dismissed H-1B Case: Healthcare

U.S. Department of Homeland Security 
20 Massachusetts Ave. NW, Rm. A3042 
Washington, DC 20529 
U. S. Citizenship 
and Immigration 
FILE: WAC 04 091 51354 Office: CALIFORNIA SERVICE CENTER Date: OCT 2 6 2005 
PETITION: Petition for a Nonimmigrant Worker Pursuant to Section IOl(a)(l5)(H)(i)(b) of the 
Immigration and Nationality Act, 8 U.S.C. 4 1 lOI(a)(lS)(H)(i)(b) 
ON BEHALF OF PETITIONER: 
INSTRUCTIONS: 
This is the decision of the Administrative Appeals Office in your case. All materials have been returned 
to the office that originally decided your case. Any further inquiry must be made to that office. 
Robert P. Wiernann, Director 
Administrative Appeals Office 
WAC 04 091 51354 
Page 2 
DISCUSSION: The service center director denied the nonimmigrant visa petition. The matter is now on 
appeal before the Administrative Appeals Office (AAO). The appeal will be dismissed. The petition will be 
denied. 
The petitioner is an intermediate facility for the developmentally disabled. It seeks to employ the 
beneficiary as health services coordinator and to classify him as a nonirnmigrant worker in a specialty 
occupation pursuant to section lOl(a)(lS)(H)(i)(b) of the Immigration and Nationality Act (the Act), 
8 U.S.C. 5 1 lOl(a)(lS)(H)(i)(b). 
The director denied the petition on the ground that the record failed to establish that the proffered position 
is a specialty occupation. 
Section 214(i)(l) of the Act, 8 U.S.C. 5 1184(i)(l), defines the term "specialty occupation" as an 
occupation that requires: 
(A) theoretical and practical application of a body of highly specialized knowledge, 
and 
(B) attainment of a bachelor's or higher degree in the specific specialty (or its 
equivalent) as a minimum for entry into the occupation in the United States. 
As provided in 8 C.F.R. 5 214.2(h)(4)(iii)(A), to qualify as a specialty occupation the position must meet 
one of the following criteria: 
(1) A baccalaureate or higher degree or its equivalent is normally the minimum 
requirement for entry into the particular position; 
(2) The degree requirement is common to the industry in parallel positions among 
similar organizations or, in the alternative, an employer may show that its 
particular position is so complex or unique that it can be performed only by an 
individual with a degree; 
(3) The employer normally requires a degree or its equivalent for the position; or 
(4) The nature of the specific duties is so specialized and complex that knowledge 
required to perform the duties is usually associated with the attainment of a 
baccalaureate or higher degree. 
Citizenship and Immigration Services (CIS) interprets the term "degree" in the criteria at 8 C.F.R. 
5 214.2(h)(4)(iii)(A) to mean not just any baccalaureate or higher degree, but one in a specific specialty 
that is directly related to the proffered position. 
The record of proceeding before the AAO contains (1) Form 1-129 and supporting documentation; (2) the 
director's request for evidence (RFE); (3) the petitioner's response to the RFE; (4) the notice of decision; 
and (5) Form I-290B, counsel's appeal brief, and supporting materials. The AAO reviewed the record in 
its entirety before issuing its decision. 
WAC 04 091 51354 
Page 3 
On Form 1-129 the petitioner described itself as an intermediate care facility for developmentally disabled 
persons, established in 1995, with 19 employees and a gross annual income of $980,000. The petitioner 
stated that it proposed to hire the beneficiary as a health services coordinator to "deal with the 
interpretation, analysis and implementation of quality standards in the health services provided by the 
petitioner's health staff and personnel." In an accompanying letter the petitioner indicated that the job 
would involve the analysis of health services agreements and contracts and the review of the facility's 
policies and procedures manual. Specific duties of the position were described as follows: 
[The beneficiary] will deal directly with human resources in developing a standard policy 
to be followed by the health care staff of the facility. He will then schedule or monitor 
that each care staff has the requisite training, instruction or continuing education to fully 
comply with the quality standards imposed by state and local regulations and the proper 
standard of care as expected by each patient in the facility. 
He will develop an effective cornrnunication/information system between the client, the 
care staff and personnel in order to monitor, avoid and eventually eliminate tardiness, 
absenteeism and truancy among the healthcare staff. He will see to it that the system is 
being implemented and followed as planned. 
