1. HCA Healthcare (Nashville, Tenn.) – 190 Hospitals
Why it matters for international nurses:
HCA Healthcare is the largest hospital operator in the country and one of the most active systems in hiring and placing nurses across multiple states. Its size, for-profit structure and multi-state footprint make it a key player for international nurse sponsorship and healthcare immigration opportunities.
Leadership and strategy
- Sam Hazen, CEO
Sam Hazen has been with HCA for more than 40 years and became CEO in 2019. He moved up through the organization in operations and finance, overseeing hundreds of hospitals and leading large-scale growth. Under his leadership, HCA continues to invest in workforce development, hospital expansion and performance improvement all areas that depend heavily on a steady nursing pipeline.
- Mike Marks, Executive Vice President and CFO
Mike Marks, appointed CFO in 2024, has held numerous financial leadership roles at HCA since 1996. His experience in revenue cycle management and hospital finance positions HCA to keep investing in staffing strategies, including international nurse recruitment to fill persistent shortages in critical care, med-surg and specialty areas.
Immigration angle:
For foreign-trained nurses, HCA’s broad network and history of using structured workforce programs make it a natural destination for EB-3 nurse green card cases and, when appropriate, temporary work visas. Systems of this scale frequently partner with immigration law firms like VisaMadeEZ to streamline the process of sponsoring international nurses and complying with complex immigration regulations.
2. Veterans Health Administration (VHA) – 170 Hospitals
Why it matters for international nurses:
The VHA is the nation’s largest integrated healthcare system, serving U.S. military veterans. While federal employment comes with very specific hiring and eligibility rules, the VHA’s staffing needs heavily influence the broader healthcare workforce market, especially in primary care, behavioral health and inpatient services.
Leadership and structure
- Douglas Collins, Secretary of Veterans Affairs
As head of the Department of Veterans Affairs (VA), Douglas Collins oversees the VHA, Veterans Benefits Administration and National Cemetery Administration. His background in public service and military reserve roles shapes the department’s priorities around access, modernization and budget.
- Richard Topping, Assistant Secretary for Management and CFO
Richard Topping manages the VA’s massive budget and modernization efforts, including the rollout of a new financial and acquisition system. His experience with Medicaid, Medicare and Tricare financing reflects the complexity of federal healthcare funding and the need for efficient staffing models.
Immigration angle:
While direct federal hiring of foreign nurses is more restricted than in the private and nonprofit sectors, the VHA relies heavily on affiliated community providers, VA Community Care programs and contract partners. Those outside partners often sponsor international nurses, and demand from the veteran population contributes to nationwide nurse shortages that encourage hospitals to recruit globally.
3. CommonSpirit Health (Chicago) – 158 Hospitals
Why it matters for international nurses:
CommonSpirit is one of the largest nonprofit Catholic health systems in the U.S., with hospitals spanning urban, suburban and rural communities. Its ongoing restructuring and performance improvement efforts are directly tied to workforce stabilization including nurse recruitment and retention.
Leadership and strategy
- Wright Lassiter III, President and CEO
Wright Lassiter leads 158 hospitals and more than 2,000 care sites across 24 states. His focus on innovation, including artificial intelligence for clinical and operational decision-making, demonstrates a commitment to reshaping care delivery. A large part of that transformation hinges on having enough nurses at the bedside.
- Michael Browning, Senior Executive Vice President and CFO
Michael Browning joined CommonSpirit amid financial challenges, with the system working to trim operating losses and divest select hospitals. Despite recent losses, the system’s footprint is enormous, and stabilizing operations requires reliable, sustainable staffing precisely where international nursing recruitment often becomes part of the long-term plan.
Immigration angle:
As CommonSpirit optimizes its national footprint, facilities in high-need markets are increasingly looking abroad to fill chronic nurse vacancies. A system with this reach often uses centralized processes for visa sponsorship and relies on immigration attorneys specializing in international nurse visas to ensure compliance and consistency across states.
4. Lifepoint Health (Brentwood, Tenn.) – 135 Hospitals
Why it matters for international nurses:
Lifepoint Health is a major player in community-based healthcare, with a large presence in non-urban markets where nurse shortages can be especially severe. These communities frequently depend on foreign-educated nurses to keep essential services open.
Leadership and strategy
- David Dill, Chair and CEO
David Dill has overseen Lifepoint’s growth from about $3 billion in revenue to more than $10 billion. His approach emphasizes partnerships and expansion into new markets each new hospital or service line comes with a demand for more nurses, respiratory therapists and allied health professionals.
- Aaron Lewis, President and CFO
Aaron Lewis, who became president and CFO in 2023, oversees finance, IT, shared services and innovation under the Lifepoint Forward initiative. His background in development and physician services gives him a broad view of workforce challenges and the importance of aligning staffing models with growth.
Immigration angle:
Hospitals in smaller communities often struggle most with recruiting domestic nurses. These are prime settings for international nurse sponsorship under EB-3 and similar categories. Lifepoint facilities frequently benefit from structured, long-term immigration strategies supported by legal partners familiar with healthcare-specific immigration rules.
