While the peak of the COVID pandemic may be behind us, the United States health care industry continues to deal with unprecedented staffing shortages, particularly when it comes to nurses. Even a cursory Google search brings up a multitude of stories and reports on this growing shortage, including here in New York. For example, one 2022 report suggests the total workforce of registered nurses in the United States decreased by more than 100,000 from 2020 to 2021 – the largest drop observed in more than four decades.
With more and more nurses exiting the workforce, and demand increasing, hospitals and health care facilities are forced to consider all available options. In the Immigration Practice Group and Health Care Industry Team at Harris Beach, we have seen a significant uptick in the number of employers and clients seeking to hire nurses from abroad. In the past few months alone, we have worked with several clients to develop large-scale nurse recruiting programs, with goals ranging from a handful of international nurses to more than 200. Although a long-term process, more health care providers in the United States are making this investment in order to solidify their workforce.
As we have previously addressed, the temporary work visa options for nurses are limited. With the relevant government agencies – namely, the U.S. Department of Labor and U.S. Citizenship & Immigration Services – operating under the premise that registered nurses do not typically fall within a “specialty occupation” requiring a bachelor’s degree as the normal entry-level requirement, the H-1B visa typically is not a viable option to hire foreign RNs. Consequently, often times the only temporary/nonimmigrant visa option for RNs is the TN visa. This category, however, is available only to Canadian and Mexican citizens, and thus the pool of candidates is restricted.
As a result, employers are often forced to jump directly to seeking foreign nurses through an immigrant visa (“green card”) process. Most employment-based permanent residence processes/categories require the U.S. employer to obtain a permanent Labor Certification from the Department of Labor, certifying there are no minimally qualified U.S. workers for the offered position. However, professional nurses (and physical therapists) have received special designation as “Schedule A” occupations – essentially a blanket finding by the DOL that there is not an adequate number of qualified U.S. workers, which exempts U.S. employers from having to obtain a Labor Certification to sponsor a foreign RN/PT for permanent residency. With the Labor Certification process currently taking, in many cases, 12 to 18 months to complete, this is a significant streamlining benefit.
