The company needs to measure the performance of each employee, as it will determine whether or not the employee is in support of the company's activities to realize the company's vision, mission and objectives. The decrease of Human Resources performance, especially nurses and the absence of standard performance assessment on nurses is considered to cause a decrease in nurse performance at Royal Prima Hospital, Medan. The research aims to identify the factors that cause human resource performance in Royal Prima Hospital, Medan and analyze using the Human Resource Scorecard by assessing four perspectives: financial perspective, customer, internal business process and learning and growth. Collecting data of this research by interviewing method and questionnaires spread. Based on the results of the research, the RS Royal Prima performance is 78%. If we see from Key Performance Indicator results we conclude that there are three perspectives that require attention from the management of Royal Prima Hospital to be evaluated in order to improve nurse performance ie customer perspective, learning and growth perspective and the last is an internal business process perspective.