He will analyze the facility's requirements in determining the training and instruction 
appropriate and needed by the care staff to update them with the latest medical 
breakthroughs, equipment, and procedures. 
He will improve on existing policies in handling complaints and suggestions by a client 
and/or its patients. He will review a care staff performance and record before 
recommending re-negotiation or renewal of histher contract. 
The minimum educational requirement for the proffered position, the petitioner states, is a bachelor's 
degree in nursing (B.S.N.), in a related health care or science field, or in business administration. The 
beneficiary received a bachelor of science in nursing from Remedios T. Romualdez Memorial Schools in 
Makati, the Philippines, on March 21, 1997. 
In his decision the director determined that a majority of the proffered position's duties are administrative 
in nature, requiring some knowledge of a registered nurse but not the services of a health services 
manager. Registered nurses, the director pointed out, do not require a baccalaureate level degree. The 
director found that the administrative duties of the proffered position reflected those of an administrative 
services manager as described in the Department of Labor (D0L)'s Occupational Outlook Handbook 
(Handbook), and quoted an excerpt from the Handbook indicating that entry into such a position does not 
require a baccalaureate degree in a specific specialty. Job advertisements in the record from other 
companies were not similar enough to the petitioner to establish that a degree requirement is common to 
the industry, the director indicated, and the evidence of record did not establish that the duties of the 
position are so complex or unique that a baccalaureate degree is required to perform them. The petitioner 
failed to show that it normally requires a degree or its equivalent for the position, or that the duties are so 
specialized and complex that baccalaureate or higher level knowledge is required to perform them. The 
director was not persuaded that the proffered position could not be performed by an experienced 
WAC 04 091 5 1354 
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individual with less than a baccalaureate level of education, and concluded that the proffered position 
does not qualify as a specialty occupation under any of the criteria enumerated at 8 C.F.R. 5 214.2 
(h)(4)(iii)(A). The director also noted that the petitioner had neglected to provide certain evidence about 
its business operations specifically requested in the RFE, and determined that the petitioner had failed to 
meet its burden of proof to establish eligibility for the requested benefit. 
In determining whether a position meets the statutory and regulatory criteria of a specialty occupation, 
CIS routinely consults the DOL Handbook, supra, as an authoritative source of information about the 
duties and educational requirements of particular occupations. Factors typically considered are whether 
the Handbook indicates a degree is required by the industry; whether the industry's professional 
association has made a degree a minimum entry requirement; and whether letters or affidavits from firms 
or individuals in the industry attest that such firms "routinely employ and recruit only degreed 
individuals." See Shanti, Inc. v. Reno, 36 F.Supp. 2d 1151, 1165 (D.Minn. 1999) (quoting HirdIBlaker 
Corp. v. Sava, 712 F.Supp. 1095, 1102 (S.D.N.Y. 1989)). CIS also analyzes the specific duties and 
complexity of the position at issue, with the Handbook's occupational descriptions as a reference, as well 
as the petitioner's past hiring practices for the position. See Shanti, Inc. v. Reno, id., at 1165-66. 
On appeal counsel asserts that the duties of the proffered position are not those of an administrative 
services manager, or a registered nurse, but rather those of a medical and health services manager as 
described in the DOL Handbook. The Handbook states that a bachelor's or master's degree in a health or 
business-related specialty is the standard educational credential for medical and health services managers, 
counsel points out, making it a specialty occupation. An individual with administrative training alone, 
counsel argues, could not perform the duties of the proffered position. A bachelor's degree in nursing or 
a related medical field is required, according to counsel, because the position involves the review and 
analysis of hospital manuals, health services agreements, interpretation of hospital policies, procedures 
and guidelines, as well as complex medical terminology. 
The Handbook describes the occupational category of medical and health services managers, in pertinent 
part, as follows: 
The occupation, medical and health services manager, encompasses all individuals who 
plan, direct, coordinate, and supervise the delivery of healthcare. Medical and health 
services managers include specialists and generalists. Specialists are in charge of specific 
clinical departments or services, while generalists manage or help to manage an entire 
facility or system. 
. . . . Future medical and health services managers must be prepared to deal with evolving 
integrated healthcare delivery systems, technological innovations, an increasingly 
complex regulatory environment, restructuring at work, and an increased focus on 
preventive care. They will be called upon to improve efficiency in healthcare facilities 
and the quality of the healthcare provided . . . . 
Large facilities usually have several assistant administrators to aid the top administrator 
and to handle daily decisions . . . . 
