On March 27, 2026, the U.S. Department of Labor (DOL) proposed a new rule that would raise prevailing wage levels for several employment-based immigration programs, including H-1B, H-1B1, E-3, and PERM labor certification for EB-2 and EB-3 green cards. If this rule is finalized, it could significantly increase labor costs for U.S. employers that sponsor foreign national workers.
For healthcare organizations, this proposal deserves close attention. Hospitals, long-term care facilities, staffing companies, and healthcare systems that rely on international talent may see increased wage obligations in certain sponsorship cases. At VisaMadeEZ, we work with healthcare employers across the country to develop practical immigration strategies, especially for organizations seeking to hire international nurses, sponsor registered nurses for green cards, and navigate the complex rules surrounding healthcare immigration.
What Is the DOL Changing?
For more than 20 years, the DOL has used wage data from the Occupational Employment and Wage Statistics (OEWS) survey to determine prevailing wages. Under the current system, four wage levels are assigned based on percentiles in the wage distribution:
- Level I (Entry Level): 17th percentile
- Level II (Qualified): 34th percentile
- Level III (Experienced): 50th percentile
- Level IV (Fully Competent): 67th percentile
These wage levels are used in both temporary and permanent employment-based immigration processes, including H-1B visa filings and PERM labor certification applications.
Under the proposed rule, the DOL would raise these wage levels, with the most notable change affecting entry-level positions. In practical terms, Level I wages would jump substantially and would effectively move up to the current Level II floor. According to the DOL, the revised methodology could increase required wages by an average of about $14,000 per year, depending on the occupation and geographic area.
Why This Matters for Healthcare Employers
For employers in the healthcare industry, prevailing wage increases can directly affect recruitment budgets, workforce planning, and long-term immigration sponsorship strategy. While many international nurses are typically sponsored through the EB-3 green card process rather than H-1B, prevailing wage rules remain highly relevant in a number of healthcare hiring scenarios.
Healthcare employers may feel the impact if they sponsor:
- Foreign national physical therapists
- Medical technologists and clinical laboratory professionals
- Healthcare managers or specialized professionals in H-1B status
- Registered nurses in roles that qualify for PERM-based sponsorship
- Other professionals in EB-2 or EB-3 immigration categories
If finalized, the rule could increase the cost of sponsoring international healthcare workers, especially in metropolitan areas where wage levels are already high.
Impact on International Nurse Sponsorship
Healthcare organizations looking to hire international nurses should pay particular attention to how this proposal may affect PERM cases and overall immigration budgeting. Although many registered nurse positions may qualify for Schedule A green card processing, wage compliance remains a critical part of the sponsorship process.
For employers sponsoring international registered nurses, higher prevailing wages may influence:
- Staffing budgets
- Green card sponsorship timing
- Job offer structure
- Multi-location hiring strategies
- Long-term workforce planning for nursing shortages
This is especially important for healthcare systems facing persistent labor shortages and using immigration as part of a broader recruitment solution. Employers seeking to sponsor foreign nurses should begin reviewing current compensation models now to determine whether future wage changes could affect ongoing or planned cases.
What Healthcare Organizations Should Do Now
The proposed rule is not yet final. The DOL is accepting public comments until May 26, 2026, and any final version of the rule would take effect no earlier than 60 days after publication of the final rule. Until then, current prevailing wage levels remain in place.
Still, healthcare employers should not wait to assess risk. This is a good time to:
- Review current and future employment-based immigration cases
- Evaluate wage levels for sponsored healthcare professionals
- Identify positions that may become more expensive to sponsor
- Revisit hiring plans for international nurses and other foreign healthcare workers
- Work with experienced immigration counsel to build a compliant sponsorship strategy
At VisaMadeEZ, we help healthcare employers understand the legal and operational impact of immigration rule changes. Whether your organization needs support with nurse immigration, EB-3 visa for nurses, Schedule A green card processing, or broader healthcare immigration law issues, our team can help you prepare for what comes next.
Looking Ahead
The DOL’s proposed prevailing wage increase could reshape the economics of employer-sponsored immigration, particularly for industries already under staffing pressure. For healthcare organizations, the rule may affect not only administrative planning, but also the ability to compete for global talent in a tight labor market.
If your hospital, nursing facility, or healthcare organization is planning to hire international nurses or sponsor other foreign healthcare professionals, now is the time to review your immigration strategy. Early planning can help reduce disruption and position your organization to stay compliant if the rule moves forward.
VisaMadeEZ is dedicated to helping healthcare employers navigate U.S. immigration law with clarity and confidence. If you need guidance on sponsoring international nurses, healthcare workforce immigration, or green card options for registered nurses, our team is here to help.
