How to Hire Foreign Caregiver & Elderly Care Workers in NY (2026)

Is there a caregiver shortage in New York, and is hiring abroad realistic?

New York faces a persistent shortage of direct care personnel, including home health aides, personal care aides, and nursing assistants. The demand is heavily concentrated in the New York City metropolitan area, Long Island, Westchester County, and major upstate urban centers such as Buffalo, Rochester, and Albany. Demographic shifts across the state have driven up demand in both residential care facilities and home-based care networks, while local staff retention remains low due to high living costs and physical demands.

However, employers must understand the legal realities of recruiting from abroad before committing resources. Hiring non-clinical caregivers (such as personal care aides or home health aides) directly from foreign countries is technically possible, but it is not a rapid fix. There is no temporary worker visa tailored specifically for year-round non-clinical caregiving. The H-2B visa requires proof of a temporary or seasonal need, which standard long-term care facilities and home care agencies cannot demonstrate because patient care is continuous. Consequently, non-degree care staff must be sponsored through permanent immigration pathways that involve multi-year processing times.

For clinical positions, such as Registered Nurses (RNs), foreign hiring is significantly faster and widely utilized across New York health systems. Canadian and Mexican RNs can enter quickly under professional visa classifications, and foreign-credentialed nurses qualify for expedited permanent residency. If your organization requires non-clinical personal care workers, long-term legal sponsorship can build a stable future pipeline, but it will not resolve immediate staffing shortfalls this quarter.

Which visa pathways apply to New York elder care facilities and agencies?

Immigration law is federal, meaning visa classifications are identical across all states, though local wage and licensing requirements vary. You must consult the US Department of Labor (DOL), US Citizenship and Immigration Services (USCIS), or a qualified immigration attorney to confirm current rules before filing. The primary pathways relevant to New York care providers include:

• EB-3 Other Workers (Unskilled Category): This permanent residency (green card) route is used for positions requiring less than two years of training or experience, including personal care aides and home care aides. The employer must complete a Permanent Labor Certification (PERM) with the US DOL to prove that no qualified US worker was available in the local New York market.
• EB-3 Professional or Skilled Workers: This route applies to staff filling roles that require at least two years of specialized training, education, or a relevant bachelor's degree. Registered Nurses fall under federal "Schedule A" pre-certification, which waives the standard PERM labor market search and speeds up the filing process.
• TN Visa (USMCA): Available exclusively to citizens of Canada and Mexico for professional occupations listed under the United States-Mexico-Canada Agreement. Registered Nurses qualify for TN status, allowing them to start work in weeks or months. Non-degree personal care aides and home health aides do not qualify for TN status.
• H-2B Visa: Designed strictly for non-agricultural temporary or seasonal labor. Because long-term care facilities and home health agencies operate year-round, federal regulators routinely deny H-2B petitions for standard caregiving staff due to the lack of seasonal peak-load need.

New York licensing, registration, and credential requirements

Before any foreign national can work in New York, they must meet the regulatory requirements established by New York State authorities. The applicable state entities depend on the specific role:

• Home Health Aides (HHAs) and Personal Care Aides (PCAs): Regulated by the New York State Department of Health (NYS DOH). HHAs must complete a DOH-approved 75-hour training program and pass a competency evaluation to be registered in the NYS Home Care Worker Registry. Foreign training certificates are not automatically recognized; candidates must complete an approved state training program or undergo a official equivalency evaluation through an authorized New York training provider.
• Licensed Practical Nurses (LPNs) and Registered Nurses (RNs): Regulated by the New York State Education Department (NYSED) Office of the Professions. Foreign-educated nurses must have their credentials verified through CGFNS International (or an equivalent approved credentials service), pass the NCLEX exam, and obtain a New York professional license prior to beginning practice.
• Criminal History Record Check (CHRC): New York Public Health Law requires all direct care employees working in licensed home care services agencies (LHCSAs), certified home health agencies (CHHAs), and residential care facilities to undergo a background check and fingerprinting administered by the NYS DOH CHRC program before providing unsupervised care.

What is the timeline from decision to a worker starting in New York?

