EB-3 Nurse Sponsorship: Schedule A, VisaScreen, and Filing Steps

EB-3 nurse sponsorship is the employment-based green card route where a U.S. hospital, nursing home, or staffing agency petitions for a foreign-born registered nurse as a permanent employee. Because registered nurses sit on Schedule A, Group I of the federal labor regulations, the employer skips the labor market test that slows down most other EB-3 cases. What replaces that shortcut is a stack of credentialing steps for the nurse, financial proofs for the employer, and a visa backlog that depends heavily on the nurse’s country of birth.

Who Can Be Sponsored

To qualify as a professional nurse under EB-3, you need to meet at least one of three Department of Labor requirements: hold a CGFNS certificate, hold a full and unrestricted nursing license in the U.S. state where you plan to work, or have passed the NCLEX-RN administered by the National Council of State Boards of Nursing.¹ In practice, nearly every state board requires the NCLEX-RN for licensure, so most internationally educated nurses take it regardless.

You also need nursing education from an accredited program, whether an associate or bachelor’s degree, and a valid nursing license from wherever you currently practice. The U.S. treats that home-country license as a starting point, not a substitute for American credentialing.²

VisaScreen and English Proficiency

Every foreign nurse seeking a U.S. immigrant or work visa must present a health care worker certification before being admitted. USCIS calls it a “health care worker certification,” but it is generally known as the VisaScreen, run by CGFNS.³ It verifies that your education, training, and licensure are comparable to those of a U.S.-trained nurse and that your credentials are authentic and unencumbered.

Part of the VisaScreen is proving English proficiency on a federally approved test. HHS sets the tests and minimum scores. For registered nurses, the thresholds are an overall 6.5 on the IELTS Academic with at least a 7.0 on speaking, or an 81 on the TOEFL iBT with minimums of 57 on reading, listening, and writing and 24 on speaking.⁴ Missing a single subsection minimum sinks the certificate no matter how strong the overall score is.

Without the VisaScreen, you are legally inadmissible for the purpose of working as a nurse, whether you enter on an immigrant visa or adjust status inside the United States.⁵

Why Schedule A Speeds Things Up

Most employment-based green cards require PERM labor certification: the employer advertises the job, interviews U.S. applicants, and proves to the DOL that no qualified American worker is available. That alone can run six months to a year. Registered nurses fall under Schedule A, Group I, an occupation DOL has pre-certified as facing a national shortage, so the labor market test is skipped entirely.⁶

The employer still prepares ETA Form 9089, but files it directly with USCIS alongside the I-140 rather than with DOL. Physical therapists are the only other occupation with the same Schedule A, Group I designation.¹

What the Employer Has to Do

Skipping the labor market test does not mean skipping employer obligations. Three big ones apply before the petition goes in.

Prevailing Wage

The employer requests a prevailing wage determination from DOL using Form ETA-9141. This sets the minimum salary based on the occupation and the worksite’s geographic area. The offered wage must meet or exceed that floor throughout the sponsorship, from petition filing until the nurse receives permanent residency.⁷

Notice of Filing

The employer must post a notice at the worksite telling current employees that it intends to hire a foreign worker for the position. If the facility has a union, the notice goes to the bargaining representative. Otherwise, it goes in a location where workers can easily see it. The notice must stay up for at least 10 consecutive business days and also appear in whatever internal channels the facility normally uses for recruitment.⁸

Ability to Pay

USCIS will not approve the petition unless the employer proves it can actually pay the offered wage on an ongoing basis. The petition must include annual reports, federal tax returns, or audited financial statements for each year from the priority date forward. Employers with 100 or more workers can substitute a statement from a financial officer.⁷ Petitions quietly die here more often than nurses realize. A small rural hospital on thin margins may struggle, especially if it is sponsoring several nurses at once.

Filing the I-140

The employer files Form I-140, Immigrant Petition for Alien Workers, with USCIS along with the Schedule A labor certification (ETA Form 9089).⁹ The package includes your transcripts, diplomas, nursing licenses, VisaScreen certificate, NCLEX-RN results, and identity documents such as a passport and birth certificate. Any family members included need their own identity documents.

The I-140 filing fee is $715. For a faster decision, the employer can file Form I-907 for premium processing, which guarantees USCIS action within 15 business days. The premium processing fee rose to $2,965 effective March 1, 2026.¹⁰ Premium processing speeds up only the I-140 decision. It does not shorten the visa backlog.

Once USCIS approves the I-140, your priority date is locked in. That date is your place in line. What happens next depends on whether a visa number is available and whether you are inside or outside the United States.

Wait Times by Country of Birth

An approved I-140 does not mean you can get a green card right away. Congress caps the number of employment-based green cards each year, and no single country can receive more than roughly 7% of the total. For nurses from high-demand countries, the wait is long.

As of June 2026, EB-3 final action dates from the State Department’s Visa Bulletin show:¹¹

India: priority dates through December 15, 2013 are current, roughly a 12-year backlog.
China (mainland born): priority dates through August 1, 2021 are current, roughly a 5-year backlog.
Philippines: priority dates through August 1, 2023 are current, roughly a 3-year backlog. The State Department has warned that increased demand may force further retrogression during fiscal year 2026.
Most other countries: priority dates through June 1, 2024 are current, roughly a 2-year backlog.

These dates shift monthly, sometimes forward and sometimes backward. Your country of birth, not your citizenship or where you currently live, determines the line you stand in.

