About NYC Health + Hospitals
NYC Health + Hospitals (H+H) is a public benefit corporation of the City of New York. It is the nation's largest safety-net hospital system, treating patients regardless of their ability to pay or immigration status. The system includes Bellevue Hospital (the oldest public hospital in the US), Harlem Hospital, Lincoln Hospital in the Bronx, Kings County Hospital in Brooklyn, Elmhurst Hospital in Queens, and six other acute care facilities, plus an extensive network of community health centers and correctional health services.
H+H employs over 40,000 people across clinical, administrative, IT, and support functions. Clinical staff — nurses, physicians, nurse practitioners, physician assistants, social workers, and allied health professionals — make up the majority of the workforce. Compensation is governed by a combination of union contracts (NYSNA and 1199SEIU for nursing staff, DC37 for administrative staff) and civil service salary grades for other titles.
Salary data for H+H employees is publicly available through NYC Open Data, where annual compensation for all city employees earning above a threshold is published each year. This transparency allows for accurate benchmarking of H+H pay against private-sector comparators.
2026 Salary Ranges by Role
| Role | Base Salary Range (2026) | Notes |
|---|---|---|
| RN, Staff Nurse | $78,000 – $110,000 | Night/weekend differentials add 10–15% |
| RN, Senior / Charge Nurse | $95,000 – $128,000 | Step-based increases per union contract |
| Nurse Practitioner (NP) | $110,000 – $155,000 | Specialty NPs (psych, acute care) at higher end |
| Physician Assistant (PA) | $115,000 – $150,000 | Surgical PAs at upper range |
| Physician — Hospitalist | $250,000 – $380,000 | Includes shift differential and on-call |
| Physician — Specialist | $300,000 – $500,000+ | Cardiology, surgery, oncology at high end |
| Medical Social Worker (MSW) | $62,000 – $90,000 | LCSW licensure increases range |
| Administrative / Clerical | $55,000 – $120,000 | Wide range by grade and title |
| IT / Systems Administrator | $75,000 – $130,000 | Epic EHR specialists command premium |
Registered Nurses: Union Representation and Differentials
Nursing staff at H+H are represented by two unions depending on the specific hospital: the New York State Nurses Association (NYSNA) at several facilities including Bellevue, Kings County, and Metropolitan, and 1199SEIU at others. Union contracts set minimum wage rates, step increases, and working conditions. Negotiated step increases mean that RNs receive automatic annual pay increases based on years of service, independent of performance reviews.
Shift Differentials
Hospital nursing operates around the clock, and H+H pays shift differentials to incentivize evening, night, and weekend work:
- Evening differential (3pm–11pm): Approximately 10% above base hourly rate
- Night differential (11pm–7am): Approximately 15% above base hourly rate
- Weekend differential: Additional premium for Saturday and Sunday shifts
An RN earning $85,000 base who regularly works night shifts could see total cash compensation of $95,000–$100,000 when differentials are included. Over a full career, the compounding effect of step increases plus differentials means veteran H+H nurses often earn significantly more than their base salary rate suggests.
Take-Home Pay at Key H+H Salary Levels
The following table shows estimated annual take-home for single filers at three representative H+H salary levels, after federal income tax, Social Security, Medicare, NY State income tax, and NYC local income tax. Standard deductions applied ($15,000 federal, $8,000 NY State). NYCERS pension contributions (3%–6%) reduce taxable income modestly and are not reflected here.
| Role / Salary | Gross Annual | Est. Total Taxes | Annual Take-Home | Monthly Take-Home |
|---|---|---|---|---|
| RN Staff ($85,000) | $85,000 | ~$24,010 | ~$60,990 | ~$5,083 |
| Nurse Practitioner ($130,000) | $130,000 | ~$39,750 | ~$90,250 | ~$7,521 |
| Physician / Hospitalist ($300,000) | $300,000 | ~$119,200 | ~$180,800 | ~$15,067 |
The physician take-home of approximately $180,800 on $300,000 reflects the steep marginal tax rates at higher income levels in NYC — federal top brackets, NY State rates up to 10.9%, and NYC local tax at 3.876%. A physician earning $300,000 at H+H keeps about 60 cents of every dollar. Pre-tax 403(b) contributions (up to $23,500 in 2026) and NYCERS pension contributions would modestly increase take-home by reducing taxable income.