In smaller facilities, top administrators handle more of the details of daily operations . . . 
WAC 04 09 1 5 1354 
Page 5 
Handbook, 2004-05 edition, at 55-56. Counsel's contention that the proffered position is that of a health 
services manager is not substantiated by the evidence of record. The duties of a medical or health 
services manager, as described in the Handbook, appear to exceed the duties of the position at issue in 
this petition with respect to their scope of responsibility and the knowledge required to perform them. 
The evidence of record does not demonstrate the level and specific types of health care services provided 
by the petitioner to its patients and/or clients. The petitioner states that it has 19 employees, but it does 
not identify the other employees whose services the beneficiary would be coordinating. The petitioner 
refers to them generically as its healthcare staff without indicating whether they are registered nurses, 
lower-level nurses, nurse's aides, or other workers. In the RFE, as the director pointed out in his decision, 
the petitioner was requested to submit an organizational chart and quarterly wage reports which would 
have described its organizational hierarchy. The requested documents have not been submitted. Simply 
going on record without supporting documentation does not satisfy the petitioner's burden of proof. See 
Matter of SofJici, 22 I&N Dec. 158, 165 (Comm. 1998) (citing Matter of Treasure Craft of California, 14 
I&N Dec. 190 (Reg. Comm. 1972)). Nor do mere assertions by counsel satisfy the petitioner's burden of 
proof. See Matter of Obaigbena, 19 I&N Dec. 533,534 (BIA 1988); Matter of Ramirez-Sanchez, 17 I&N 
Dec. 503,506 (BIA 1980). Thus, the record does not establish that the proffered position reflects that of a 
medical or health services manager, as described in the DOL Handbook. 
Though the director found that the duties of the proffered position were primarily administrative in nature 
and reflected the duties of an administrative services manager, the AAO is persuaded that the medically- 
related knowledge required by the duties of the position reflects the occupation of a head nurse or nurse 
supervisor. That occupation is described in the Handbook, 2004-05 edition, at 302: 
Head nurses or nurse supervisors direct nursing activities, particularly in hospitals. They 
plan work schedules and assign duties to nurses and aides, provide or arrange for training, 
and visit patients to observe nurses and to ensure that the patients receive proper care. 
They also may ensure that records are maintained and equipment and supplies are 
ordered. 
With respect to the educational requirements for such positions, the Handbook indicates that there are 
three alternative paths for registered nurses generally. They include a four-year B.S.N. degree from a 
college or university; a two- or three-year associate degree in nursing (A.D.N.) from a community or 
junior college; and a diploma program, usually three years, at a hospital. See id. at 302. Thus, the 
Handbook makes clear that a baccalaureate degree in a specific specialty is not the normal minimum 
requirement for entry into a registered nursing position. Less than baccalaureate level education may 
suffice for many positions. Certain advanced practice nurses, the Handbook notes, have educational and 
clinical requirements beyond those generally applicable to all RNs. However, there is no indication in the 
Handbook that head nurses or nurse supervisors, though their duties may exceed those of some other 
registered nurses, require a B.S.N. as a minimum degree requirement for entry into such a position. 
Rather, it would appear that a two-year associate degree in nursing is often sufficient educational 
background. Accordingly to the Handbook, therefore, a baccalaureate or higher degree in the specific 
specialty of nursing - i.e., a B.S.N. - is not the minimum requirement for entry into the nursing position 
proffered by the petitioner, as required to meet the first alternative criterion of a specialty occupation set 
forth in 8 C.F.R. 5 214.2(h)(4)(iii)(A)(l). 
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A policy memorandum from the legacy Immigration and Naturalization Service in November 2002 
provides additional guidance for CIS on the adjudication of H-1B petitions for registered nurses. In 
surveying the educational requirements for the nursing occupation, the H-1B Memorandum notes that the 
minimum requirement for entry into the field as a registered nurse is a two-year associate degree in 
nursing (A.D.N.). Though a four-year B.S.N. can be earned at some U.S. and foreign universities, the 
degree is not required for most entry-level nursing positions in the United States. The H-1 B Memorandum 
indicates that certain advanced practice nurses - such as clinical nurse specialists, nurse practitioners, 
certified registered nurse anesthetists, or certified nurse-midwives - do require a B.S.N. or higher degree, 
which makes them specialty occupations. Likewise, some nursing specialties - such as critical care, peri- 
operative, rehabilitation nursing, oncology, and pediatric nursing - require a B.S.N. or equivalent 
knowledge, making them specialty occupations as well. In addition, some nurses in high-level 
management positions - "such as an upper-level 'nurse manager' in a hospital administration," according 
to the H-1B Memorandum - require a B.S.N. or higher degree, making them specialty occupations. 
