1. Plan statutory staffing, duty coverage and hiring together
This Korea-based 2026 calculator helps hospital owners and their families assess staffing before changing patient volumes or operating hours.
Meeting an annual-average statutory headcount does not ensure that the required physician and registered nurse are present together during every duty period.
Adding all statutory staff to all duty posts can also count the same employees twice.
The calculator checks headcounts, simultaneous posts, separate day/night person-hours and incremental hiring costs.
The decision it supports
Estimate a hiring lower bound, compare nursing substitution options and check the extra monthly cash needed using confirmed quotes.
The result precedes a complete individual roster: review it with the competent public health authority and a labor adviser before changing contracts.
2. Korean jurisdiction, facility scope and rule dates
The Medical Service Act edition is effective October 2, 2026; the Enforcement Rule edition is effective June 12, 2026.
Both were verified through the official API on November 6, 2026.
The medical hospital option uses ordinary medical-hospital rules.
The long-term care hospital option uses the Annex 5 physician row, including eligible Korean-medicine doctors in that row’s combined count.
Separate review
General hospitals with specialty requirements, dental or Korean-medicine hospitals, additional specialties and arrangements using only the separate Korean-medicine-doctor row are outside automatic determination.
Psychiatric hospitals, qualifying rehabilitation facilities, listed national facilities and designated institutions may use internal duty standards under Article 39-18(3).
Hospital versus nursing facility
A Korean long-term care hospital is not an elderly nursing facility.
Nursing-facility care-worker and visiting-doctor rules are different.
Check the licensed facility type rather than relying on its trading name; choose other facility when this model does not apply.
3. Enter average patients and actual duty patients separately
- Annual-average daily inpatients: the verified staffing assessment basis, not today’s occupancy or licensed beds.
- Annual-average daily outpatients: convert at 3 outpatients per inpatient equivalent for physicians and 12 for nursing.
- Actual duty inpatients: current patients during the duty period, excluding outpatients; do not substitute the annual average.
- Current eligible staff: people actually working at the facility, after checking licences, leave, departures, overlapping duties and whether they count.
A zero annual-average basis for a new or suspended facility requires confirmation rather than an assumed zero budget.
Zero actual duty inpatients also does not establish zero duty staff: confirm operating status and the basic staffing obligation with the authority.
Reference standards may remain visible while hiring and budgets are withheld.
4. Annex 5 annual-average staffing formulas
Different patient equivalents
Physician equivalent = average inpatients + average outpatients / 3
Nursing equivalent = average inpatients + average outpatients / 12
Keep fractional equivalents until the final headcount is rounded up.
Fractional annual averages remain meaningful inputs.
Medical hospital
Physicians = ceil(physician equivalent / 20).
Registered nurses = ceil(nursing equivalent / 2.5).
This model does not automatically credit assistant substitution for ordinary medical hospitals; separately verify any special authorization.
Long-term hospital physician row
Physicians = 2 + ceil(max(0, physician equivalent − 80) / 40).
Nursing total = ceil(nursing equivalent / 6).
The physician row requires 2 up to 80 patient equivalents and one more for each additional 40, including the row’s Korean-medicine-doctor pooling provision.
That pooling does not decide licence-specific scope of practice.
Annual-average headcounts are not a requirement to place every statutory employee on the daytime shift simultaneously.
Enter daytime person-hour demand from the actual clinical and operating plan, rather than multiplying the statutory total by all daytime hours.
5. Article 39-18 simultaneous duty requirements
Medical hospital
Up to 200 actual inpatients: 1 physician-category professional and 2 RNs; add 1 and 2 for each additional block of 200.
For positive P, physician posts = ceil(P / 200); RN posts = 2 × ceil(P / 200).
Moving from 200 to 201 changes 1 physician and 2 RNs to 2 physicians and 4 RNs.
Long-term care hospital
Physician-category duty posts: 1 up to 300 inpatients, plus 1 for each additional 300.
RN duty posts: 1 up to 80, plus 1 for each additional 80.
For positive P: ceil(P / 300) physicians and ceil(P / 80) RNs.
At 81 rather than 80 inpatients, the physician requirement remains 1 while the RN requirement increases to 2.
The legal physician category names medical doctors, dentists and Korean-medicine doctors; the professionals must be eligible to perform the facility’s actual duties.
This ordinary medical-hospital model counts medical doctors; the long-term option uses the confirmed physician-row pool.
Do not apply ordinary formulas to an institution using internal standards.
The current provision is Enforcement Rule Article 39-18, rather than the former Decree Article 18.
6. Assistant substitution and the RN floor
An example with 14 nursing staff
For a long-term hospital nursing total N, maximum credited assistants = floor(2N / 3); minimum RNs = N − that maximum.
