USCIS issued guidance recently for determining whether or not a nursing position meets the definition of an “specialty occupation.” Specialty occupations are typically eligible for H-1B and E-3 professional work visas. The guidance advises that with the increase of nursing specialization, adjudicators need to take a careful case-by-case approach to analyzing whether an individual position is a specialty occupation. This is good news in light of the challenges hospitals and medical facilities have faced in obtaining H-1Bs for key nurse personnel.
The memo begins by clearly stating that the standard Registered Nurse position does not qualify for H-1B classification. The memo then notes that there is are three typical paths to obtaining an RN: a bachelor’s of science degree (BSN), an associate’s degree in nursing (ADN), or a diploma from an approved nursing program. The memo also notes that the increasingly, nurses are obtaining the Bachelor’s degree first, and that the private sector favors more highly educated nurses.
The memo lists a number of specializations in nursing: addiction, cardiovascular, critical care, emergency room, genetics, neonatology, nephrology, oncology, pediatric, peri-operative, rehabilitation, and other nurses. Depending on the facts of each case, some of these specializations may qualify as specialty occupations. The memo also offers a “non-exhaustive” list of Advanced Practice Registered Nurse occupations that may be specialty occupations: Certified Nurse-Midwife (CNM), Certified Clinical Nurse Specialist (CNS); Certified Nurse Practitioner (CNP); and Certified Registered Nurse Anesthetist (CRNA).
The memo advises adjudicators and stakeholders that the the appropriate evidentiary standard for determining whether a position is a specialty occupation is the “preponderance” standard, which means whether it is more likely than not. To evaluate the cases, adjudicators are instructed to weigh such factors in the record as (1) the nature of the petitioner’s business; (2) industry practices; (3) a detailed description of the duties to be performed within the petitioner’s business operations; (4) advanced certification requirements; (5) ANCC Magnet Recognized status; (6) clinical experience requirements; (7) training in the specialty requirements; and (8) wage rate relative to others within the occupation.
Time will tell how this plays out, but this memo opens the door for employers to pursue H-1Bs more confidently in cases where Registered Nurses are particularly specialized.