{"id":895,"date":"2026-03-05T10:05:07","date_gmt":"2026-03-05T09:05:07","guid":{"rendered":"https:\/\/www.talentorbit.de\/?p=895"},"modified":"2026-03-05T10:45:32","modified_gmt":"2026-03-05T09:45:32","slug":"nursing-recruitment-abroad","status":"publish","type":"post","link":"https:\/\/www.talentorbit.de\/en\/personalvermittlung-pflege-ausland\/","title":{"rendered":"Recruiting nursing staff from abroad: costs, procedure and recognizing reputable agencies"},"content":{"rendered":"

Short answer for employers:<\/strong>\u00a0International nurses can be recruited via the Triple Win program, the Western Balkans scheme or private agencies. Expect total costs of \u20ac15,000-30,000 per skilled worker and a lead time of 6-12 months. The accelerated skilled worker procedure (\u20ac411 fee) can shorten the visa process to approx. 4 months. Since the PUEG (July 2023), part of the costs can be refinanced via care rate negotiations.<\/p>\n

One in five care workers in Germany is a foreign national. According to\u00a0Integration media service (2025)<\/a>\u00a0that was over 306,700 people in 2024. And since 2022, employment growth in the care sector has been\u00a0IAB Research Report<\/a>\u00a0exclusively<\/em>\u00a0by international specialists. The number of German nursing staff? Declining.<\/p>\n

That is the reality, not the forecast.<\/p>\n

Nevertheless, many institutions are hesitant. The costs seem high, the process opaque, and anyone who has experienced a poorly supervised placement is understandably skeptical. But the alternative - temporary work at \u20ac5,000 to \u20ac7,000 a month, overtime, bed closures - is more expensive. Not on paper, but on the ward.<\/p>\n

This guide is for management, nursing service managers and HR departments who want to make an informed decision. It deals with the institutional recruitment of nursing staff from third countries -\u00a0not<\/em>\u00a024-hour home care by Eastern European helpers. These are two fundamentally different topics that are unfortunately constantly mixed up in Google searches.<\/p>\n

About this guide:<\/strong>\u00a0Created by\u00a0TalentOrbit International GmbH<\/a>\u00a0- specializes in the placement of international healthcare professionals from the Philippines, India, Kazakhstan and Kyrgyzstan. Our assessments are based on practical support for employers throughout the entire recruitment and integration process.<\/p>\n

The figures: Why international nursing staff are indispensable<\/h2>\n

Demographic trends are further exacerbating the situation. According to\u00a0Nursing staff forecast by the Federal Statistical Office<\/a>\u00a0the demand for nursing staff is expected to rise to 2.15 million by 2049. There could then be a shortage of between 280,000 and 690,000 nursing staff. The range shows that even in the optimistic scenario, there is a shortage of more skilled workers than some federal states employ in total.<\/p>\n\n\n\n\n\n\n\n\n\n
Key figure<\/th>\nValue (source)<\/th>\n<\/tr>\n<\/thead>\n
Employees in care professions (2024)<\/td>\napprox. 1.7 million (BA)<\/td>\n<\/tr>\n
Of which foreign nursing staff<\/td>\n306,700 \/ 17.8% (BA 2025)<\/td>\n<\/tr>\n
Proportion of foreigners in geriatric care<\/td>\n21.7% (IAB 2024)<\/td>\n<\/tr>\n
Percentage of foreigners in nursing care<\/td>\n16.5% (IAB 2024)<\/td>\n<\/tr>\n
Projected shortage until 2049<\/td>\n280,000-690,000 (Destatis)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Sources: Federal Employment Agency, Focus on the Labor Market 2024; IAB Research Report 22\/2024; Federal Statistical Office, Press Release No. 033\/2024<\/em><\/p>\n

Who the\u00a0Shortage of skilled workers in the care sector<\/a>\u00a0as a temporary problem should remember this figure: It takes an average of 204 days to fill a vacancy in geriatric care with domestic applicants. Over half a year. During this time, the existing team compensates - with overtime, by taking time off, with gradual exhaustion.<\/p>\n

