How to Hire Foreign Caregivers in Nebraska (2026 Guide)

The Caregiver Shortage in Nebraska and Local Market Realities

Caregiver shortages in Nebraska create severe operational challenges for assisted living facilities, home care agencies, and nursing homes. Demand for personal care aides, home health workers, and certified nursing assistants (CNAs) continues to outstrip local labor supply. This deficit is felt acutely outside major metropolitan centers like Omaha and Lincoln. In non-metropolitan regions such as the Panhandle, the Sandhills, and the Central Platte Valley, healthcare facilities frequently freeze admissions or operate below maximum occupancy due to missing direct care staff.

Hiring foreign caregivers offers a structured way to build a stable workforce, but Nebraska employers must understand the regulatory reality before committing resources. Caregiving is year-round, continuous work. Because of this, short-term seasonal visas like H-2B are rarely applicable for standard care facilities unless you can demonstrate a specific, temporary peak-load need. The primary legal immigration path for long-term foreign caregivers is the EB-3 (Other Workers) permanent residency program.

Your financial calculations must account for both state minimums and federal prevailing wage mandates. Nebraska state minimum wage reached $15.00 per hour on January 1, 2026, following the phased implementation of Initiative 433. However, prevailing wage rates set by the U.S. Department of Labor (DOL) for personal care aides and nursing assistants in Nebraska generally range between $16.50 and $23.00 per hour, depending on whether your facility is located in the Omaha-Council Bluffs metro, Lincoln, Grand Island, or a rural non-metropolitan area. Employers must pay whichever rate is higher.

Nebraska Licensing and Qualification Requirements

Immigration authority is federal, but health worker licensing is entirely state-specific. Foreign caregivers cannot provide hands-on patient care in Nebraska without meeting requirements set by the Nebraska Department of Health and Human Services (DHHS) Division of Public Health.

Key Nebraska qualification standards include:

• Nebraska Nurse Aide Registry: Caregivers performing nursing assistant duties in licensed long-term care facilities must be registered on the Nebraska Nurse Aide Registry. To qualify, candidates must complete a 75-hour state-approved training course and pass both written and manual skills exams administered by an approved testing entity.
• Nebraska Medication Aide Registry: Caregivers tasked with routine medication administration in assisted living or home care settings must complete additional state-approved training (a 24-hour course for assisted living or a 40-hour course for broader settings) and pass the state medication aide examination.
• Foreign Credential Evaluation: Caregiving credentials or diplomas earned abroad do not automatically transfer to Nebraska. Candidates with international nursing or healthcare credentials must submit their transcripts to a recognized evaluation service, such as CGFNS International, to verify equivalency, or they must plan to complete Nebraska-approved CNA training upon arrival.
• Non-Medical In-Home Care Aides: Direct support staff who provide non-clinical personal assistance (such as companionship, light housekeeping, and meal preparation) are not required to hold CNA credentials. However, the employing home care agency must remain compliant with Nebraska DHHS licensure rules governing personal care services.

Legal Visa Routes: EB-3, H-2B, and Reality Check

Navigating federal visa categories requires selecting the proper legal track for the work being performed. Always confirm current immigration rules and petition requirements with the Department of Labor, USCIS, or a licensed immigration attorney.

The standard visa options for foreign caregivers include:

• EB-3 Unskilled / Other Workers (Permanent Residency): This is the primary legal path for full-time, permanent caregivers, home health aides, and nursing assistants. The process grants the worker a permanent resident visa (green card). Employers must complete the PERM labor certification process to prove that qualified local U.S. workers are unavailable before sponsoring the foreign national.
• H-2B Visa (Temporary Non-Agricultural): H-2B is restricted to temporary, seasonal, or peak-load staffing. Because care facilities operate 24 hours a day, 365 days a year, federal regulators routinely deny H-2B petitions for standard caregiving jobs. It is rarely a viable route for general elderly care facilities.
• TN Visa (USMCA): TN status is available only to citizens of Canada and Mexico. It is strictly limited to specific professional roles listed in the trade agreement, such as Registered Nurses (RNs). Entry-level caregivers, personal care aides, and CNAs do not qualify for TN status.
• EB-3 Skilled Workers or Schedule A Nurses: If you are recruiting foreign Registered Nurses or Licensed Practical Nurses rather than non-degree caregivers, they fall under Schedule A designation. Schedule A bypasses the lengthier PERM labor certification step, speeding up processing times.