A total of 14 therefore permits 9 credited assistants and requires at least 5 RNs.
Current staffing of 5 RNs and 8 assistants totals 13, leaving one statutory vacancy.
Having 5 RNs does not establish continuous coverage of a duty RN post.
The substitution limit applies to annual-average staffing, not duty RNs.
Assistants do not replace duty RNs.
Operational assistant hiring may exceed the credited limit, but the excess cannot satisfy additional statutory nursing vacancies.
When existing RNs already cover the total, the substitution scenario does not force hiring assistants merely to reach the limit.
Both scenarios retain the same user-entered day and night workload.
They change only the profession used to fill remaining statutory nursing vacancies, rather than treating every RN task as interchangeable with assistant work.
Verify task permissions and actual patient needs before defining person-hour demand.
7. Convert roster gaps into hiring lower bounds
Day and night are disjoint windows.
Eight duty hours every day create a 56-hour weekly duty window and a 112-hour remaining window.
Day demand of 280 person-hours with 200 covered leaves an 80-hour gap.
One night post needs 56 person-hours; 40 covered leaves a 16-hour gap.
Use the largest constraint
Time lower bound = max(
ceil(day gap / new-hire day capacity),
ceil(night gap / new-hire night capacity),
ceil((day gap + night gap) / new-hire total capacity),
night target − existing minimum simultaneous staff)
Also satisfy the statutory staffing deficit.
Do not add the statutory headcount to duty posts or automatically add separate day and night recruitment counts.
A new RN may have a day ceiling of 40 hours and a night ceiling of 16, but a combined ceiling of only 40.
The example’s 96 person-hour gap therefore requires at least 3 RNs, not an assumed 56-hour worker.
Surplus daytime hours are not transferred to night coverage without an actual revised roster.
8. Compare two nursing hiring scenarios
Fill statutory vacancies with RNs
Retain currently credited assistants, credit nursing hires already needed for time gaps, then fill the remaining statutory vacancy with RNs.
Daytime, night-hour and simultaneous RN shortages may require more hires than the statutory vacancy alone.
Assistants may still need hiring for their independently entered operating workload; do not fill the same shared nursing vacancy twice.
Use permitted assistant substitution
First meet the RN floor and RN time and duty constraints.
Fill only the remaining total nursing vacancy with assistants within the substitution cap, then RNs if necessary.
Assistants already hired for their own time gaps count only within the cap.
For ordinary medical hospitals, both scenarios may be identical because automatic substitution is zero.
Identical results are meaningful.
RN hires needed for operational time or night coverage may already satisfy the nursing total, leaving no vacancy for assistant substitution to change.
Increasing assistant substitution alone cannot resolve an RN duty gap.
9. Incremental monthly and 12-month budgets
Multiply each role’s additional hiring lower bound by a confirmed monthly loaded cost, then sum the roles.
The 12-month estimate assumes the same additional staffing for 12 full months.
It excludes existing payroll, facility investment, revenue and nursing-grade reimbursement.
Match quote scope
Use comparable actual quotes covering wages, night and holiday allowances, employer contributions, retirement accruals, relief staffing and relevant recurring costs.
No market wage or statutory employer rate is automatically added.
One-time recruitment fees and part-month joining dates require separate budgeting.
Avoid adding the same relief cost twice when leave coverage is already reflected in your assumptions.
If a role needs new hires but its price is unconfirmed, the total cost is withheld and only a confirmed subtotal appears.
A confirmed zero differs from an unknown price.
A role requiring no hires has zero incremental cost even without a quote; that does not mean its existing payroll is zero.
A star appears only when both scenarios have comparable totals and identifies the lower entered cost, not legal compliance or patient safety.
10. Worked example: 80 long-term hospital inpatients
Assume average inpatients 80, outpatients 0, actual duty inpatients 80 and 8 duty hours daily.
Current staff: 2 physicians, 5 RNs, 8 assistants, 1 dietitian and 2 safety workers.
Daytime demand is respectively 80, 280, 280, 40 and 0 person-hours weekly.
Fictional roster and quotes
- Existing day coverage: physicians 80, RNs 200, assistants 280 and dietitian 40 person-hours.
- Existing night coverage: physicians 40, RNs 40 and safety workers 56; minimum simultaneous coverage is 0 physicians, 0 RNs and 1 safety worker.
- Each new hire can supply at most 40 day, 16 night and 40 combined hours per week.
- Statutory targets: 2 physicians and 14 nursing staff; duty posts: 1 physician, 1 RN and 1 safety worker.
- Hiring lower bound: 1 physician and 3 RNs; no additional assistant, dietitian or safety worker. Both scenarios match.
