Showing posts with label Registered Nurses. Show all posts
Showing posts with label Registered Nurses. Show all posts

Wednesday, November 26, 2025

American Hospital Association Urges Trump to Exempt Health Care Personnel from $100,000 H 1B Fee

Recently, the American Hospital Association (“AHA”) voiced its support for an exemption from the $100,000 H-1B fee for health care workers. 

In its letter, AHA urges the federal government to exempt health care personnel from the $100,000 H‑1B visa fee established by President Trump’s September 2025 proclamation, “Restriction on Entry of Certain Nonimmigrant Workers,” (MU’s blog on the fee is available here) arguing that the fee threatens hospitals’ ability to recruit and retain qualified foreign‑trained professionals.

 

Health care systems across the United States continue to grapple with profound clinician and nurse shortages that are projected to deepen significantly in the years ahead. 

 

The H-1B visa is essential to meeting shortages in health care occupations in the US. In fiscal year 2024 alone, of nearly 400,000 H‑1B petitions approved, 16,937 (4.2%) were for medical and health occupations, including physicians, surgeons, and registered nurses.

 

AHA also articulated its strong support for the bipartisan Healthcare Workforce Resilience Act (discussed by MU here). These combined measures represent a coherent strategy to preserve and expand the U.S. health care workforce. Ensuring exemption from the fee is not only a regulatory measure—it is a critical component of maintaining continuous and equitable access to health services across communities nationwide.

Monday, November 10, 2025

CALL FOR CONGRESSIONAL SUPPORT OF HEALTHCARE WORKFORCE RESILIENCE ACT

As discussed in a previous blog post, Musillo Unkenholt is pleased to report that the Healthcare Workforce Resilience Act (HWRA) has been reintroduced into Congress. The HWRA has bipartisan sponsorship of Senators Durbin and Cramer in the Senate and Representatives Brad Schneider and Don Bacon in the House.

The HWRA offers an immediate response to the U.S.’s nursing shortage crisis by recapturing 25,000 previously authorized but unused immigrant visas (Green Cards) for highly-qualified international nurses who meet strict professional requirements. The bill does not displace any U.S. nurses or increase the total number of available immigrant visas (Green Cards).

Musillo Unkenholt endorses the HWRA, an efficient and long-awaited step toward immigration reform that will work to meet the country’s growing need for a strong U.S. health care workforce.

The HWRA has the highest chance of passing in Congress with more co-sponsorship. If you or your employer would benefit from common-sense lawmaking to remedy the U.S. nursing shortage, contact your congressional representative about co-sponsorship of the HWRA.

Thursday, September 11, 2025

HEALTHCARE WORKFORCE RESILIENCE ACT REINTRODUCED INTO CONGRESS

Musillo Unkenholt is pleased to report that the Healthcare Workforce Resilience Act (HWRA) has been reintroduced into Congress. The HWRA has bipartisan sponsorship of Senators Durbin and Cramer in the Senate and Representatives Brad Schneider and Don Bacon in the House.

As America grapples with a devastating nursing shortage that is directly undermining the quality, accessibility, and affordability of healthcare for millions of Americans in rural communities across the country, Musillo Unkenholt endorses policymakers taking immediate action.

The HWRA offers an immediate response to this crisis by recapturing 25,000 previously authorized but unused immigrant visas (Green Cards) for highly-qualified international nurses who meet strict professional requirements. The bill does not displace any U.S. nurses or increase the total number of available immigrant visas (Green Cards).

This bipartisan solution will help to ensure rural and elderly Americans receive the nursing care they need today while policymakers seek additional solutions to help America produce more nurses in the future and end this crisis once and for all.

Musillo Unkenholt endorses the HWRA, an efficient and long-awaited step toward immigration reform that will work to meet the country’s growing need for a strong US health care workforce.

Tuesday, August 5, 2025

Immigrant Caregivers are Crucial to Staff Direct Care Industry

President Trump’s “immigration crackdown” has elicited a warning from the direct care industry: immigrants are essential.

Although immigrants comprise 17% of the total American labor force, they make up 31% of the home care workforce and 21% of the residential care aide and nursing assistant workforce, according to a 2024 report from Leading Age, an organization representing nonprofit aging services providers.

 

A recent article by USA TODAY highlights the severity and scope of the direct care worker shortage, which is set to reach critical levels as the US faces even higher demand to care for aging Baby Boomers.

 

In 2020, 55.8 million people in the US were 65 and over, according to census dataA study in Health Services Research estimates that number will reach nearly 70 million by 2030.

