Peggy Chen and her team discovered about 20% of direct care workers are undocumented.

Foreign-born registered nurses comprise up to 15% of the total RNs in the United States, a new study finds.

The RAND Corporation study investigated the number of foreign-educated and foreign-born health workers in the U.S. The study found 5.4% of RNs who were both foreign-born and foreign-educated, with most coming from the Philippines, Canada, India, the United Kingdom and Nigeria.

The investigators also found foreign-born individuals account for up to 24% of the workforce category that includes nursing aides and home aides. The largest numbers in that group were from Mexico, the Philippines, Jamaica, Haiti and the Dominican Republic. It’s estimated around 20% of direct care workers are undocumented.

There are four types of visas that allow admission to the U.S. for healthcare professionals. The most formalized is for foreign-educated physicians.

Lead author and RAND associate natural scientist Peggy G. Chen, M.D., said that while all foreign workers fill healthcare workforce gaps, policy changes are needed to address the inadequate supply of primary care physicians. 

The authors also called for an improved experience for many foreign-born workers, who can be preyed upon. In July, a Colorado businessman was found guilty of human trafficking after he lured nurses from the Philippines to work in nursing homes.