Pros and cons: an honest assessment of international recruitment<\/h2>\n

Most of the pro and con lists on the internet are either written by agencies that only see advantages or by commentators who have never been involved in an integration project. Here is a sober assessment - with a clear classification at the end.<\/p>\n

What speaks in favor of recruiting abroad<\/h3>\n

Long-term personnel stability.<\/strong>\u00a0Internationally recruited specialists are looking for a permanent job. They move their lives, not their schedule. Reputable agencies report retention rates of over 85 % after two years - some, like TalentOrange, publish 96 % after five years. You'll never achieve that with temporary work.<\/p>\n

High professional competence.<\/strong>\u00a0In many countries of origin, nursing is a university degree. A specialist from the Philippines has a Bachelor of Science in Nursing, often four years of study plus clinical practice. According to the IAB, two out of three foreign employees in the nursing sector work as specialists - not as assistants.<\/p>\n

Economic efficiency.<\/strong>\u00a0Depending on the region, a temporary worker costs a facility between \u20ac4,000 and \u20ac7,000 per month - between \u20ac48,000 and \u20ac84,000 per year. An internationally recruited specialist costs \u20ac15,000 to \u20ac30,000 plus the regular salary. The calculation is explained in detail below.<\/p>\n

Refinanceability.<\/strong>\u00a0Since the Care Support and Relief Act (PUEG, July 2023), recruitment costs can be claimed on a pro rata basis via the care rate negotiation. At the same time, the legislator has restricted the refinancing of temporary work. This shifts the calculation in favor of sustainable recruitment.<\/p>\n

Team rejuvenation.<\/strong>\u00a0Many care teams are ageing. International professionals not only bring manpower, but also a different perspective on care - and often an appreciation for working conditions that experienced German nursing staff have long taken for granted.<\/p>\n

What speaks against it - and how to deal with it<\/h3>\n

Lead time.<\/strong>\u00a06 to 15 months. This is not a quick fix. If you urgently need staff today, you can bridge the gap with temporary work - but you should start recruiting abroad at the same time. Both at the same time is not a contradiction, but good planning.<\/p>\n

Language barrier.<\/strong>\u00a0Even with a B2 certificate, specialists need three to six months to master dialects, nursing jargon and documentation style. This is normal. A specialist language course after arrival and a mentor on the ward help more than impatience.<\/p>\n

Integration effort.<\/strong>\u00a0The new colleagues need a practical instructor, help in finding accommodation, support in dealing with the authorities. The existing team needs intercultural awareness training - not as a compulsory event, but as a genuine discussion about what is changing and why this is good. Without this investment, the risk of dropping out increases.<\/p>\n

Recognition risk.<\/strong>\u00a0Not every specialist passes the knowledge test at the first attempt. Failure rates vary depending on the federal state and examination center. Good agencies mitigate this with targeted exam preparation - ideally AZAV-certified so that the costs are eligible for funding via education vouchers.<\/p>\n

Migration.<\/strong>\u00a0Those who are well qualified and linguistically fit are also courted by other employers. Loyalty is created through fair conditions, genuine integration and prospects - not through gagging contracts. Institutions that treat their international specialists well rarely lose them.<\/p>\n

Our conclusion: The advantages clearly outweigh the disadvantages - but only for organizations that see integration as part of the project rather than a secondary task. Anyone who commissions a placement agency and then hopes that the rest will take care of itself will be disappointed.<\/p>\n

Legal basis: The Skilled Immigration Act<\/h2>\n

The reformed\u00a0Skilled Immigration Act<\/a>\u00a0has gradually come into force since November 2023 and was fully implemented on June 1, 2024. The situation has improved noticeably for employers who want to hire nursing staff from abroad - even if \u201esimply\u201c is a word that rarely appears in German administrative law.<\/p>\n

The three pillars<\/h3>\n

Pillar 1 - Skilled workers with recognized qualifications:<\/strong>\u00a0Persons with a professional qualification recognized in Germany can pursue any qualified occupation. For nurses as a regulated profession, the recognition requirement continues to apply.<\/p>\n

Pillar 2 - Professional experience:<\/strong>\u00a0Skilled workers with at least two years of professional experience and a professional qualification recognized by the state in their country of origin can enter the country under simplified conditions - even if recognition in Germany is still pending.<\/p>\n

