Which applicant tracking systems hospitals actually use, and how long an RN job stays open

The short answer: nobody publishes a count of which applicant tracking system (ATS) each U.S. hospital runs, so any "market share" ranking you read online is an estimate. What can be verified today is narrower and more useful: what each vendor says about its own healthcare footprint, and the fact that a hospital's ATS is visible in the hostname of its apply page. The systems that appear again and again on hospital careers sites are Workday, Oracle (Recruiting Cloud and the older Taleo), iCIMS, UKG, SAP SuccessFactors and symplr, with Infor, Jobvite, Cornerstone, Paycom, Greenhouse and Lever appearing less often or for non-clinical hiring. This page quotes the vendors, shows the ten-second URL check, and then answers the question hospital talent teams ask right after "which ATS": how long an RN position stays open.

Why there is no reliable hospital ATS market-share number

Four things make the number hard to pin down, and they explain why the table below quotes vendors instead of ranking them:

• Vendors count organizations, not hospitals. Workday says "More than 850 healthcare organizations run business and financial operations flawlessly with Workday"; Infor says it has "partnered with over 750 healthcare organizations across the U.S." A health system with forty hospitals is one organization in both counts, and neither figure is limited to recruiting.
• The ATS is often a module of the HR system of record. Oracle positions Oracle Recruiting as "a recruiting solution that's part of Oracle Cloud HCM"; Workday Recruiting ships inside Workday HCM; UKG and Infor sell recruiting inside their HCM suites. A hospital that bought the suite for payroll ends up with that vendor's ATS whether or not talent acquisition chose it.
• Many hospitals run two layers. A career-site and CRM layer (Phenom is the common one) or a conversational screening layer (Paradox) sits in front of the ATS. Workday now describes its own "Candidate Experience agent powered by Paradox". Which product "is the ATS" depends on who you ask.
• Health systems merge and switch. Acquired hospitals keep the acquirer's ATS or run both for years. A count taken in January is wrong by December.

What each vendor publishes about its hospital footprint

Everything in this table is quoted from the vendor's own website as read on 1 October 2026. None of these vendors publishes a price list for hospital recruiting; all quote after a demo. UKG and symplr are missing because their published figures could not be verified on that date, so nothing is attributed to them.

Read across the table and the pattern is clear: the vendors with the largest hospital footprints are HR suites first and applicant tracking systems second. The pure-play ATS vendors that dominate tech hiring publish no hospital numbers at all.

How to tell which ATS a hospital uses in ten seconds

Open any job on the hospital's careers site and click Apply. The hostname you land on is the ATS. These are the patterns we see across hospital career sites:

Two cautions. A branded careers domain (careers.hospitalname.org) is usually a Phenom or vendor-hosted front end, so follow the Apply button before deciding. And large systems commonly show two patterns at once, one for the parent and one for a recently acquired hospital.

Why the ATS matters less than what feeds it

Whichever system a hospital runs, it holds the same thing: people who applied. The Bureau of Labor Statistics counts 3,465,400 registered nurse jobs in 2025, projects about 180,800 RN openings a year over the decade, and reports that hospitals employ 59% of RNs. Roughly one nurse in twenty changes jobs in a year; the other nineteen never enter any ATS. That is why hospital talent teams layer sourcing on top of the ATS rather than switching the ATS: the system of record is rarely the bottleneck, the pipeline into it is.

Betterleap sits in that layer. It connects to the systems hospitals run (the homepage names Oracle, UKG, symplr, Taleo, iCIMS and Workday, among 25+ ATS integrations), re-engages past candidates already in the ATS, and sources from 35M+ healthcare professionals with licenses verified through 25+ state board partnerships, so the ATS fills from the whole licensed market instead of this month's applicants.

Average time to fill a registered nurse position

The most-cited benchmark is the RN Recruitment Difficulty Index in the 2026 NSI National Health Care Retention & RN Staffing Report, a survey of 527 acute care hospitals conducted in January 2026 and published in March 2026. Disclosure: NSI Nursing Solutions is a nurse recruitment firm and the report promotes its services; the survey figures are reported in aggregate and are the only national hospital-reported RN time-to-fill series published every year.

• 78 days to recruit an experienced RN, regardless of specialty, "five days quicker than the prior year". The report's own phrasing: "it takes over 2.5 months to recruit an experienced RN".
• 56 to 102 days depending on specialty. Telemetry nurses took the longest at 87 days, Med/Surg 83 days, and ER the shortest at 70 days.
• By region: the West averaged 70 days and the South-Central 74; the North-Central was slowest at 82; the South-East and North-East matched the national average.
• Magnet-recognized hospitals filled RN roles in 68 days, ten days faster than the benchmark.
• Vacancy: the national RN vacancy rate is 8.6%, 33.1% of hospitals report ten percent or higher, and the average hospital carries 43 unfilled RN FTEs.

What federal data adds

BLS does not measure time to fill, but its Job Openings and Labor Turnover Survey (JOLTS) shows why hospital requisitions age. For health care and social assistance in August 2026 (preliminary), the job openings rate was 5.4% and the hires rate 2.9%, against 4.3% and 3.3% for all nonfarm employment. Put differently, the sector carried about two open positions for every hire it made that month, while the economy as a whole carried about 1.4. The sector's openings level was 1.36 million.

What this means for a hospital talent acquisition team

• Do not expect the ATS to move time to fill. The vendors with the largest hospital footprints sell the ATS as part of the HR suite; a hospital rarely gets to choose it on recruiting merit, and 78 days is the hospital-reported average across all of them.
• Benchmark by specialty, not by the headline. A 90-day telemetry fill is near the norm; a 90-day ER fill is twenty days slow.
• Measure the pipeline into the ATS. With roughly two openings per hire in the sector, the constraint is candidates who never applied. Sourcing licensed, passive nurses and re-engaging past applicants are the two levers that work with any of the systems in the table above.

Sources

• Workday, workday.com/en-us/solutions/industries/healthcare.html and workday.com/en-us/products/talent-management/talent-acquisition.html; Oracle, oracle.com/human-capital-management/recruiting and oracle.com/industries/healthcare; iCIMS, icims.com and icims.com/solutions/industry/healthcare-hospitals; SAP, sap.com/products/hcm.html; SmartRecruiters, smartrecruiters.com; Infor, infor.com/industries/healthcare; Cornerstone, cornerstoneondemand.com/industries/healthcare; Jobvite, jobvite.com; Greenhouse, greenhouse.com; Paycom, paycom.com/software/talent-acquisition. All read 1 October 2026. UKG (ukg.com) and symplr (symplr.com) could not be verified that day and are not quoted.
• NSI Nursing Solutions, Inc., 2026 NSI National Health Care Retention & RN Staffing Report (survey January 2026, published March 2026, 527 participating facilities), nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf, read 1 October 2026.
• U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, Registered Nurses, bls.gov/ooh/healthcare/registered-nurses.htm (2025 base year; read 1 October 2026), and Job Openings and Labor Turnover Survey, bls.gov/jlt, August 2026 preliminary job openings and hires rates for health care and social assistance and for total nonfarm, read 1 October 2026.
• Betterleap, betterleap.com.