Why the HWRA Could Be a Game-Changer for Hospital Staffing Strategies

By Liz Nesladek, Chief Commercial Officer, Conexus MedStaff

The Staffing Crisis Is Escalating

The U.S. healthcare system is under mounting pressure. Nurse retirements, pandemic burnout, and the demands of an aging population have created staffing shortages that are especially acute in rural and underserved areas.

• 293 rural hospitals were at risk of immediate closure in 2023 due to workforce shortages.
• 42 out of 50 states are projected to face critical nurse shortages by 2030.
• Two in five nurses are expected to leave the profession in the next five years.

This is no longer just a staffing issue—it’s a threat to care delivery, quality, and access. Hospitals need immediate solutions that complement long-term pipeline efforts.

The HWRA Is Reintroduced

On September 10, 2025, Senators Kevin Cramer (R-ND) and Dick Durbin (D-IL) officially reintroduced the bipartisan Healthcare Workforce Resilience Act (HWRA) in the U.S. Senate.

This legislation would:

• Recapture 25,000 unused immigrant visas for nurses and 15,000 for physicians—visas that were authorized by Congress years ago but never allocated.
• Accelerate deployment of internationally educated nurses and doctors already in the immigration system.
• Provide critical support to rural and underserved hospitals, where staffing shortages are most urgent.
  

What does “recapturing visas” mean?

It refers to making use of previously approved but unused green card slots for healthcare professionals—no new visas are being created, and no U.S. workers are displaced. These are already-credentialed, ready-to-go professionals who can help fill critical gaps now.

How the HWRA Helps Hospitals: A Practical Example

Imagine a 100-bed hospital in rural Iowa. They’ve been trying to fill ICU nurse vacancies for over a year. Domestic recruitment has stalled, and staff burnout is escalating.

With the HWRA, this hospital could:

• Deploy international nurses already approved and licensed—within months
• Fill high-need roles quickly, maintaining service lines that were at risk of closure
• Alleviate pressure on existing teams, reducing turnover and improving care continuity

This is just one of many use cases where the HWRA could bring stability not in years, but in months.

Conexus in Action

At Conexus MedStaff, we go beyond staffing. We advocate for real, system-level solutions. As active members of the Alliance for International Healthcare Recruitment (AAIHR), we are supporting the HWRA through lobbying and direct engagement with lawmakers.

Our goal is to ensure international nurse staffing remains a sustainable, ethical, and compliant option for U.S. hospitals.

Through our staffing model, we help clients:

• Access a pipeline of highly qualified international nurses
• Utilize appropriate visa types for faster, more reliable deployment
• Navigate immigration and compliance seamlessly
• Improve retention and long-term workforce planning

For example: 96% of Conexus nurses complete their initial assignments, and 85% convert to full-time permanent roles, helping our partner hospitals reduce turnover and protect investment in onboarding.

Future-Proofing Workforce Strategy

The HWRA is a crucial step forward—but it also signals a bigger shift:
Workforce planning and immigration policy are now intertwined.

Hospital executives, HR teams, and clinical leaders must think beyond traditional recruitment tactics. Strategic workforce planning now demands collaboration across legal, clinical, and policy teams to stay ahead of both risk and opportunity.

Act Now: Next Steps for Hospital Leaders

This is the time to prepare your talent pipeline and build workforce resilience. Here’s how:

• Partner with Conexus to understand how the HWRA could impact your workforce strategy
• Stay informed on policy developments and immigration legislation
• Explore our international workforce models to align staffing with long-term goals
  

We’re not just monitoring the HWRA—we’re helping our partners act on it.

If you’d like to discuss what this could mean for your facility, get in touch with our team today. We’re here to help you turn policy progress into workforce stability.