The time required to bring a candidate from overseas to New York depends entirely on the visa category and state credentialing requirements:

• TN Visa (Canadian or Mexican RNs): Typically 1 to 3 months. Once the candidate secures CGFNS VisaScreen certification and New York licensure, application occurs directly at a port of entry (for Canadians) or a US consulate (for Mexicans).
• EB-3 Schedule A (Registered Nurses): Typically 12 to 18 months. Because the PERM process is waived, the employer moves directly to filing Form I-140 with USCIS, followed by consular processing or adjustment of status.
• EB-3 Other Workers (Non-clinical Caregivers): Typically 3 to 5 years. The process requires obtaining a Prevailing Wage Determination, conducting mandatory US worker recruitment under PERM (12 to 18 months), securing Form I-140 approval, and waiting for the candidate's priority date to become current under federal visa limits.

Wage obligations and mandatory employment costs in New York

Employers sponsoring foreign workers must comply with both federal prevailing wage rules and New York State labor laws. You must pay the higher of the required federal prevailing wage or the mandated state minimum wage for care workers.

New York maintains specific statutory minimum wage levels for home care workers under state labor law. In New York City, Long Island (Nassau and Suffolk counties), and Westchester County, the minimum wage for home care aides is set at $18.50 per hour. In Upstate New York regions, the minimum wage for home care aides is $17.50 per hour. Employers operating downstate must also comply with the New York Wage Parity Law, which mandates additional health and supplemental benefit payments per hour worked.

When applying for a PERM labor certification, the US Department of Labor determines the prevailing wage based on the specific Metropolitan Statistical Area (MSA) where the work will be performed, such as the New York-Newark-Jersey City area or the Buffalo-Cheektowaga area. Employers must guarantee in writing that they will pay this wage once the worker arrives and begins employment.

What this costs you, roughly

Sponsoring a foreign care worker involves defined administrative, legal, and operational expenses. Estimated cost ranges include:

• Legal and Attorney Fees: $4,000 to $9,000 (covers PERM drafting, USCIS filings, and consular guidance).
• USCIS Government Filing Fees: $1,500 to $3,000 (includes Form I-140 and related fee surcharges; optional premium processing adds $2,805 where applicable).
• PERM Mandatory Advertising Costs: $1,000 to $2,500 (local newspaper ads and job posting requirements in the New York recruitment area).
• Credential and Translation Reviews: $300 to $1,200 (CGFNS, NYSED evaluation fees, and document translation).
• Relocation and Initial Settlement Support: $1,500 to $4,000 (customary assistance with initial travel, licensing fees, or temporary housing).

Recruitment ethics and protecting workers from fee fraud

Under US federal regulations, a legitimate employer must pay all costs associated with the PERM labor certification process, including legal fees and mandatory advertising costs. Federal law strictly prohibits employers or third-party recruiters from passing these costs onto the foreign worker or deducting them from future wages.

Foreign job seekers who are asked to pay upfront recruitment, placement, or visa processing fees are often targets of fraudulent schemes. Employers who partner with dishonest agencies operating fee-for-placement models face severe legal exposure, including liability for immigration fraud and state labor code violations. You must ensure that your recruitment processes are transparent and that candidates are never charged for their prospective employment.

Finding foreign care candidates through the Workmerica registry

If your organization decides to build a international talent pipeline for New York care facilities, you can use the Workmerica registry to connect directly with foreign-trained healthcare personnel and care staff. Workmerica is not a recruitment agency, does not charge per-hire fees, and takes no part in placement or contract negotiations.

To search for potential candidates:

• Filter by Destination Preference: Search specifically for profiles of candidates who have selected New York as a preferred work location.
• Filter by Qualifications: Look for workers with verified nursing credentials, home care experience, or language capabilities matching your patient population.
• Contact Candidates Directly: Communicate with candidates directly to evaluate their interest, explain your location, and discuss potential sponsorship pathways.

Please note that the Workmerica registry is young and continually growing. You will find candidates seeking sponsorship, but you must independently verify all credentials, check licensing suitability with NYSED or the NYS DOH, and consult with legal counsel to manage visa filings.