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.
Experienced New York Immigration Attorneys Can Help Address Nursing Need
The Harris Beach Immigration Team has worked with employers of all sizes on both small-scale and large-scale green card processes for international nurses, and, through this experience, has developed efficiencies to minimize the processing times for these applications. While government processing times continue to remain lengthy, there are ways these delays can be mitigated. For example, for large-volume filers, it is advisable to maintain a valid prevailing wage determination on a rolling basis throughout the year; this is of particular value given the extension of prevailing wage processing times from 3 to 4 months (which were seen as recently as 2021) to now about 8 to 9 months in many cases. It is also critical to frame the job requirements in such a way that allows for the earliest possible filing of the I-140 Immigrant Visa Petition, which in some cases can be filed before the nurse/candidate has a state nursing license in hand – another step that often comes with several months of delays.
For employers willing to invest time in the process, the “Schedule A” immigrant visa category for nurses can be an important piece in a hospital/health care facility’s staffing strategy. Because of the unique nuances and timing considerations involved in this process, it is critical for employers to work with experienced immigration counsel who can help mitigate the limitations of this program and advance this process as quickly as possible.
If you have questions about visa and immigration options for nurses or other health care workers, contact the Harris Beach Immigration Team to discuss the options available to you. Our Immigration Law Practice Group includes immigration attorneys who work across New York state in our Albany, Buffalo, Ithaca, Long Island, New York City, Rochester and Syracuse offices. Our immigration lawyers focus on strategies – including immigrant visas for permanent U.S. resident status and temporary visas for foreign nationals – to ensure employers are able to hire, transfer, and retain the brightest and best non-U.S. talent.
This alert is not a substitute for advice of counsel on specific legal issues.
Harris Beach has offices throughout New York state, including Albany, Buffalo, Ithaca, Long Island, New York City, Rochester, Saratoga Springs, Syracuse and White Plains, as well as Washington D.C., New Haven, Connecticut and Newark, New Jersey.