NYCERS Pension: Tier 6 Benefits for H+H Employees
NYC Health + Hospitals employees are enrolled in the NYC Employees' Retirement System (NYCERS) under Tier 6 (for those hired after April 1, 2012). NYCERS is a defined benefit pension — a guaranteed lifetime income based on salary and years of service, funded by both employee contributions and the City of New York.
Employee Contribution Schedule (Tier 6)
- 3.0% on the first $45,000 of annual salary
- 3.5% on salary $45,001–$55,000
- 4.0% on salary $55,001–$75,000
- 4.5% on salary $75,001–$100,000
- 6.0% on salary above $100,000
For an RN earning $85,000: 3% × $45,000 + 3.5% × $10,000 + 4% × $25,000 + 4.5% × $5,000 = $1,350 + $350 + $1,000 + $225 = $2,925/year in pension contributions. These contributions are made pre-tax for federal purposes.
Benefit Formula and Retirement Eligibility
Under Tier 6, NYCERS members are vested after 10 years of service. Normal retirement is at age 63 or after 27 years of service. The benefit formula: 1.67% of Final Average Salary (FAS, highest 5 consecutive years) per year of service for the first 20 years, or 35% of FAS after exactly 20 years. Beyond 20 years: an additional 2% of FAS per year. After 30 years: 60% of FAS, paid for life.
An RN with a FAS of $100,000 after 30 years of H+H service receives $60,000 annually for life — a benefit equivalent to holding approximately $1.5 million in a retirement portfolio generating a 4% annual withdrawal. For clinical staff who might otherwise carry significant student loan debt and face high NYC living costs, the defined-benefit pension is a powerful financial stabilizer.
Public Service Loan Forgiveness at H+H
NYC Health + Hospitals is a qualifying employer under PSLF. Every full-time employee — nurses, physicians, PAs, NPs, social workers, IT staff, and administrators — who has federal student loans is potentially eligible for PSLF after 10 years of qualifying employment and 120 qualifying payments under an income-driven repayment plan.
For physicians at H+H, PSLF is particularly valuable. A physician who completed medical school with $250,000 in federal student loan debt, earning $300,000 at H+H, enrolls in the SAVE plan. Their income-driven payments are substantial (SAVE caps payments at 10% of discretionary income for graduate borrowers), but after 120 payments any remaining balance — potentially $150,000–$200,000 given accumulated interest — is forgiven tax-free. The PSLF benefit for high-debt physicians at qualifying employers is worth $100,000 to $300,000 in present-value terms and is a significant factor in the physician recruitment calculus at public hospitals.
PSLF Enrollment Tip: H+H employees should submit an Employment Certification Form (ECF) annually — not just once at the beginning or end. Annual ECFs document each year of qualifying employment, preventing disputes about whether specific periods counted. The MOHELA servicer currently administers PSLF; transfer your loans there immediately if you have not already.
Benefits Beyond Salary
H+H employees receive the full NYC employee benefits package, which includes:
- Health insurance: GHI, HIP, and other plans with the city paying the majority of premiums. Employer-paid premium value: $15,000–$20,000/year for individual coverage
- Dental and vision: Covered through the NYC Employee Benefits Program
- Supplemental retirement: Access to 457(b) deferred compensation plan, allowing up to $23,500/year in additional pre-tax savings
- Paid leave: Generous sick leave, vacation accrual, and personal days under union contracts
- Tuition reimbursement: H+H offers tuition assistance for clinical staff pursuing advanced degrees — directly supporting career advancement from RN to NP, for example
Data Sources: Salary ranges from NYC Open Data (Citywide Payroll Data) and BLS.gov Occupational Employment Statistics. Tax calculations use 2026 IRS brackets, NY State tax tables, and NYC local tax schedules. Pension details from NYCERS Tier 6 plan documents. See full methodology →
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