CGFNS under review.

[donmurray]

U.S. to look into nurse-screening firm

The Phila.-based company has operated since 1996 without competition or oversight. Some complain that it is inept.

By Thomas Ginsberg

Inquirer Staff Writer

Federal officials will review operations of a Philadelphia company that screens most foreign nurses seeking jobs in the United States.

The nonprofit Commission on Graduates of Foreign Nursing Schools has operated since 1996 - with no rivals and no federal oversight.

The Inquirer reported this month that the company had delayed or fumbled applications and compiled a poor customer-service record, while spending $1.5 million in recent years on lobbying and litigation to expand its business.

Some critics say that a faster and fairer screening process might ease the recruitment of qualified immigrants at a time when hospitals need more nurses.

Currently, a foreign nurse may wait six months to two years to complete the company's process of screening and testing.

Paul Pierre, chief of operations and work flow at the Bureau of Citizenship and Immigration Services in the Department of Homeland Security, said this week that regulators intend to review the Philadelphia company's operations and records this year.

"We have not scheduled any visit yet, but we do plan to do site visits in this calendar year," Pierre said. "We would announce our visits ahead of time and require prepared documentation for review."

Such scrutiny of the company apparently would be the first. It would take place under federal rules issued in September that spelled out, for the first time, how authorities must register and monitor any company in the business of issuing certificates for health-care-worker visas.

Pierre said officials were aware of some complaints but emphasized that the review was "something that we would have done anyway as part of this new [regulation]." He noted that regulators also will inspect other companies that screen foreign health-care workers.

A company spokeswoman, Judith Pendergast, said: "We will be happy to comply with the evaluation as it is spelled out in the rules."

The Philadelphia company won its exclusive position over nurse visas in 1996 under an amendment by Sen. Arlen Specter (R., Pa.) to a bill limiting immigration.

No other companies were named, and there was no process for others to get approval until recently.

"I have heard of complaints... basically about them being a monopoly, but not about improprieties," Pierre said. "A monopoly review would be superfluous at this point because we've now opened up to other entities. So that complaint has been taken care of."

At least one other company - International Education Research Foundation Inc., a nonprofit in Culver City, Calif. - has said it is considering applying.

Bruce Morrison, an immigration lobbyist and former U.S. representative from Connecticut, said there were financial backers who were eager to find a competitor to challenge the Philadelphia company.

"I think that, in this calendar year, there will be somebody going down that road," Morrison said. "I know people are looking at it. They have interest in this marketplace and want to see competition in this field."

Last year, immigrants accounted for roughly a third of the new nurses entering the U.S. workforce. The Philadelphia company's revenues grew from $2.5 million eight years ago to projected $15 million this year, almost all from fees charged to nurses.

Its revenues are expected to rise further this year, when thousands of Canadian nurses must also start undergoing the company's "VisaScreen" review when their NAFTA-based exemption expires.

The company has acknowledged some problems and says it invested "millions" of dollars in the last year into its file-management and customer service.

But it has staunchly defended its operations and obligation to protect U.S. nursing standards, saying the majority of qualified applicants pass its rigorous reviews smoothly.

Morrison said quality control was not the issue.

"Somebody just has to improve the information-technology and management," Morrison said. "It's the same problem the immigration service has: It gets two tons of paper a day that has to find its way to the right file."

A competitor also would have to contend with various state requirements. Forty states, including Pennsylvania and New Jersey, require nurses to pass the Philadelphia company's qualifying test before applying for a U.S. license.

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Contact staff writer Thomas Ginsberg at 215-854-4177 or [email protected].

[canoehead, BSN, RN]

If they would just get everyone to take the NCLEX it would be cheaper, and the money would go to nursing boards.

It would be even more effective if we had reciprocity among all the states.

Why doesn't the ANA volunteer to take over all this business and funnel the profits into promoting nursing as a profession?

[Hellllllo Nurse, BSN, RN]

I don't agree with the importation of foreign nurses, anyway. It's just a tactic for hospitals to get cheaper labor and avoid the issue of working conditions for nurses. We have plenty of qualified nurses right here in the U.S. already. It makes much more sense to draw them back to the bedside with reasonable work-laods, staffing ratios, and maybe a little respect.

[Florida Native, BSN]

While it is a positive move that BCIS is finally going to review CGFNS' operation, it would be better if a full outside audit were conducted. Far too many nurses outside the U.S. have faced the cold, uncaring attitude by those in charge at CGFNS. Many of the nurses I work with came from countries where they earned about eighty dollars per month. Many borrow money on the black market to try and pay CGFNS fees. When CGFNS receives the money nothing happens for months. I am personally aware of nurses who have waited for years for CGFNS to get it right. Unfortunately, most nurses from outside the U.S. do not know who to complain to. CGFNS by its own admission drops between a third and one half of the calls placed to their company everyday. Many of these are placed from overseas. Any other business would be facing Federal Trade Commission action for similar behavior. The monopoly at CGFNS must end and those responsible for taking money and not providing the service paid for must be held accountable.

Regarding the return of nurses to the bedside after leaving the profession, in the 1990s I was a leader in the student movement to reform the then Immigration Nursing Relief Act. The act was ultimately allowed to sunset. In the course of developing supporting data for that project I discovered several studies on nurses who had left the profession during previous periods of oversupply. When conditions changed, the nurses seldom left their new careers and returned to nursing. Ideally it would be good to see them return but as a practical matter generally they do not.