Timelines: From Decision to First Shift

Sponsoring a foreign caregiver through the EB-3 visa process requires long-term workforce planning. It is not an immediate solution for filling an open shift next month.

A typical EB-3 timeline involves three major phases:

• PERM Labor Certification (12 to 18 months): Drafting job duties, receiving a prevailing wage determination from the DOL, conducting mandatory local newspaper and job board recruitment in Nebraska, and submitting Form ETA-9089.
• USCIS Immigrant Petition (3 to 6 months): Submitting Form I-140 (Immigrant Petition for Alien Workers) after PERM approval. Employers can use premium processing (15 calendar days) for Form I-140 for an additional fee.
• Consular Processing and Visa Issuance (12 to 24 months): The candidate completes background checks and interviews at a U.S. consulate in their home country. Waiting times vary based on visa backlogs tracked in the Department of State Visa Bulletin.

Expect a total timeline of 24 to 36 months from the day you start the process until the caregiver arrives in Nebraska to start work.

What You Are Obliged to Pay and Provide

Sponsoring international care staff carries specific financial liabilities. Employers must cover mandated government costs and plan for local operational expenses.

What this costs you, roughly:

• PERM Recruitment and DOL Compliance: $1,500 - $3,500 (mandatory local newspaper advertising and job posting fees).
• USCIS Filing Fees: $715 for Form I-140, plus $300 Asylum Program Fee, plus optional $2,805 for Form I-140 premium processing.
• Legal Fees: $4,000 - $8,500 in immigration attorney costs for PERM and I-140 preparation.
• Nebraska Licensing and Exams: $150 - $400 for DHHS Nurse Aide Registry testing and application processing.
• Relocation Airfare: $1,000 - $2,500 per worker (customary to ensure arrival, and legally mandatory for certain temporary visa categories).
• Housing Support: Housing is not mandated by law for permanent EB-3 employees. However, due to tight housing inventories in rural Nebraska counties like Scottsbluff, Box Butte, or Thomas, employers often provide temporary housing or a temporary monthly housing allowance ($800 - $1,500) to help new arrivals adjust.

Worker Exploitation and Legal Liability

Federal law explicitly prohibits employers and third-party recruiters from passing recruitment, legal, or PERM-related fees onto foreign workers. Legitimate employers pay all fees associated with securing the labor certification and visa petition. Any recruitment agency that demands payment from foreign applicants for job placement or visa processing is operating fraudulently. Sponsoring an applicant who has paid illegal placement fees exposes your company to severe legal penalties, Department of Labor audits, and potential revocation of your ability to sponsor foreign workers. Ensure all recruiting channels are legal and transparent.

Finding Foreign Caregivers on Workmerica

If you are a Nebraska employer interested in connecting with foreign candidates, you can search the Workmerica registry. Workmerica is an open database where international workers, including caregivers, home health aides, and healthcare assistants, publish profiles stating their qualifications and their intent to relocate to specific U.S. states like Nebraska.

Workmerica is not a recruitment agency, does not charge per-hire fees, and takes no referral commissions. You contact workers directly to assess their backgrounds, discuss Nebraska DHHS licensing expectations, and initiate legal visa sponsorship through your own immigration attorney. Candidates never pay to join or maintain a profile on the platform. The Workmerica registry is young and growing, meaning candidate profiles build up over time. It provides a direct, peer-to-peer route to identify motivated foreign caregivers who want to live and work in Nebraska.