 

From 2022 to 2037, a National Center for Health Workforce Analysis estimated the demand for home health aides will rise 35%, the demand for personal care aides will rise 38%, and the demand for nursing assistants will rise 41%.

 

Articles by Axios and AP News echo the essentiality of immigrant caregivers in US nursing homes, and warn of the effect President Trump’s immigration policies are already having on nursing home staffing in the US.

 

AP News reports:

 

“The aging of the massive Baby Boom generation is poised to fuel even more demand for caregivers, both in institutional settings and in individuals’ homes. BLS projects more growth among home health and personal care aides than any other job, with some 820,000 new positions added by 2032.”

 

Due to high demand and Department of State backlogs, immigrant nursing aides who qualify for a Green Card are currently waiting more than three years to enter the U.S. after their cases are approved.

 

Because of lengthy backlogs, staffing companies employing nursing assistants and nurse aides are best equipped to withstand immigration delays in their business models; however, meeting the demand for direct caregiving in the US in the coming years will require policies to extend temporary work authorization for direct care workers and policies to alleviate Department of State backlogs for permanent immigration solutions.

Wednesday, July 2, 2025

Webinar: Immigration Updates for the Healthcare Industry

MU will be hosting a FREE webinar on Thursday, July 10 at 3PM Eastern for our friends and clients.  Please join us! 

IMMIGRATION UPDATES AND THE STATE OF THE HEALTHCARE INDUSTRY

Join us for an information-packed webinar designed for HR leaders, immigration professionals, and staffing companies navigating today’s complex immigration landscape.

In just half an hour, we’ll deliver critical updates and actionable strategies on:

  • 🚦 Green Card Processing Timelines & Prevailing Wage Determinations – how to stay ahead and avoid any delays in filing
  • 📈 RFE Rates & Trends under the Trump Administration – and how to minimize your risk
  • 💸 "Ability to Pay" Challenges – especially for staffing firms during retrogression, with proven solutions
  • 👩‍⚕️ H-1B Options for Registered Nurses – what you need to know now
  • 📰 Policy Shifts & Breaking News from Washington – decoded and explained
  • 🏛️ Legislative Outlook – what’s coming and how it could impact your workforce strategy

Reserve your spot today!

Monday, June 2, 2025

Foreign-Trained Nurses Can Help Fill Critical Gaps in the Healthcare Sector

As the U.S. healthcare system grapples with a critical nursing shortage, maintaining lawful, streamlined immigration pathways for foreign-trained nurses is essential to ensuring effective and continuous patient care.

A recently published article by Digital Health Insights (DHI) highlights the severity of this shortage, which is exacerbated by tightening immigration policies and a growing number of nurses leaving the profession.

 

Drawing on data from the Migration Policy Institute, DHI notes that as of 2021, nearly 20%, approximately 2.8 million, of healthcare workers in the United States are immigrants.

 

The total supply of RNs in the U.S. decreased by more than 100,000 from 2020 to 2021, which is the greatest drop in the past 40 years. Between 2020-2022, nursing turnover skyrocketed to 27% nationwide.

 

Due to high demand and Department of State backlogs, foreign-trained nurses who qualify for a Green Card are currently waiting more than two years to enter the U.S. after their cases are approved. An approved case indicates the foreign-trained nurse meets all U.S. requirements to enter the profession and has a U.S. employer sponsor.

 

To address these barriers, DHI proposes innovative solutions, such as extending the National Interest Waiver for Physicians to include other healthcare professionals. Likewise, it suggests that the U.S. follow the example of countries like Canada and the United Kingdom, which have implemented dedicated healthcare visa programs.

 

Meeting the U.S. healthcare workforce shortage—particularly in nursing—requires accessible and effective legal pathways for foreign-trained professionals.

Thursday, May 8, 2025

Department of State Launches IV Scheduling Status Tool

On April 29, 2025, the Department of State launched the Immigrant Visa (IV) Scheduling Status Tool, which will provide greater transparency for Green Card applicants who are currently delayed from entering the US while awaiting their Green Card interview abroad.

Updated monthly, the IV Scheduling Status Tool provides information by post and visa category indicating the month and year in which recently scheduled cases became documentarily complete.

The date a case becomes “documentarily complete” is date that NVC determines an applicant has paid the necessary fees and submitted all required documents.

The IV Tool is available for applicants in all employment-based Green Card categories, including Registered Nurses and other healthcare workers.

Friday, May 2, 2025

USCIS Should Update H-1B Policy for Nurses

The USCIS should consider issuing a new policy memo to modernize and liberalize the approvability of H-1B visas for registered nurses. The current guidance—based on a 2015 memo from the Obama administration—is outdated and no longer reflects the realities of the U.S. healthcare workforce.