5. Ascension (St. Louis) – 119 Hospitals
Why it matters for international nurses:
Ascension is one of the largest Catholic health systems and has undergone significant restructuring, including hospital divestitures and operational changes. As it moves back into growth mode, stable nurse staffing is central to its mission of serving vulnerable populations.
Leadership and strategy
- Eduardo Conrado, President and CEO
Eduardo Conrado, a former technology executive, now leads Ascension’s efforts to modernize care delivery and expand access. His background in digital transformation shapes how the system thinks about telehealth, data and patient experience and each of these strategic priorities requires experienced nurses in both traditional and new care settings.
- Saurabh Tripathi, Executive Vice President and CFO
Saurabh Tripathi has helped significantly narrow Ascension’s operating loss and position the organization for strategic growth, including a planned acquisition of AmSurg. His experience in operational transformation and large-scale systems makes workforce planning a central part of financial turnaround.
Immigration angle:
As Ascension integrates new assets and revisits growth strategies, the need for a reliable nursing workforce will intensify. Many faith-based systems historically welcome international nurses who share their mission-driven focus. With the right immigration counsel, Ascension facilities can continue to responsibly sponsor foreign-educated nurses and comply with evolving U.S. immigration regulations.
6. ScionHealth (Louisville, Ky.) – 94 Hospitals
Why it matters for international nurses:
ScionHealth is a relatively new but quickly expanding system focused on acute and specialty care, including long-term acute care hospitals (LTACHs). These settings often require highly specialized nursing skills and are commonly understaffed.
Leadership and strategy
- Rob Jay, CEO
As founding CEO, Rob Jay has led ScionHealth since its creation in 2021. Under his leadership, the system acquired Cornerstone Healthcare Group, adding LTACHs and senior living facilities. This expansion significantly increases the need for nurses experienced in chronic, complex and post-acute care.
- Doug Shirley, CFO
Doug Shirley, appointed CFO in 2025, brings a background in revenue cycle and operational finance. His focus on financial improvement aligns with creating sustainable staffing models including leveraging international nurse recruitment where appropriate.
Immigration angle:
Specialty hospitals and LTACHs are often ideal employers for international nurses with ICU, ventilator, or complex medical-surgical experience. Because these facilities are harder to staff locally, immigration-based recruitment can be essential. VisaMadeEZ regularly assists such hospitals with end-to-end immigration strategies tailored to specialty care environments.
7. Trinity Health (Livonia, Mich.) – 92 Hospitals
Why it matters for international nurses:
Trinity Health is a large Catholic system with a diverse geographic footprint, ranging from major metropolitan areas to smaller regional communities. Many of its markets are managing persistent nurse vacancies and rely on long-term recruitment and retention strategies.
Leadership and strategy
- Mike Slubowski, President and CEO
Mike Slubowski has led Trinity Health since 2019 and has deep experience in Catholic healthcare leadership. His focus on culture, technology and processes underscores the importance of a stable, mission-driven workforce, particularly nursing.
- Daniel Isacksen, Executive Vice President and CFO
Daniel Isacksen has spent decades in Catholic healthcare finance and led financial turnaround efforts in previous roles. Stabilizing finances across Trinity’s broad network inevitably includes careful planning around nurse labor costs, contract labor and sustainable staffing areas where international recruitment can reduce reliance on expensive temporary staffing.
Immigration angle:
Catholic systems like Trinity Health frequently serve underserved communities, where recruiting local nurses can be difficult. International nurses are often drawn to this mission-focused work. With proper immigration planning from prevailing wage to consular processing these organizations can responsibly sponsor nurses while maintaining compliance and ethical recruitment practices.
8. Advocate Health (Charlotte, N.C.) – 69 Hospitals
Why it matters for international nurses:
Advocate Health, formed from the merger of Atrium Health and Advocate Aurora Health, is now one of the largest nonprofit health systems in the country. Its major academic and community hospitals are natural hubs for international nurse careers.
Leadership and strategy
- Eugene Woods, CEO
Eugene Woods has led Advocate Health since its formation, building on his leadership of Atrium Health. He has focused on innovation, education and growth, highlighted by the creation of The Pearl, an innovation district that includes a new medical school campus in Charlotte. Academic environments like this typically drive demand for highly trained nurses in both clinical and teaching roles.
- Brad Clark, Executive Vice President and CFO
Brad Clark, who stepped into the CFO role after serving in senior finance roles at Atrium and Wake Forest Baptist, oversees financial planning across a multistate system. His background in mergers, acquisitions and revenue cycle is central to integrating operations and aligning staffing strategies post-merger.
Immigration angle:
Large academic and teaching hospitals often face high nurse turnover and complex service demands. They are also more likely to have established international nurse recruitment and visa sponsorship programs. Advocate Health’s scale makes it an important potential employer for nurses seeking H-1B (in limited advanced roles), TN (for eligible Canadian/Mexican RNs) or more commonly, EB-3 immigrant visas. Immigration law firms like VisaMadeEZ help systems like these develop consistent, scalable sponsorship policies.