Getting the Green Card: Two Paths

Consular Processing (Nurse Abroad)

If you are outside the United States when your priority date becomes current, your approved I-140 is forwarded to the National Visa Center. The NVC collects fees and civil documents, including police clearances from every country where you have lived for six months or more, and you complete Form DS-260 online. The employment-based immigrant visa application processing fee is $345 per person.¹² Once the file is documentarily complete, the NVC schedules an interview at the U.S. embassy or consulate nearest you. If the consular officer approves, you are admitted as a permanent resident when you enter the United States on that visa.

Adjustment of Status (Nurse Already in the U.S.)

Nurses already in the country on another visa, such as H-1B or TN, can adjust status by filing Form I-485 without leaving.¹³ You can only file once a visa number is available. If your priority date is current at the time of I-140 filing, you may file the I-485 concurrently.¹⁴ The I-485 requires a medical exam by a USCIS-designated civil surgeon on Form I-693. USCIS does not regulate what civil surgeons charge, but expect several hundred dollars.

Portability After 180 Days

One of the most important protections for sponsored nurses is job portability under INA Section 204(j). Once your I-485 has been pending for 180 days or more and your I-140 has been approved, you can transfer your green card application to a new employer as long as the new job is in the same or a similar occupational classification. Moving from one nursing job to another at a different hospital qualifies.¹⁵

To port, you file Form I-485 Supplement J confirming the new job offer. Even if the original employer withdraws the I-140 after the 180-day mark, it can remain valid for portability purposes if it was approvable when filed.¹⁵

Contracts and Financial Risk

The immigration case and the employment contract are two separate documents with very different stakes. Many hospitals and staffing agencies require sponsored nurses to sign contracts committing to two or three years of employment after arrival. These often include repayment clauses that require you to reimburse immigration and recruitment costs if you leave early. Penalties of $20,000 or more are common in the staffing industry.¹⁶

Some of these contracts have faced legal challenges under the Trafficking Victims Protection Act, which prohibits using threats of financial harm or legal action to compel someone to work. When a repayment clause is so large that a nurse cannot realistically afford to leave, regulators have treated it as coerced labor. In a 2025 New York enforcement action, a staffing agency was required to eliminate mandatory arbitration clauses, remove unlawful non-compete provisions, and cap contract terms at 5,460 hours inclusive of overtime.¹⁶

Read every page before signing. Watch what triggers the repayment obligation, whether it includes termination without cause, and whether you would be responsible for the employer’s legal fees in arbitration. If anything reads as coercive, get an immigration attorney involved before you commit. The 180-day portability rule gives you an eventual exit under immigration law, but a contract can still try to impose financial penalties well before that window opens.

What It All Costs

Costs split between employer and nurse, and the division varies. Hospitals often cover more; staffing agencies more often push costs onto the nurse through repayment provisions.

NCLEX-RN registration: $200, plus $150 international scheduling fee if you test outside the U.S.
VisaScreen certification: several hundred dollars to CGFNS for credential evaluation and English verification, depending on services.
IELTS or TOEFL: roughly $200 to $300 per sitting, and many nurses take the test more than once.
State nursing licensure: application fees from $50 to $350 depending on the state, plus $40 to $70 for fingerprinting and background checks.
I-140 filing fee: $715, paid by the employer.
Premium processing (optional): $2,965 as of March 1, 2026.¹⁰
NVC immigrant visa fee (consular processing): $345 per person.¹²
I-485 adjustment of status: $1,440 for most applicants.
Medical exam (I-693): several hundred dollars including vaccinations, depending on the civil surgeon.

All together, credentialing, testing, government fees, and medical exams typically run from about $4,000 to over $10,000 per nurse. Get in writing what the employer covers before you begin, and be skeptical of any arrangement that loads costs onto you up front with a promise of reimbursement after arrival.

1
eCFR. 20 CFR 656.5 – Schedule A
2
CGFNS International, Inc. How to Work as a Nurse in the U.S.
3
U.S. Citizenship and Immigration Services. Health Care Worker Certification
4
Health Resources and Services Administration. Updated List of Tests and Scores for Foreign Health Care Workers
5
eCFR. 8 CFR 212.15 – Certificates for Foreign Health Care Workers
6
U.S. Citizenship and Immigration Services. USCIS Policy Manual Volume 6 Part E Chapter 7 – Schedule A Designation Petitions
7
U.S. Citizenship and Immigration Services. USCIS Policy Manual Volume 6 Part E Chapter 4 – Ability to Pay
8
U.S. Department of Labor. 20 CFR Part 656 – Labor Certification Process for Permanent Employment of Aliens in the United States
9
U.S. Citizenship and Immigration Services. I-140, Immigrant Petition for Alien Workers
10
U.S. Citizenship and Immigration Services. USCIS to Increase Premium Processing Fees
11
U.S. Department of State. Visa Bulletin for June 2026
12
U.S. Department of State. Fees for Visa Services
13
U.S. Citizenship and Immigration Services. I-485, Application to Register Permanent Residence or Adjust Status
14
U.S. Citizenship and Immigration Services. Concurrent Filing of Form I-485
15
U.S. Citizenship and Immigration Services. Job Portability After Adjustment Filing and Other AC21 Provisions
16
Attorney General of New York. Attorney General James Recovers Over $660,000 for Foreign-Recruited Nurses Exploited by Health Care Staffing Agency