The U.S. Faces a Critical Nursing Shortage

Nursing remains one of the most understaffed professions in the United States. This shortage is driven by several key factors:

  • An aging population that is increasing demand for healthcare services.
  • A large number of nurses retiring from an aging workforce.
  • Bottlenecks in nursing education due to faculty shortages and limited training capacity.

To address this crisis, allowing more foreign-trained nurses into the U.S. through H-1B visas could provide much-needed relief.

Why H-1B Approval for Nurses Makes Sense Now

Historically, USCIS has been reluctant to approve H-1B petitions for registered nurses because bedside nursing roles did not universally require a Bachelor of Science in Nursing (BSN). However, that landscape has changed significantly.

According to a recent study by the American Association of Colleges of Nursing (AACN), 72% of registered nurses in the U.S. now hold at least a BSN. (Source)

Given this shift, the USCIS should revise its policy to instruct officers to generally approve H-1B petitions for RN positions requiring a BSN.

No Risk of Job Offshoring

Some critics of the H-1B program argue that it can lead to offshoring of American jobs—especially in the IT sector. That concern does not apply to nursing. RN positions are inherently in-person and cannot be outsourced. A nurse must be physically present to care for patients. The real choice facing U.S. patients is not between a U.S. nurse and an international one—it is between having a nurse or going without care.

Monday, April 21, 2025

Immigration Policy Essential to Ease U.S. Healthcare Staffing Crisis

Legal immigration pathways remain necessary to meet U.S. healthcare staffing needs for positions throughout the industry, including Registered Nurses, physicians, and nursing aides. A recent article from NPR highlights how Trump administration policies limiting legal pathways for nurses and other healthcare workers compromise healthcare throughout American hospitals, nursing homes and the entire healthcare system.

Citing research analysis by JAMA Network, a consortium of peer-reviewed, general medical and specialty publications, NPR emphasizes the prevalence and essentiality of foreign-born workers in the U.S. healthcare system:

  • 25% of physicians in the U.S. were born outside of the U.S.
  • Nearly 17% of the total healthcare workforce, or roughly 3.4 million workers, were born outside the U.S.
  • 1.1 million healthcare workers in the U.S. are noncitizens without permanent residency in the U.S.

The Trump administration has enacted a series of measures and threatened others to end legal protections for millions of U.S. immigrants, creating uncertainty not only for immigrants, but for their employers. The administration has attempted to end Temporary Protected Status (TPS) for millions of legally authorized workers in the U.S. and has threatened the status of immigrants, including doctors and nurses, brought to the country illegally as children who receive legal protection through the Deferred Action for Childhood Arrivals, or DACA, program.

Even prior to President Trump’s reelection, staffing shortages in the U.S. healthcare workforce have restricted access to healthcare in the U.S. A 2024 survey from the American Healthcare Association found that nearly half of nursing homes in the U.S. said they’ve had to limit new admissions because of staffing shortages, and the JAMA Network letter reports that shortages of nurses and other personnel caused two-thirds of hospitals to operate below full capacity in 2023.

If Trump administration policies continue to restrict legal immigration pathways, current healthcare staffing shortages will be further exacerbated, hospitals will face bottlenecks and healthcare facilities will be unable to meet healthcare needs in the U.S. Legal immigration pathways for nurses and healthcare workers are an essential tool in providing healthcare in the U.S.

Friday, March 28, 2025

Healthcare Workforce Coalition meets with Lawmakers on Increasing Nurse Visas

 In March 2025, the Healthcare Workforce Coalition issued a press release on their recent meetings on Capitol Hill. The purpose of their meetings was to urge lawmakers to swiftly pass legislation to ease serious US healthcare workforce shortages.

The Healthcare Workforce Coalition is made up of healthcare industry leaders, including Ascend Learning, Brickyard Health, Fisher Titus Medical Center, Greater Baltimore Medical Center, LifeBridge Health, MedPro International, MedStar Health, Meritus Health, PRS Global, and St. Joseph’s University.

Representatives of the Healthcare Workforce Coalition met with the offices of US Senators and Representatives from both parties to urge support for measures to make visas for foreign-educated Registered Nurses and physicians immediately available.

Tuesday, March 18, 2025

CGFNS International reports nurse migration rates to the U.S. remained high in 2024

CGFNS International released a report last month concluding that nurse migration to the US remains high as healthcare systems continue to look to foreign-educated nurses to address persistent staffing shortages.

