The U.S. is attractive to foreign nurses who come to fill a growing, critical need in the health care industry. The Health Resources and Services Administration (HRSA) has determined that the U.S. shortage in this field will rise from over 110,000 vacant nursing positions in the U.S. in 2000 to over 700,000 vacant positions by the year 2020. Clearly, foreign nurses help reduce this deficit to the benefit of all. There are many ways a foreign nurse can enter the U.S.
The H1C Visa allows a nurse to enter on a temporary work visa to work for hospitals or employers that are pre-qualified by the U.S. as having a special need for nurses that is greater than the general need across the country. Some who have BS degrees in nursing may be able to enter the U.S. on the H1B Visa. LPR or Green Card status allows a nurse and his or her family to permanently come into the U.S. through a sponsor after completing a nursing program as well as the overall requirements for Commission on Graduates of Foreign Nursing Schools (CGFNS) and VisaScreen certification. Those RNs who are already in the U.S. may now file for LPR status and receive work authorization within 90 days of filing the petition and application with a sponsor. Options vary on a case-by-case basis.
What We Can Do For You:
At Rodrick Law Offices, we consult with nurses, hospital administrators, contracting agencies and others, to discuss case strategies, help determine the most appropriate option, and provide guidance on the paperwork to file in order to obtain the status most suitable under the circumstances for the nurse or the program. We also outline critical pre-filing strategies that will help assure prompt, efficient filing and processing. We at Rodrick Law Offices are familiar with the process of the CGFNS, the requirements for VisaScreen, state licensure and the overall challenges with the TOEFL, TWE, and TSE. If appropriate, we can help with submitting the applications and documentation to the CGFNS (including aggressive follow-up), submitting forms for the visa at the consulate or with the INS for temporary work status or LPR status in the U.S.
FREQUENTLY ASKED QUESTIONS BY NURSES:
Question 1. How may a foreign national nurse obtain an H1B visa?
Not all nurses will qualify for an H1B visa. The reason is that many registered nursing positions do not require a Bachelor's degree. INS generally will approve an H1B petition if the nurse works in a supervisory capacity; if the state where the nurse will work requires a Bachelor's degree in nursing to obtain a license; if the nurse is an Advanced Practice Registered Nurse or otherwise has additional, specialized training or experience required for the position; or if the Petitioner can successfully show why a four-year degree is necessary for the particular nursing position. Generally, emergency room nurses and supervisors have a better chance of obtaining an H1B petition approval than do other nurses.
Question 2. May a nurse obtain an H1B visa even when s/he does not have a license in the state where a job has been offered?
Nurses who qualify for an H1B petition approval in all respects except for possessing the nursing license to practice in a particular state may obtain an H1B petition approval valid for up to one year, provided the only barrier to the license is the need for a social security number. There was a 'Catch 22' situation created where the Social Security Administration could not issue the Social Security Number (SSN) to a person who did not have an H1B petition approval and the INS could not approve the H1B petition without the SSN. So INS agreed to issue an H1B petition approval for a period of one year to enable the nurse to qualify for the state licensure requirements and obtain the SSN. Accordingly, a nurse will be able to enter on the H1B visa, obtain the required social security number and finalize the licensure requirements in order to practice as a RN. S/He would have to show the valid nursing license in order to extend the H1B status beyond the first year approval period.
Question 3. If a foreign national nurse obtains her/his R.N. degree from an accredited U.S. school and has a nursing license from the state in which s/he is working, will s/he still need to have a CGFNS certificate?
Unfortunately, yes, according to INS' current interpretations of the law and regulations. In a strange anomaly of the law, a nurse who has studied in a U.S.-accredited school will still need to obtain a CGFNS (Commission on Graduates of Foreign Nursing Schools) certificate in order to demonstrate that the U.S. Nursing degree and state licensure equate to a U.S. Degree in Nursing. This is an area where hospitals and health care facilities may do well to lobby for a change in the law.
Question 4. Must the CGFNS certificate be filed when the I-140 is filed? If not, what happens in concurrent filing cases?
The CGFNS certificate need not be filed when the I-140 petition is filed. INS has not specifically indicated what it will do in situations where the I-140 and I-485 are filed at the same time. We have seen and heard of INS denials of the I-485 in such cases, if the CGFNS certificate is not included at the time of filing the I-485, but typically the INS will send a Request for Evidence to ask for the CGFNS Certificate. This RFE generally requires a response within 12 weeks of its issuance.
Question 5. There are companies that contract nurses to various medical facilities throughout the United States but may not know exactly where the nurse will be placed at any given time. May these companies still file I-140s for nurses?
Generally, yes. The contracting company may wish to file the I-140 designating the state where the nurse is licensed or will be licensed as the location where the nurse will work, rather than designating a particular hospital or other health care facility that may be unknown at the time of filing the I-140 petition.
Question 6. If a nurse is licensed in State A, which does not require the CGFNS qualifying exam, but a hospital wishes to file an I-140 for that nurse to work in State B, and State B requires the NCLEX but also grants a license based on reciprocity with State A, does that nurse need to take the CGFNS qualifying exam?
Likely not. The reason it is difficult to provide definitive answers is that the INS has recently issued regulations on nurses and many of their policies are not consistent among the various Service Centers and from one INS examiner to the next. Accordingly, it may be possible to file the I-140 petition showing the nurse has the license in State A but will work in State B. At least one Service Center has approved such a petition. When the I-485 is filed, the nurse should obtain an EAD and get the license from State B as soon as possible, to be prepared for the likelihood of an RFE.
Question 7. Is there any way to avoid taking the CGFNS exam and obtain an approval of the I-140?
According to the regulations, a nurse need not take the CGFNS exam if s/he has a valid, full and unrestricted nursing license from a state in the U.S. to obtain the I-140 approval. However, s/he will need the CGFNS Certificate in order to obtain permanent residence status and for the INS to approve the I-485 application for the Nurse.
Question 8. If a nurse obtains a CGFNS certificate abroad but does not have a state nursing license, may s/he complete consular processing and enter the U.S. as a lawful permanent resident?
In most cases, yes, as long as the nurse also has the visa screen certificate. A number of employers indicate in their contracts with nurses that they will first be employed as a nursing assistant when they enter the U.S. until they are able to pass the NCLEX and obtain their RN license. To date, most consulates have accepted this position as valid.
Question 9. If a nurse is licensed in a U.S. state, will s/he still need the visa screen to obtain lawful permanent resident status?
Yes, the visa screen is required even if the nurse is already licensed in a U.S. state.
Question 10. If a nurse chooses to file the I-485 before obtaining the visa screen, will INS wait to issue the advance parole and employment authorization document until they receive the visa screen certificate?
In most cases, there is no delay in issuing the EAD and AP. INS would typically approve the employment authorization document and advance parole document applications.
Question 11. May a nurse download the CGFNS paperwork from the Internet?
Yes, the necessary forms may be downloaded from the CGFNS Website.
Question 12. Will CGFNS contact me if they are waiting for documents from a certain school or state?
Not usually. It is best to check with CGFNS periodically to determine whether they need any additional information to process your application.
Question 13. Must a foreign national nurse have a current license in his/her home country in order to qualify for a Visa Screen?
Question 14. Once the I-140 is approved for a nurse, can s/he obtain a Social Security Number?
No, the Social Security Administration does not accept the approval of the I-140 as a valid reason to grant a social security number, as the approval of the I-140 is not an approval to work.
Question 15. If a nurse has an EAD and a valid state nursing license, may s/he engage in employment as a nurse while the I-485 is pending?
Yes, this is permitted.