A more streamlined wage determination process for nurses will help the long-term care industry address a historic workforce crisis, according to industry experts.
A coalition of long-term care provider groups — including the American Health Care Association / National Center for Assisted Living, the American Seniors Housing Association, LeadingAge and AMDA–the Society for Post-Acute and Long-Term Care Medicine — asked the Department of Labor to improve its process of issuing prevailing wage determinations for Schedule A positions — namely, registered nurses and physical therapists.
ASHA President and CEO David Schless told McKnight’s Senior Living that any efforts to “clear the logjams of workers,” such as delays in the prevailing wage determination decisions for nurses, should be addressed to accelerate the visa processing process to bring workers into the overall healthcare space.
In a letter to National Prevailing Wage Center Director Lindsey Baldwin, the coalition said that the pandemic made the nursing shortage “critically worse.” The situation is compounded by delays in prevailing wage determinations, which also delays the permanent residence process and the start of employment, coalition members wrote.
“The prevailing wage determination is the one bottleneck that delays employers in filing an immigration petition for registered nurses,” the letter reads. “Creating a separate queue and a more reasonable timeframe for wage determinations for registered nurses would not only help the healthcare industry, but would also benefit the [Department of Labor].”
Right now, Schedule A occupations are lumped under the Program Electronic Review Management, or PERM, processing queue. Although employers seeking to hire foreign-educated workers for RN and physical therapy positions can bypass the PERM labor certification process, they still must obtain a prevailing wage determination from the DOL.
The coalition is asking for a separate category for Schedule A occupations, which the DOL already recognizes as shortage occupations for purposes of the permanent residence immigration process. The move, they say, would help prioritize Schedule A prevailing wage requests.
With only one category for RNs and physical therapists under the wage survey, as well as standard degree and licensing requirements, the coalition further pressed that it would be relatively simple for the DOL to assign the appropriate wage level for those occupations.
Schless said that ASHA has long advocated for immigration reform to address the demand for caregivers and other employees in the industry. Legislation making “meaningful changes” is necessary to address the demand for care, he added.
“We continue to explore other opportunities to address this crisis and believe that it will require both administrative and legislative actions and recognize, unfortunately, there are no quick fixes,” Schless said. “There are simply not enough people for the number of jobs available in the country, and so we must look for foreign workers to fill some of these jobs.”
