Nursing Shortages Require International Solutions


Presbyterian Homes and Services (PHS) serves 26,000 older adults each year in Minnesota, Iowa, and Wisconsin and has developed 72 campuses for itself and other nonprofit organizations since 1991. But a nurse shortage was making it necessary for PHS to pay 2% of its annual expenses to hire agency pool staff, says Traci Larson, vice president of employee experience. Those numbers convinced PHS that it had to find a better way to recruit staff.


Since 2002, PHS has filled its open positions by recruiting nurses from the Philippines. Not only does this country have a history of work-related immigration, but it has a 94% literacy rate. The Philippine government trains many more registered nurses (RN) and other medical professionals than are needed in the Philippines and the national strategy is to immigrate nurses and other professionals to other parts of the world.

Implementation Details:

PHS’s recruitment program is managed by PHS-INR, a wholly owned LLC subsidiary of PHS. A parallel organization named IPR manages the program in the Philippines. PHS-INR works with churches in the Philippines to identify and hire RNs. It also raises money to fund scholarships for Filipino nursing students.

A Filipino nurse applicant has to go through approximately 23 steps of competency in order to immigrate to the U.S. and the immigration process can take from 18 months to 3.5 years. Immigrating nurses are paid at the beginning of the PSL prevailing wage scale and the sites hiring Filipino nurses pay $3.60 per hour “INR” charge which covers the majority of INR expenses. This is done throughout the contract period—3 years or more with family. ($22,650.00)

Factors for Success:

  • Be patient with the immigration laws and process.
  • Make sure you have connections in the Philippines full-time who can work with you as a team.


The organization currently employs 78 Filipino nurses, who make up 17% of its RN workforce, and 70 family members of those nurses, who are employed in a variety of positions. Twelve PHS nurses have grown to supervisor positions, including clinical administrators and charge nurses.

Last year, PHS lowered the costs associated with hiring agency staff to less than .2% of its annual expenses.

Need more information?

Contact Jim Chalmers, President of International Personnel Resources, LLC at 651-631-6107.