9. Christus Health (Irving, Texas) – 66 Hospitals
Why it matters for international nurses:
Christus Health serves communities in Texas, Louisiana, New Mexico and Arkansas states that frequently experience nursing shortages, especially outside major metropolitan areas. Its faith-based mission and regional footprint make it a significant employer for both domestic and international nurses.
Leadership and strategy
- Ernie Sadau, President and CEO
Ernie Sadau has led Christus since 2011, focusing on expanding services and strengthening the system’s role in regional healthcare. His involvement with hospital associations reflects an active voice in workforce policy and healthcare finance.
- Randy Safady, Executive Vice President and CFO
Randy Safady, a CPA with more than 30 years of experience, guides Christus’ financial strategy and capital allocation. Managing multiple markets with varying patient needs requires a flexible approach to staffing, including the use of foreign-trained nurses where recruitment gaps exist.
Immigration angle:
Christus hospitals often serve growing communities with limited local nurse supply. International nurses from the Philippines, India, the Caribbean, Africa and beyond are frequently attracted to Texas and the Southwest. With the right immigration guidance, Christus facilities can maintain strong compliance while leveraging global talent to support patient care and reduce chronic staffing shortages.
10. Community Health Systems (CHS) (Franklin, Tenn.) – 65 Hospitals
Why it matters for international nurses:
CHS is one of the largest for-profit health systems in the U.S., with a strong focus on community hospitals. As it refines its portfolio and divests select assets, it remains a major employer in many smaller and mid-sized markets areas where nurse recruitment is especially challenging.
Leadership and strategy
- Kevin Hammons, CEO
Kevin Hammons, previously CHS’ chief financial officer, became CEO in late 2024. His long tenure with the company and lead role in major projects, including an enterprise resource planning initiative designed to drive cost savings, indicate strong focus on efficiency and financial stability.
- Jason Johnson, Executive Vice President and CFO
Jason Johnson, with CHS since 2012, now serves as CFO. He oversees enterprise-level financial planning at a time when CHS continues to streamline operations and focus on core markets.
Immigration angle:
In many CHS communities, recruiting nurses locally is increasingly difficult. International nurse staffing can play a crucial role in keeping hospitals fully operational, particularly in med-surg, telemetry, and emergency services. For-profit systems often partner with dedicated immigration law firms to manage high-volume visa sponsorship while staying aligned with federal labor and immigration law.
What This Means for International Nurses and U.S. Healthcare Employers
The leadership teams guiding these 10 largest health systems are under intense pressure to maintain access to care, manage costs and improve quality. One theme cuts across every organization: they cannot achieve their goals without enough nurses.
For international nurses, that reality translates into opportunity:
- Consistent demand for RNs: Nationwide shortages, especially in rural and underserved regions, support long-term demand for foreign-educated nurses.
- Structured recruitment programs: Large health systems often develop centralized international nurse recruitment programs, with standardized sponsorship and onboarding.
- Multiple visa pathways: From EB-3 immigrant visas to specific temporary categories, there are viable U.S. immigration options for qualified nurses who meet licensing and credentialing requirements.
For hospitals and health systems, the message is equally clear:
- International nurse recruitment is no longer optional in many markets it’s essential to maintaining service lines and avoiding overreliance on travel contracts.
- Immigration compliance is complex and constantly evolving; large systems benefit from working with a dedicated healthcare immigration law firm that understands both staffing strategy and legal requirements.
How VisaMadeEZ Supports Health Systems and International Nurses
VisaMadeEZ is an immigration law firm dedicated to helping U.S. healthcare organizations hire and retain international nurses in a compliant, ethical and efficient way.
We assist:
- Hospitals and health systems with designing and implementing international nurse sponsorship programs (EB-3, select temporary visas, TN where applicable)
- Recruitment companies and staffing agencies partnering with large systems to place foreign-educated nurses
- Individual international nurses who have U.S. job offers and need legal guidance on their immigration options
Whether you are:
- A health system executive planning a multi-year workforce strategy,
- A hospital HR director overwhelmed by ongoing staffing shortages, or
- An international nurse exploring U.S. nursing jobs and visa sponsorship,
VisaMadeEZ can help you navigate the intersection of healthcare staffing and immigration law.
Ready to Explore International Nurse Hiring or a U.S. Nursing Career?
If your organization is considering sponsoring international nurses or if you’re a foreign-educated nurse with a U.S. job offer VisaMadeEZ can guide you through each step of the immigration process.
Contact VisaMadeEZ to discuss:
- International nurse visa options
- Program design for large health systems
- Compliance with U.S. immigration and labor laws
- End-to-end support from petition to visa issuance
By understanding how the nation’s largest health systems operate and how immigration law fits into their staffing strategies you can make smarter, more informed decisions about international nurse recruitment and your future in U.S. healthcare.
