded, organizations are slowly restoring executive compensation while still keeping budgets tight.

Who’s at the Top

CEOs unsurprisingly led the pack. Across revenue categories, the average mid-point CEO salary was $486,194, with the average maximum hitting $606,535. CEOs in the 90th percentile at the highest-revenue organizations averaged $1.04 million.

COOs came in below that, with an average mid-point of $337,231. On the lower end, top compliance executives averaged a mid-point of $159,609 — the lowest of the 19 positions covered in the report.

Base salaries for top executives ranged widely by organization size: $181,125 for those with revenue up to $49.9 million, $311,000 for revenue between $50 million and $199.9 million, and $465,838 for those with revenue exceeding $200 million.

How Raises Are Tied to Performance

Just over 70% of participating organizations said they linked 2025 salary increases to performance, while 29.3% factored in cost of living. Only 7.6% tied raises directly to profits.

Industry reports noted that long-term care exec raises at 3.36% were notably higher than the 2.63% rate reported for home health and hospice leaders. “LTC increases haven’t been in the 2% range since 2021,” Zabka said, “so long-term care is seeing a stronger return since COVID times.”

That’s cold comfort for operators still wrestling with the financial pressures facing nursing homes on multiple fronts — from Medicaid reimbursement gaps to rising labor costs throughout their staff. But it signals that at least at the top of the org chart, the sector is stabilizing.

The full 90-page report, covering 110 organizations and key positions across three healthcare sectors, is available from HCS for $675. The organization has also opened its annual nursing home and CCRC salary surveys; nursing home responses are due May 11.