Confirmed fictional monthly costs of KRW 12,000,000 per physician and KRW 4,000,000 per RN produce KRW 24,000,000 monthly extra and KRW 288,000,000 over 12 months.
These are neither market quotes nor recommended wages, and the staffing remains a lower bound pending individual roster validation.
At 81 duty inpatients the RN duty target becomes 2.
Recheck the existing roster and new-hire capacities after changing patient counts, rather than approving contracts using an outdated review.
11. Step-by-step use and practical decisions
- Check the licence, facility type, applicable annex row and internal-standard exceptions.
- Enter annual-average inpatient/outpatient records and actual duty inpatients separately.
- Enter daytime demand, planned night posts, actual covered hours and minimum simultaneous night coverage.
- Use new-hire day, night and combined capacities excluding breaks, leave, training and other duties.
- Confirm comparable loaded-cost quotes and compare hiring, monthly costs and 12-month budgets.
- Save the TXT review alongside the licence, patient records, qualification register, individual rosters and quotes.
Before expanding capacity, save existing and proposed patient plans separately to assess added hires and cash needs.
When night staff leave, change actual covered night hours and minimum simultaneous staffing rather than altering the average patient basis to fit a desired answer.
During recruitment negotiations, compare feasible night availability as well as monthly price: different availability can change the number of hires.
12. Withheld results, invalid inputs and limits
Aggregate hours are not a complete roster
The constraints identify a necessary staffing lower bound.
They do not establish coverage for every individual shift, permitted consecutive work, licence-specific practice, rest, working-hours compliance or patient acuity.
If no workable individual roster exists, additional staff or changed operating hours may be needed.
A positive hour gap with zero new-hire capacity is infeasible at those inputs.
The calculator rejects coverage beyond the current staff’s physical time window and a claimed minimum simultaneous count requiring more night hours than actually covered.
When the duty window changes, update daytime and new-hire capacities too.
Extremely small capacities or excessive amounts can exceed safe integer precision; hiring or budgets are then withheld, so check hours, headcounts and KRW units.
Both supported inpatient facilities include a dietitian target of 1 under Article 38.
Long-term care hospitals additionally include at least 1 simultaneous facility-safety duty worker.
Pharmacists, medical technicians, social workers, midwives, additional specialties, infection control, security equipment and security staffing are not fully modelled.
The result does not determine licensing, reimbursement, quality or administrative sanctions.
13. Frequently asked questions
Why are hires needed when the statutory count is already met?
Annual-average headcounts can coexist with night-post or day/night person-hour gaps.
Those operational constraints may require additional staff.
Can assistants replace duty RNs?
No.
Annex 5 staffing substitution and Article 39-18 duty RN requirements are separate.
Assistants are not credited as duty RNs.
Why are zero duty inpatients withheld?
Zero alone does not resolve the basic duty obligation.
Confirm whether the facility is new, suspended, temporarily empty or otherwise operating with the competent authority.
Where do Korean-medicine doctors go?
Use the separate current Korean-medicine-doctor field.
They enter only the long-term physician-row pool, not the ordinary medical-hospital count.
Using the separate Korean-medicine-doctor row alone requires review.
Why do both hiring options match?
RN hires required for operating hours or duty may already fill the total nursing vacancy.
Extra assistant substitution then changes neither the headcount nor the cost.
Why enter a combined capacity?
Separate ceilings of 40 day hours and 16 night hours do not necessarily permit 56 total hours.
The combined ceiling prevents using both maxima without a total limit.
Is the confirmed subtotal the whole budget?
No.
A needed role with an unconfirmed quote withholds the total.
Zero hiring means zero incremental cost, not zero existing payroll.
Does hiring this number establish compliance?
No.
It is a mathematical lower bound before individual roster review.
Verify licences, practice scope, rest, working hours and all other facility duties with the public health authority and labor adviser.
14. Official sources and next action
Official National Law Information API verification: November 6, 2026.
Medical Service Act ID 001788, MST 290667, effective October 2, 2026: Article 36(5) and Article 41.
Enforcement Rule ID 007863, MST 286963, effective June 12, 2026: Article 38, Annex 5 and Article 39-18.
The annex search identifier is 18190583.
Recheck subsequent amendments, patient assessment periods, licence type, annex row, eligible staffing and actual quotes before use.
Save the review and prepare patient records, individual day/night rosters, qualification evidence and loaded-cost quotes.
Ask the competent public health authority and labor adviser to verify the applicable rules and actual coverage before changing capacity, hours or hiring contracts.
Use the clinic opening capital and loan planner for facility funding and the total labor cost calculator to organize the scope of your actual cost inputs.