In 2024, CGFNS received 24,733 VisaScreen applications, down 4.6% from 2023, but still nearly 200% above pre-pandemic fiscal year 2018.

Allocation by country and visa type

Candidates with credentials from the Philippines accounted for more than 51% of issued VisaScreen certificates in 2024, followed by Canada with 8%, and Kenya with 6.5%.

76% of visa screen certificates issued by CGFNS were issued to candidates seeking permanent green cards, followed by candidates seeking TN visas (12%) and H-1Bs (11%).

According to the President and CEO of CGFNS, the report’s findings confirm that U.S. healthcare systems, “continue to depend on nurse immigrants to address persistent staffing shortages.”

Looking ahead

The report states that between 6% and 16% of registered nurses (RNs) in the U.S. are foreign-born, representing between 258,000 and 688,000 migrant nurses as of 2023. 

High immigration rates in the face of barriers such as visa retrogression highlight the continued appeal of nurse migration as a pathway for career advancement and economic opportunity.

However, visa retrogression persists, alongside new, likely stricter, immigration policies from the Trump Administration.

The report notes that while an increase in visa wait times may strain direct-hire models, staffing agencies can more effectively absorb wait periods, making staffing and recruitment even more essential for nursing immigration to the US in the coming years.

Wednesday, February 26, 2025

CGFNS International to Change Its Name to TruMerit™

The Commission on Graduates of Foreign Nursing Schools (CGFNS) announced it will change its name to TruMerit™.

Immigration regulations require that when filing an immigration petition for certain healthcare occupations, including Registered Nurses, the Petitioner must include a healthcare worker’s certificate (sometimes called a Visa Screen) from an authorized credentialing organization, such as CGFNS.

CGFNS indicated the name change will be the centerpiece of a comprehensive rebranding of the organization, which will also involve changes to its website, customer portals, credentials and certificates, and social media channels. The rebranding effort will begin rolling out in mid-March and will be completed by the summer.

Tuesday, February 11, 2025

English Exam Score Set at 50 for International Nurses: Could Increase in Future, says HRSA

The Commission on Graduates of Foreign Nursing Schools (CGFNS) announced that it will reset its standard passing English exam score to 50, after raising the standard to 63 in the Fall of 2024.

Immigration regulations require that when filing an immigration petition for certain healthcare occupations, including Registered Nurses, the Petitioner must include a healthcare worker’s certificate (sometimes called a Visa Screen) from an authorized credentialing organization. A passing English exam score is required for Visa Screen issuance.

One such English exam, the PTE, will now have a standardized passing score of 50 across all Visa Screen providers.

However, the Health Resources and Services Administration (HRSA) could soon increase the standardized English exam score across all providers.

To determine the appropriate English exam score requirement to protect patient safety and to safeguard healthcare professionals coming into the U.S. to work, HRSA has asked for comments through the Federal Register and will be reviewing a comprehensive report on English proficiency standards within the coming month.

Tuesday, November 5, 2024

USCIS DATA ON SCHEDULE A NURSES 2018-2022

In April 2022, MU filed a Freedom of Information Act (FOIA) request, requesting a complete dataset of all I-140 registered nurse immigrant petitions approved between Fiscal Year (FY) 2018 – Fiscal Year 2022.  The USCIS finally responded, producing a 443 page list of I-140 immigrant petitions approved between FY 2018 – FY 2022 for registered nurses. MU has summarized the data provided by the USCIS below:

 

 

FY 2018

FY 2019

FY 2020

FY2021

FY 2022

Total # of Approved RN I-140s

3905

5695

7484

7489

12095

 

As indicated by the data produced by the USCIS, there has been a steady increase in the number of approved I-140 immigrant petitions for registered nurses, with a notable jump in FY 2022, reflecting a critical need among U.S. employers for foreign national registered nurses. The demand among U.S. employers, coupled with a growing nursing workforce shortage should persuade Congress to embrace legislation, such as the Healthcare Workforce Resilience Act, which seeks to address the nation’s shortage of nurses in the aftermath of the COVID-19 pandemic.

In summary, the data produced by USCIS not only illustrates the urgent demand for foreign national registered nurses but also reinforces the need for legislative measures to address this critical shortage in healthcare.

Monday, October 28, 2024

International Education Evaluations, LLC Now Authorized to Issue Visa Screens

As of October 25, 2024, USCIS has added International Education Evaluations, LLC to the list of organizations authorized to issue certificates and certified statements for Registered Nurses. Notice of the organization’s addition was provided in the Federal Register.

