Direct answer
Hospital CNOs can connect high-level hospital savings levers to funding for nurse retention and wellness after the traditional funding stack has been worked.
The sequence remains straightforward: CFO and operating budget first, Foundation second, then grants. When those sources do not fully fund the priorities nursing has identified, NEFP, the Nursing Excellence Fundraising Program, can add another potential layer through business contributions from the System Stream network.
The destination is investment in people: nurse retention, wellness, professional support, and the infrastructure that helps nurses stay and thrive.
Nursing does not become the fundraiser. The hospital does not have to buy or implement a System Stream solution for a nursing excellence funding request to be considered. The answer to a funding shortfall should not weaken the workforce the hospital is trying to retain and recruit.
The retention and wellness gap CNOs already know
Most hospital CNOs do not need another explanation of why nurse retention and wellness matter.
They already see the cost of turnover, persistent vacancies, pressure on preceptors, strain on nurse leaders, and the erosion that occurs when wellness and professional support remain underfunded cycle after cycle.
What CNOs often need is a clearer path from hospital financial improvement opportunities to dollars that can advance the retention and wellness priorities nursing has already identified.
The practical question is:
How can a CNO connect high-level hospital savings levers to nurse retention and wellness funding after the traditional funding stack, without weakening the workforce?
On one side are financial improvement opportunities that already sit within the CFO’s world. On the other are nursing priorities that may remain partially unfunded after the operating budget, Foundation, and grants have been worked.
Why retention and wellness still stall after the stack
Retention and wellness initiatives rarely stall because nursing lacks a workforce case.
They stall because they compete with staffing demands, technology investments, capital priorities, regulatory requirements, and other operating pressures inside a limited budget.
The pattern is familiar:
- Nursing identifies and ranks its retention and wellness priorities.
- The CFO and operating budget fund what they can.
- The Foundation may support a portion.
- Grants may cover another piece when eligibility and timing align.
- A shortfall remains.
- Leadership must decide whether to defer the initiative or find another funding path.
Deferral leaves the workforce need unresolved. Weakening nursing resources to create margin works against retention and recruiting. Turning nursing leaders into fundraisers consumes time that should remain focused on nursing practice, workforce stability, wellness, and patient care.
Our team starts from a different premise: invest in people, work the traditional funding stack first, then explore another potential funding path when a legitimate shortfall remains.
What “hospital savings levers” means at CNO altitude
For a CNO, hospital savings levers should remain high-level.
This is not about becoming an expert in procurement, revenue cycle, technology contracts, or financial optimization. It is not a product catalog or benefits redesign workshop.
Hospital savings levers are broad expense categories and financial improvement opportunities that can strengthen the organization’s financial position. They can include areas such as:
- Healthcare and workforce-related costs
- Revenue recovery and payment optimization
- Technology and indirect operating spend
- Healthcare-specific operating expenses
- Other strategic expense and financial improvement opportunities
The CNO does not need to evaluate every category or determine whether a particular opportunity is viable. Those responsibilities belong with finance and the appropriate operational leaders.
The CNO needs enough literacy to ask a strategic question:
If the hospital can responsibly improve its financial position through opportunities already in the CFO’s domain, can broader network business activity also help support nurse retention and wellness after our traditional funding sources have been worked?
Retention and wellness as the funded destination
Before introducing another funding path, name the destination clearly.
Potential priorities may include:
- Nurse well-being, resilience, and recovery support
- Initiatives designed to reduce preventable turnover risk
- Preceptor and mentorship capacity
- Recognition and engagement programs
- Professional development and certification support
- Leadership development that strengthens unit and middle-management stability
These are investments in people, not soft extras.
Industry data provides useful context. According to the 2026 NSI National Health Care Retention & RN Staffing Report, staff RN turnover was 17.6%. NSI estimated the average cost of turnover for a bedside RN at $60,090 and the average annual cost of RN turnover to a hospital at $5.19 million.
National averages are not a substitute for a hospital’s own workforce data. They do reinforce an important leadership point: underinvestment in retention and wellness can carry a significant financial consequence.
Work the funding stack before anything new
CNO credibility rises when nursing demonstrates funding-stack literacy before asking leadership to consider another path.
The sequence is:
- Determine what the CFO and operating budget can support.
- Determine what the Foundation can support.
- Pursue appropriate grants.
- Define what remains unfunded.
Use those paths fully. Be specific about what each source can cover, then quantify the remaining shortfall.
