An RN resigns, the requisition opens, and the default is automatic: replace the RN with an RN. Sometimes that is exactly right. But in a South Florida market where experienced RNs command a steep premium and take weeks to land, the better first question is one surprisingly few facilities pause to ask: does this seat actually require the RN license, or the work an excellent LPN does every day?

Getting the answer right is worth real money in both directions. Staffing RN-level judgment with an LPN creates clinical and regulatory risk you cannot afford. Paying RN rates for task-level care burns budget and, just as costly, bores a nurse into leaving. Here is how to think it through.

What each license actually covers

The distinction is scope of practice, and in Florida it is reasonably clean. Registered nurses (two-to-four-year degree, NCLEX-RN) own assessment, care planning, IV push medications, patient education, and supervision of other nursing staff. When a resident's condition turns at 2 a.m., the judgment call belongs to an RN. Licensed practical nurses (about a year of training, NCLEX-PN) deliver the bulk of hands-on bedside care under RN or physician direction: medication passes, wound care, vitals, treatments, ADL support. Florida is comparatively permissive about what certified LPNs can take on, including much IV therapy, but assessment and the care plan itself stay with the RN.

Neither license is a discount version of the other. They are different tools, and most of the staffing pain we see comes from using one where the work called for the other.

What each costs in this market

In 2026, across Miami-Dade and Broward, staff LPNs in long-term care typically earn from the mid-$50,000s to the high-$60,000s. Experienced RNs start in the high-$70,000s and run well into the $90,000s, and higher in acute, specialty, and leadership tracks, as we covered in our DON salary guide. Call it a 30 to 45 percent premium for the RN license.

But sticker price is the least interesting number. The scarcer hire is also the slower hire: an experienced RN vacancy in South Florida routinely sits open for weeks longer than an LPN seat, and every one of those weeks is agency coverage, overtime, and strain on the nurses who stayed. When an open seat is bleeding money monthly, the honest comparison includes time-to-fill and likelihood-to-stay; the arithmetic from our turnover cost breakdown applies in full.

The floor you cannot trade away

Before any substitution math, the regulatory floor: Florida and federal rules require RN coverage in skilled nursing (an RN Director of Nursing, minimum daily RN presence, RN-owned assessments and care plans), and surveyors check. Assisted living, behavioral health, and home health each carry their own requirements. No LPN hiring strategy, however capable the nurses, staffs its way around that floor. The question is never RN or LPN for the building; it is the right mix above the mandated RN backbone.

How to decide, seat by seat

  • Audit the actual work. Shadow the open seat for a shift on paper: how much of it is assessment, supervision, and judgment, and how much is skilled task execution? The proportions usually answer the question by themselves.
  • It's an RN seat if the role signs off on assessments and care plans, supervises other nurses, absorbs high-acuity swings, or exists partly to satisfy RN coverage requirements. Underfill it and you carry the risk personally at survey time.
  • It's an LPN seat if the work is medication passes, treatments, and consistent bedside care under supervision that already exists. A skilled, settled LPN in this seat frequently outlasts an overqualified RN who takes it as a stopgap and leaves within the year.
  • Consider splitting it. One stubborn RN vacancy often converts into a stronger unit as an RN-plus-LPN pairing: more hands at the bedside, RN judgment where it is required, and two fillable searches instead of one unicorn hunt.

Whichever you hire, hire for keeps

The RN-versus-LPN decision only pays off if the person you hire stays. That means matching not just license to seat but nurse to building: the acuity, the pace, the culture, the honest hard parts. It is the screening we run on every permanent placement search at Vyla: we work the South Florida market daily, we know what RNs and LPNs are actually accepting in Miami-Dade and Broward this quarter, and every placement is backed by a 90-day guarantee because the goal is a nurse who stays, not a seat that briefly stops flashing.

Tell us about the seat you're rethinking and we'll give you a straight read on whether it's an RN hire, an LPN hire, or a smarter split, and what each would take to fill right now. We respond within one business day.

Frequently asked questions

What is the main difference between an RN and an LPN?

Scope of practice. RNs complete a two-to-four-year degree, pass the NCLEX-RN, and can assess patients, build care plans, administer IV push medications, and supervise other nurses. LPNs complete a roughly one-year practical nursing program, pass the NCLEX-PN, and deliver hands-on bedside care (medications, wound care, vitals, ADL support) under the direction of an RN or physician. In Florida, LPNs can do quite a lot with the right certifications, but assessment and care planning remain RN territory.

How much more does an RN cost than an LPN in South Florida?

In the Miami-Dade and Broward market in 2026, staff LPNs typically earn in the mid-$50,000s to high-$60,000s, while experienced RNs run from the high-$70,000s well into the $90,000s and beyond in acute and specialty settings, roughly a 30 to 45 percent premium. The real comparison is not salary but cost per unit of the work you actually need done: paying RN rates for task-level care is as wasteful as stretching LPN coverage past its legal scope is risky.

Can a Florida skilled nursing facility run mostly on LPNs?

LPNs can carry a large share of bedside care in long-term care, but not alone. Florida staffing rules and federal requirements mandate RN coverage, including an RN Director of Nursing and minimum daily RN presence, and resident assessments, care plans, and acuity spikes all require RN judgment. The workable model is an RN backbone with strong LPN depth, not one instead of the other.

Should my facility hire an RN or an LPN for an open position?

Start from the work, not the title. If the seat mostly involves assessment, supervision, high-acuity judgment, or regulatory sign-off, it is an RN seat. If it is medication passes, treatments, and steady hands-on care under existing supervision, a strong LPN often outperforms and outlasts an overqualified RN who will leave for a role that uses her full license. Many facilities do best converting one hard-to-fill RN vacancy into a well-structured RN-plus-LPN pairing.