Pillar 3 - Potential (opportunity map):<\/strong>\u00a0The new opportunity card enables entry to seek work on the basis of a points system. However, this pillar is less relevant for institutional nursing recruitment than the first two.<\/p>\n

What has changed specifically<\/h3>\n

Recognition partnership:<\/strong>\u00a0Skilled workers can now enter Germany and start the recognition procedure here. Prerequisite: employment contract, agreement on joint implementation of recognition, German language skills of at least A2. This is a real game changer - previously, recognition had to be completed before a visa was issued. More on our page about the\u00a0legal framework<\/a>.<\/p>\n

Nursing assistants from third countries:<\/strong>\u00a0For the first time, a separate residence permit has been created for nursing assistants. People with a nursing qualification below the three-year specialist qualification can now be legally employed in the health and care sector.<\/p>\n

Facilitated family reunification:<\/strong>\u00a0Skilled workers benefit from simplified regulations. Proof of sufficient living space is not required. Sounds like a detail - but for a care worker who is considering moving to Germany, the ability to bring their family home is often the decisive factor.<\/p>\n

Qualification requirements and recognition<\/h2>\n

The nursing profession is regulated in Germany. Anyone wishing to work as an international nurse requires a state license to practice the profession in accordance with the\u00a0Nursing Professions Act (PflBG)<\/a>. Without ifs and buts.<\/p>\n

The four requirements:<\/p>\n

    \n
  1. Recognition of professional qualifications:<\/strong>\u00a0The foreign qualification must be recognized as equivalent - or a compensatory measure (knowledge test or adaptation course) must be successfully completed. A complete step-by-step guide can be found in our article on\u00a0Recognition of foreign qualifications in Germany<\/a>.<\/li>\n
  2. German language skills at B2 level:<\/strong>\u00a0Non-negotiable for full recognition. More on the topic\u00a0Language<\/a>.<\/li>\n
  3. Health suitability:<\/strong>\u00a0Medical certificate of physical and mental fitness.<\/li>\n
  4. Personal reliability:<\/strong>\u00a0Certificate of good conduct or certificate of good standing from the country of origin.<\/li>\n<\/ol>\n

    Until full recognition is obtained, international specialists work as \u201erecognized nurses\u201c - with a limited field of activity, but on the way to full professional practice.<\/p>\n

    A comparison of recruitment channels<\/h2>\n\n\n\n\n\n\n\n\n
    Recruitment route<\/th>\nCosts<\/th>\nDuration<\/th>\nSpecial feature<\/th>\n<\/tr>\n<\/thead>\n
    Triple Win (ZAV\/GIZ)<\/strong><\/td>\n5.000-7.000 \u20ac<\/td>\n12-18 Mon.<\/td>\nState, ethical, language course incl.<\/td>\n<\/tr>\n
    Private agency<\/strong><\/td>\n8.000-15.000 \u20ac<\/td>\n6-12 Mon.<\/td>\nFlexible, full service possible<\/td>\n<\/tr>\n
    Western Balkans regulation<\/strong><\/td>\nVariable<\/td>\n3-6 Mon.<\/td>\n50,000 visas\/year, recognition required separately<\/td>\n<\/tr>\n
    Direct recruitment<\/strong><\/td>\n3.000-8.000 \u20ac<\/td>\n6-18 Mon.<\/td>\nHigh internal costs, expertise required<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    \u26a0\ufe0f\u00a0Important for the Western Balkans regulation:<\/strong>\u00a0It facilitates entry, but does NOT replace the recognition requirement for regulated professions. It is suitable as a residence bridge during the recognition procedure or for employment as a care assistant.<\/p>\n

    You can find a detailed comparison of brokerage models - including a quality seal check and selection checklist - in our guide to the\u00a0Nursing recruitment from abroad<\/a>.<\/p>\n

    The accelerated skilled worker procedure<\/h2>\n

    The\u00a0Accelerated skilled worker procedures according to \u00a7 81a AufenthG<\/a>\u00a0is not a nice-to-have. It's the difference between \u201eskilled worker arrives in four months\u201c and \u201eskilled worker waits a year for a visa appointment\u201c.<\/p>\n

    What it brings:<\/p>\n