The position at issue in this petition does not fit any of the foregoing examples of nursing positions that 
would require a B.S.N. or higher degree. While the proffered position may involve some first-line 
supervision of nurses or other healthcare aides, such duties would not enhance the position to that of an 
H-1B level nurse manager as referenced in the H-1B Memorandum. Accordingly, the AAO determines 
that a baccalaureate or higher degree in nursing or a related specialty is not the normal minimum 
requirement for entry into the proffered position, as required for it to meet the first alternative criterion of 
a specialty occupation at 8 C.F.R. 3 214.2(h)(4)(iii)(A)(l). 
With respect to the second alternative criterion of a specialty occupation, at 8 C.F.R. 5 214.2 
(h)(4)(iii)(A)(2), counsel has submitted on appeal job advertisements from six different organizations - 
including a hospital, a healthcare facility, a mental health clinic, a cosmetic surgery practice, and two 
unidentified entities - for positions variously entitled quality assurance coordinator/analyst; health 
services coordinator; utilization review coordinator analyst; nurse coordinator/analyst; resource 
coordinator analyst; and quality assurance manager, coordinator, or compliance officer. The 
advertisements from the hospital and the healthcare facility, however, do not describe what duties are 
involved in the advertised position. While the advertisements from the hospital, the healthcare facility, 
the mental health clinic, and one of the unidentified entities specify that a bachelor's degree in nursing, 
public health, or a related medical field is required for the position, the other two advertisements state 
only that a bachelor's degree is required, without indicating any specialty field. Furthermore, none of the 
advertising companies appears to be in the same line of healthcare as the petitioner and none of the 
advertisements provides any information about the company's size and scale of operations relative to the 
petitioner. As previously noted, the petitioner states that it has 19 employees and gross annual income of 
$980,000, though no documentary evidence thereof has been submitted. The AAO concludes that the job 
advertisements fail to establish that a bachelor's degree in nursing or a related specialty is a common 
requirement of the petitioner's industry in parallel positions among similar organizations. Thus, the 
proffered position does not qualify as a specialty occupation under the first prong of 8 C.F.R. 5 214.2 
(h)(4)(iii)(A)(2). Nor has the petitioner demonstrated that its nursing position is so complex or unique 
that it can be performed only by an individual with a B.S.N. or related degree, as required for the position 
to qualify as a specialty occupation under the second prong of 8 C.F.R. 5 214.2(h)(4)(iii)(A)(2). 
As for the third alternative criterion of a specialty occupation, the record indicates that the proffered 
position is newly created. Therefore, the petitioner cannot demonstrate that it normally requires a B.S.N. 
WAC 04 091 51354 
Page 7 
degree or its equivalent for the position. Accordingly, the position does not qualify as a specialty 
occupation under 8 C.F.R. 5 214.2(h)(4)(iii)(A)(3). 
Lastly, the proffered position does not meet the fourth alternative criterion of a specialty occupation, at 
8 C.F.R. 5 214.2(h)(4)(iii)(A)(4), because the record does not establish that the duties of the position are 
so specialized and complex that baccalaureate level knowledge in nursing or a related specialty is 
required to perform them. The petitioner has not demonstrated that the duties of the position exceed the 
scope of a typical registered nurse, an occupation for which baccalaureate level knowledge in a specific 
specialty is not usually required for entry-level positions, as the DOL Handbook and the H-IB 
Memorandum clearly indicate. 
For the reasons discussed above, the record does not establish that the proffered position meets any of the 
criteria set forth in 8 C.F.R. 5 214.2(h)(4)(iii)(A) to qualify as a specialty occupation. The petitioner has 
not established that the beneficiary will be coming temporarily to the United States to perform services in 
a specialty occupation, as required under section lOl(a)(lS)(H)(i)(b) of the Act, 8 U.S.C. 5 1101 
(a)( 15)(H>(i)(b>. 
The petitioner bears the burden of proof in these proceedings. See section 291 of the Act, 8 U.S.C. 3 1361. 
The petitioner has not sustained that burden. Accordingly, the AAO will not disturb the director's decision 
denying the petition. 
ORDER: The appeal is dismissed. The petition is denied.