Immigration regulations require that when filing a nonimmigrant or immigrant petition for certain healthcare occupations, including Registered Nurses, the Petitioner must include a healthcare worker’s certificate (sometimes called a Visa Screen) from an authorized credentialing organization.

The immigration regulations expressly authorize the Commission on Graduates of Foreign Nursing Schools (CGFNS), the National Board for Certification in Occupational Therapy (NBCOT), and the Foreign Credentialing Commission on Physical Therapy (FCCPT), to issue valid healthcare workers’ certificates.

USCIS may also approve additional organizations for issuance of certificates by providing notice in the Federal Register. MU previously published an August 2021 blog post on the addition, via Federal Register notice, of Josef Silny Associates, Inc. to the list of authorized organizations.

Tuesday, October 8, 2024

NCHWA: NURSE SHORTAGE TO CONTINUE THROUGH AT LEAST 2036

The National Center for Health Workforce Analysis projects a 9 percent nursing workforce shortage through 2036.  The problem will be particularly acute in non-metro areas, where the shortage is expected to grow to 14%.  The ten states with the largest projected RN shortages in 2036 are: Georgia (29%), California (26%), Washington (26%), New Jersey (25%), North Carolina (23%), New Hampshire (23%), South Carolina (21%), Maryland (20%), Michigan (19%), and Oregon (16%).

The current shortage is about 250,000 and is expected to grow to a shortage of 350,00 full-time registered nurses in 2026.

The National Center for Health Workforce Analysis (NCHWA) collects data, conducts research, and generates information about the U.S. health care workforce to inform and support Public- and private-sector decision making. Learn about the National Center for Health Workforce Analysis.

Legislation proposed by Rep. Bayer (D-VA) calls for 20,000 nurse visas for rural shortage areas.  Unfortunately, that legislation has probably been introduced too late in this congressional term to pass both houses of Congress before the term ends on December 31, 2024.

Wednesday, October 2, 2024

PHILIPPINE NURSES CHOOSING TO WORK ABROAD

Philippines nurses seem to be choosing contract positions with an aim toward moving abroad.   ABS-CBN News reports that ACT-Teachers party-list Rep. France Castro questioned why there did not appear to be an increase in permanent (Plantilla) healthcare positions in the last year.

Rep. Angelica Natasha Co speculated that healthcare workers opt for temporary or contractual positions when they have plans to work abroad.  Last year saw one of the greatest numbers of Philippine nurses enter the US in many years, as the American nursing shortage continues to get worse.  As of 2021, about 300,000 Philippine nurses worked abroad.

Tuesday, July 23, 2024

WEBINAR - H-1Bs FOR REGISTERED NURSES

MU Law will be hosting a FREE webinar for our clients and friends on Tuesday, July 30th, 2024 from 1:00-2:00 pm Eastern (12:00-1:00 pm Central).

Join us for this FREE webinar to learn more about:

  • Specialty Occupation Criteria
  • Potential H-1B Filing Approaches
  • H-1B Cap Exemption
  • H-1B RN Filing Trends

PLEASE JOIN US!

Wednesday, July 10, 2024

WEBINAR - H-1Bs FOR REGISTERED NURSES

 MU Law will be hosting a FREE webinar for our clients and friends on Tuesday, July 30th, 2024 from 1:00-2:00 pm Eastern (12:00-1:00 pm Central).

Join us for this FREE webinar to learn more about:

  • Specialty Occupation Criteria
  • Potential H-1B Filing Approaches
  • H-1B Cap Exemption
  • H-1B RN Filing Trends

PLEASE JOIN US!

Friday, November 3, 2023

BILL INTRODUCED TO INCREASE VISA NUMBERS FOR NURSES AND PHYSICIANS

US Senate Majority Whip Dick Durbin (D-IL) and US Senator Kevin Cramer (R-ND) introduced a bill, known as the Healthcare Workforce Resilience Act, on November 2, 2023, to address the nation’s shortage of physicians and nurses.

If passed, this bill will recapture 25,000 unused immigrant visa for nurses and 15,000 unused immigrant visas for physicians, from previous years. These visas would not be subject to the per country numerical limit that has led to lengthy waits for green cards for nurses and physicians from several countries.

Spouses and children that are accompanying or following to join these nurses and physicians, would be eligible for immigrant visas as part of this bill too. The spouses and children’s visas would not be considered as part of the 25,000 and 15,000 allocated visas for the nurses and physicians.

The nurse and physician cases would be required to be adjudicated by USCIS under USCIS’s premium processing program. There will be no additional fee for the premium processing.