The EB-3 Visa Process for Nurses: A Facility Guide

International nurses bring a wealth of experience and a fresh perspective to the way your facility delivers care. They help diversify your nursing workforce and connect with patients of multicultural backgrounds in an invaluable way.

Sponsoring a foreign-based nurse through an EB-3 visa can be a strategic investment in nurse retention, as it grants nurses permanent residence in the U.S. In this guide, we share how facilities can support foreign-trained nurses seeking employment visas.

What Is an EB-3 Visa for Nurses?

Employment-based immigration: third preference, or EB-3, is an immigration visa that allows nurses to be employed in the U.S. as permanent residents while working toward their citizenship. Under this process, healthcare employers sponsor nurses to obtain visas and become “green card” holders.

Each year, the U.S. Citizenship and Immigration Services (USCIS) issues around 40,000 of these visas — and three-quarters of those are reserved for skilled and professional workers. To be eligible for this type of immigrant visa, a worker must be categorized as one of the following:

• Skilled workers. To qualify, an individual must have either two years of experience in a job or a post-secondary education that counts toward training. Most nurses are considered skilled workers — due to specialized education and training requirements, this occupation is typically listed on a U.S. visa skilled worker list.

• Unskilled workers. Jobs requiring less than two years of training are classified as unskilled labor. Visas are only granted for permanent positions — temporary or seasonal jobs don’t qualify.

• Professionals. An individual must possess a baccalaureate degree or a foreign equivalent and proof that this type of degree is necessary for employment. Work experience or training may not be substituted for a baccalaureate degree.

To sponsor an immigrant worker in any of the above categories, an employer must be able to prove there aren’t enough qualified workers in the U.S. available. The demand for nurses is a high priority due to consistent nursing shortages and high turnover rates, and the Department of Labor recognizes this. It classifies nursing as a Schedule A occupation, meaning there are not enough qualified workers in the U.S. able, willing, and available to meet the demand.

What’s the Hiring Process for Foreign Nurses?

Hiring foreign nurses can be an effective way to address nursing shortages in your facility. Because these nurses are seeking permanent residence, they’re more likely than temporary workers to offer longevity within your organization. International nurses may also require less on-the-job training than others (such as recent nursing school graduates) — but getting them into facilities requires overcoming some legal red tape. The good news is that as a healthcare employer, there are ways that you can facilitate the employment visa process.

Before we dig into EB-3 visa requirements and process, it’s important to distinguish between EB-3 visas and employment visas for temporary and permanent workers. If your facility is looking to hire contract or temporary nurses, then you may need to utilize the H-1B program, which grants visas for nonimmigrant aliens in specialty occupations for up to three years and, in some cases, up to a maximum of six years.

If you’re looking for longer-term support for your facility, then here’s an overview of the EB-3 visa application process covering the requirements for both employers and nurse professionals.

Labor Certification

The Department of Labor issues a permanent labor certification, also called a PERM, which allows employers to hire foreign workers for permanent work. To obtain a labor certification, employers must submit a Form ETA-9089. Filing this form is the employer’s responsibility, not the nurse’s. This step must be done before submitting an immigration petition to the USCIS. Labor certifications expire after 180 days from the date of certification.

EB-3 Application Process for Nurses

To begin the visa application, nurses must have a full-time offer and proof of labor certification. They must also be able to prove they qualify as a skilled or professional worker according to USCIS.

Every nurse must have a valid nursing license to practice in the U.S. Foreign nurses can get pre-screened through the Commission on Graduates of Foreign Nursing Schools (CGFNS). The organization is approved by the U.S. Department of Homeland Security to validate credentials for LPNs/LVNs, RNs, and other healthcare professionals. The screening process involves:

• verifying nursing education and credentials from a nurse’s country of origin
• taking a predictor exam that evaluates the likelihood of passing the NCLEX
• evaluating English language proficiency

After getting screened, a nurse gets licensed in the U.S. by passing the National Council Licensure Exam (NCLEX) in their state of practice. Individuals are responsible for contacting the State Board of Nursing to find out the requirements for internationally educated nurses.

EB-3 Application Process for Employers

Employers must file Form I-140, Immigration Petition for Alien Workers to ask USCIS to allow a noncitizen to gain citizenship based on employment. The form includes personal information about the immigrant worker including names of family members, Social Security numbers (if applicable), and addresses, so all of this information will be required from any foreign nurses applying to your organization.

You may want to advise employees to have an interpreter or lawyer present when completing an I-140, as USCIS rejects forms for many reasons like missing signatures or submitting forms dated prior to 5/31/22. A form I-140 can be filed at any time and costs $700. During the application process, employers must be able to demonstrate the ability to pay the offered wage. You can do this by presenting financial statements, annual reports, or federal tax income returns.

EB-3 Visa Processing

After receiving a petition, USCIS begins processing the application. This begins with checking the application for completeness and collecting the fee. USCIS may request more information from the applicant at any time. They may also request to do an in-person interview or obtain biometrics for additional security or background checks.

EB-3 visa processing times vary based on individual situations. Once USCIS makes a decision about an applicant’s eligibility on form I-140, they submit their decision in writing.

Ethical Considerations

Healthcare employers and recruiters who hire foreign nurses have an ethical responsibility to follow the appropriate processes to help immigrants gain employment in the U.S. The Alliance for Ethical International Recruitment Practices (also called “the Alliance”) created 10 guiding principles for hiring foreign-educated health professionals (FEHPs).

Recruiters and employers can choose to get certified to demonstrate a commitment to ethical hiring practices in accordance with the guidelines set forth by the Alliance. The principles state that FEHPs have the same rights to ethical and professional treatment from recruiters and employers. As a healthcare employer, it’s important to protect the rights of any immigrant employees you hire. Here are just a few areas where you can protect their rights:

• ensuring a work environment that is free of any discrimination, retaliation, and abuse
• providing transparency about the recruitment process
• having a clear understanding of the components of an employment contract and access to a lawyer for review
• communicating details about the location, shifts, and pay prior to the employment start date
• offering additional assistance during clinical orientation for linguistic and cultural training
• informing them that an employer may not use immigration status against them, such as for punitive reasons or threats

Facilities sponsoring foreign nurses should also be considerate of nursing shortages in their countries of origin. If a nurse is leaving an area with critical needs, the receiving healthcare organization should consider a partnership called “twinning,” which allows American hospitals to donate resources and allow nurses to return to their country of origin periodically to work.

Begin Diversifying Your Nursing Team Today

Healthcare employers can facilitate nurses’ journeys from EB-3 visa to green card status by actively participating in the application process. To get more qualified nurses into your facility and begin diversifying your nursing team, consider a partnership with IntelyCare today.

Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.