Long-Term-Care-Home employee conversing with resident.

Long-term care homes are an important part of Canada’s health care system, however, they currently face a major staffing shortage. In fact, it is estimated that by 2029, long-term care homes in Ontario will require at least 58,600 more nurses and personal support workers to meet increased hours of care and new beds, which is more than double the current long-term care workforce.

While human resource challenges are not new for the healthcare sector in Canada, the COVID-19 pandemic highlighted and exacerbated the situation, and federal and provincial governments have mobilized several policies in response.

Immigration programs have become an important component in helping to alleviate the pressure faced by the long-term care sector in Canada. In particular, foreign nationals with important skills and experience, such as nurses and personal support workers, can assist in addressing these long-standing staffing shortages and provide quality care to Canadians now and in the future.


Temporary Foreign Worker Program

Most notably, the Temporary Foreign Worker Program (TFWP) allows employers in Canada to hire foreign workers when Canadians or permanent residents are not available. The TFWP involves an employer in Canada making an application to Employment and Social Development Canada (ESDC)/Service Canada for a Labour Market Impact Assessment (LMIA). If ESDC/Service Canada determines that the hiring of a foreign worker will have a neutral or positive impact on the Canadian labour market, a positive LMIA may be issued to the employer.  A foreign national can then use the positive LMIA in support of their application to work in Canada.

Typically, personal support workers or other related occupations who come to Canada to work in a specified long-term care home through the TFWP program are eligible to work in Canada for an initial period of two years.


Temporary Status for Accompanying Spouses and Dependent-Children

Although foreign nationals who have come to Canada to work in high-skill occupations, such as nurses, have always been able to apply for an open work permit for their accompanying spouses, recent changes by Immigration, Refugees, and Citizenship Canada (IRCC) has broadened the eligibility criteria to the dependent children of high-skill workers and the family members of some workers at low-skill levels.


Francophone Mobility Program

In addition, French-speaking healthcare workers may be eligible to come to Canada to work in long-term care homes through the Francophone Mobility Program without the need for an LMIA.

On June 15th, 2023, the former Minister of IRCC, the Honourable Sean Fraser, announced the expansion of the Francophone Mobility Program which was created to allow Canadian employers to hire candidates with a moderate command of French destined to live and work outside of Quebec. As a result of the expansion, those with a score of 5 on the language scale, and a job offer under any TEER of the National Occupation Classification (NOC), (except primary agriculture), are eligible for an LMIA-exempt work permit, offering an option for French-speaking healthcare workers

The expansion is currently set to last for a period of two years, until 2025, and will open doors to more French-speaking foreign nationals by offering them the opportunity to gain Canadian work experience and top qualify for permanent residence.


Express Entry – Category Based Draw

In addition to the temporary programs noted above, foreign healthcare workers with specific skills, training, or language abilities may be eligible for permanent residence through Canada’s Express Entry system, which has undergone some significant adjustments in recent years.

In May 2023, IRCC introduced six new categories for category-based selection draws, including healthcare occupations, which aim to address acute labour shortages. Category-based selection allows Canada to issue Invitations to Apply (ITAs) to prospective permanent residents with specific skills, training, or language ability. These draws generally invite candidates at much lower CRS point scores than draws which are not category-specific or limited by occupation.

To be eligible under the healthcare occupations category, applicants must:

  • have accumulated, within the past 3 years, at least 6 months of full-time, continuous work experience (or an equal amount of part-time work experience)
  • meet all of the requirements in the instructions for that round

Specified occupations that are eligible include licensed practical nurses, nurse practitioners, nurse aides, orderlies and patient service associates, among others. Please visit IRCC’s website here for a full list of eligible healthcare occupations under the Express Entry system.


Provincial Nominee Programs

Labour shortages in Canadian long-term care homes are also addressed through provincial nominee programs.

In brief, the Government of Canada has partnered with provinces and territories across the country to operate immigration programs that meet their provincial priorities, including targeting foreign workers with certain in-demand skills, such as healthcare workers.

For example, Ontario’s nominee program has focused heavily on healthcare workers over the past several years. Under the Employer Job Offer: In-Demand Skills stream, home support workers, and caregivers with a job offer and at least 9 months of Ontario work experience can be invited to apply for a provincial nomination.  Ontario’s Employer Job Offer: Skilled Worker stream conducts frequent draws targeting workers with a job offer in a wide variety of healthcare occupations including professional occupations but also supporting roles such as pharmacy technicians and massage therapists. Finally, Ontario’s Human Capital Priority stream often targets Express Entry candidates with healthcare experience at much lower scores than would otherwise be required under the Healthcare Worker category-specific draws.


Credential Recognition Programs

Finally, recognizing that many healthcare professionals trained abroad may face challenges in having their credentials recognized in Canada to obtain required licensure, various initiatives have been recently implemented to streamline the credential recognition process.

For example, for nurses in Alberta, Nova Scotia and British Columbia, new regulatory processes have shortened waiting times have dramatically increased the number of applications from nursing professionals trained in other countries. In Ontario, new legislation has been introduced, which, if passed, would allow healthcare workers licensed in other Canadian jurisdictions to work in the province without having to register with its applicable health regulatory colleges.

These programs assess foreign credentials and provide pathways for qualified individuals to obtain the necessary certification to work in the Canadian healthcare system, including long-term care facilities.


Overall, in a country like Canada with an aging population and a record number of people planning retirement, immigration remains one of the strongest tools for addressing labour shortages. Policies like the above help to ensure that current and future labour needs are met and that all Canadians have access to quality long-term care.

To discuss the various immigration options that might be available to you or your business, we invite you to contact us for more information.


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