For CNOs who need help with the timing and structure of the finance conversation, How the CNO Opens the CFO Conversation on Nursing Excellence Funding addresses that issue directly.
When organizational resistance is the larger obstacle, Formula for Change: How CNOs Clear the Bar for Nursing Excellence Funding provides a different framework.
Related conversations about hospital benefits strategy and nursing excellence funding and funding an investment in nursing excellence also have their own treatment.
Here, the focus remains narrower: connecting high-level hospital savings levers to another potential funding layer for retention and wellness after the traditional stack.
How NEFP can connect savings levers to nursing dollars
Nursing Excellence Fundraising through NEFP, the Nursing Excellence Fundraising Program, can add another potential funding layer after the CFO and operating budget, Foundation, and grants.
NEFP provides supplemental funding through business contributions from the System Stream network.
System Stream operates a network of financial solutions designed to help hospitals and other organizations identify opportunities to reduce expenses and improve financial performance. Business activity across that network generates revenue. A portion of that revenue can support contributions for approved nursing excellence initiatives, including retention and wellness priorities identified by nursing.
- High-level savings levers and financial improvement opportunities remain in the CFO’s domain.
- Business contributions from network activity can create another potential source of funding for nursing.
- Retention and wellness remain the destination nursing owns.
Several boundaries are important.
The hospital does not have to buy or implement a System Stream solution for its nursing excellence funding request to be considered. Requests are evaluated separately based on the initiative and available funds.
Nursing does not become the fundraiser. Our team develops the business relationships. Nursing leadership remains focused on nursing.
A CNO introduction to the CFO is not a purchase commitment. After the CNO understands the model and is comfortable with it, the CNO can make a personal introduction to the CFO. From there, our team can work with finance to determine whether relevant financial improvement opportunities exist.
The nursing funding request remains separate and is not contingent on the CFO purchasing or implementing a System Stream solution.
What the CNO owns, and what the CNO does not
The CNO owns the nursing priorities, their ranking, and the workforce case behind them.
The CNO does not need to evaluate every savings category, become an expert in financial improvement solutions, sell those solutions to the CFO, run a donor campaign, or sacrifice other nursing priorities to manufacture funding.
A practical CNO role is simpler:
- Rank the retention and wellness priorities that should move first.
- Document what the operating budget, Foundation, and grants can cover.
- State the remaining shortfall in clear scope and dollars.
- Determine whether another potential funding layer is worth exploring.
- If comfortable with the model, introduce our team to the CFO so finance can evaluate whether relevant opportunities exist.
That introduction opens a door. It does not create an obligation. The nursing funding request remains separate regardless of what finance ultimately decides.
A practical conversation frame
Start with the destination. Identify the retention and wellness priorities nursing believes should move forward.
Connect them to workforce reality. Lead with the hospital’s own retention, vacancy, preceptor, engagement, and wellness realities.
Walk the funding stack. Show what the operating budget, Foundation, and grants can cover and what remains.
Introduce savings levers at the appropriate altitude. Financial improvement opportunities already exist within the CFO’s world. Business activity across the broader network can help create contributions for approved nursing priorities.
Protect the boundaries. Nursing remains focused on nursing. A funding request is not contingent on a CFO purchase.
Close with a next step. Determine whether leadership is willing to explore another potential funding layer for retention and wellness priorities that remain unfunded after the traditional stack.
What this path is not
This path is not a substitute for operating-budget discipline. It does not replace the Foundation or grant opportunities. It does not require nursing to become a fundraising department. It is not a benefits-plan tutorial or a deep dive into a particular financial product.
It is a bridge between two leadership realities: hospitals continually look for responsible ways to improve financial performance, while CNOs continually look for sustainable ways to invest in the nurses they need to retain and recruit.
NEFP can provide a potential shortfall layer between those realities when the traditional funding stack is not enough.
Next step
If nurse retention and wellness priorities remain underfunded after the CFO and operating budget, Foundation, and grants, explore Nursing Excellence Fundraising.
If it would be useful to walk through the savings-lever bridge with your nursing priorities and remaining shortfall in view, schedule a 30-minute discussion (Calendly is an external scheduling link).
Bring the priorities nursing already believes matter, the funding-stack work finance can respect, and a clear destination: sustained investment in the people the hospital needs to retain and recruit.
This article is for informational and educational purposes only and is not legal, financial, tax, or investment advice. Funding outcomes are not guaranteed. Nursing Excellence Fundraising Program requests are subject to evaluation and available funds. Hospitals should evaluate funding options with their own finance, legal, benefits, and compliance teams.