sustained H-1B Case: Healthcare Administration

U.S. Department of Homeland Security 
20 Mass. Ave. N.W., Rm. A3042 
Washington, DC 20529 
identifying data deleted to 
prevent clearly unwarranted 
invasion of personal privacy 
PUBLIC COPY 
U. S. Citizenship 
and Immigration 
Services 
FILE: WAC 03 225 55770 Office: CALIFORNIA SERVICE CENTER Date: fiM 2 g 2l)ljtj 
PETITION: 
 Petition for a Nonimmigrant Worker Pursuant to Section 10 1 (a)( 1 S)(H)(i)(b) of the 
Immigration and Nationality Act, 8 U.S.C. 
 1 10 l(a)(lS)(H)(i)(b) 
ON BEHALF OF PETITIONER: 
INSTRUCTIONS: 
This is the decision of the Administrative Appeals Office in your case. All documents have been returned 
to the office that originally decided your case. Any further inquiry must be made to that office. 
@ Robert P. Wieman or 
- 
Administrative ~~~eagoffice 
WAC 03 225 55770 
Page 2 
DISCUSSION: The service center director denied the nonimmigrant visa petition and the matter is now 
before the Administrative Appeals Office (AAO) on appeal. The appeal will be sustained. The petition will 
be approved. 
The petitioner is a skilled nursing and rehabilitation services facility that seeks to employ the beneficiary 
as a rehabilitation services coordinator. The petitioner, therefore, endeavors to extend the beneficiary's 
classification as a nonimmigrant worker in a specialty occupation pursuant to section 10 1 (a)(l 5)(H)(i)(b) of 
the Immigration and Nationality Act (the Act), 8 U.S.C. 9 1 lOl(a)(lS)(H)(i)(b). 
The director denied the petition on the basis that the petitioner had failed to establish that the beneficiary 
qualifies to perform the duties of the specialty occupation. 
The record of proceeding before the AAO contains: (1) the Form 1-129 and supporting documentation; 
(2) the director's request for additional evidence (RFE); (3) the petitioner's RFE response; (4) the 
director's first denial letter, dated January 12, 2004; (5) the petitioner's motion to reopen; 
(6) the director's second denial, dated August 27, 2004; and (7) the Form I-290B and supporting 
documentation. The AAO reviewed the record in its entirety before issuing its decision. 
The first issue to be addressed is whether the proposed position qualifies as a specialty occupation. Although 
the director did not deny the petition on this basis, the AAO disagrees with the director's analysis of the issue 
and will engage in its own analysis. 
Section 214(i)(l) of the Immigration and Nationality Act (the Act), 8 U.S.C. 
 11 84(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. 
The term "specialty occupation" is further defined at 8 C.F.R. tj 214.2(h)(4)(ii) as: 
[A]n occupation which requires theoretical and practical application of a body of highly 
specialized knowledge in fields of human endeavor including, but not limited to, 
architecture, engineering, mathematics, physical sciences, social sciences, medicine and 
health, education, business specialties, accounting, law, theology, and the arts, and which 
requires the attainment of a bachelor's degree or higher in a specific specialty, or its 
equivalent, as a minimum for entry into the occupation in the United States. 
Pursuant to 8 C.F.R. 9 2 14.2(h)(4)(iii)(A), to qualify as a specialty occupation, the position must meet one of 
the following criteria: 
(I) 
 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 
WAC 03 225 55770 
Page 3 
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. 
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 proposed position. 
The petitioner, a skilled nursing and rehabilitation services facility with 152 employees, was established in 
2000 and has a gross annual income of $7,755,033. It proposes to hire the beneficiary as a rehabilitation 
services coordinator. In its July 18, 2003 letter of support, the petitioner set forth the duties of the proposed 
position as follows: 
[The beneficiarvl will rmort directlv to the Director of Rehabilitation Services for the 
and as such she will plan, administer, and direct the operation of health 
including physical, occupational, recreational[,] and speech 
therapies. 
 She will confer with members of physical, occupational, recreational[,] and 
speech therapies staff and other health care team members, individually and in conference, 
to exchange, discuss[,] and evaluate patients' information for planning, modifying[,] and 
coordinating rehabilitation treatment programs. She will allocate staff on [the] basis of 
workload, space[,] and equipment available. She will facilitate appropriate delivery of 
services to patients and families in need of inpatient rehabilitation through the effective 
management of facility resources. 
[The beneficiary] will analyze operating costs and will prepare [the] department budget. She 
will recommend patient fees for therapy based on use of equipment and therapy staff. She 
will also coordinate research projects to develop new approaches to rehabilitative therapy 
and be updated on the latest issues and development regarding various types of health 
rehabilitation programs. 
The director denied the petition, finding that the petitioner had satisfied none of the four criteria set forth at 
8 C.F.R. 5 214.2(h)(4)(iii)(A), and therefore had not established that the proposed position qualifies for 
classification as a specialty occupation. In ruling that the proposed position is not a specialty occupation, 
the director found that the duties of the proposed position were essentially those of a health services 
manager, specifically those of a nursing home administrator. 
In determining whether a proposed position qualifies as a specialty occupation, CIS looks beyond the title 
of the position and determines, from a review of the duties of the position and any supporting evidence, 
whether the position actually requires the theoretical and practical application of a body of highly 
specialized knowledge, and the attainment of a baccalaureate degree in a specific specialty, as the 
minimum for entry into the occupation as required by the Act. The AAO routinely consults the 
The petitioner is one of 24 health care facilities owned and operated by th 
- 
WAC 03 225 55770 
Page 4 
Department of Labor's Occupational Outlook Handbook (the Handbook) for its information about the 
duties and educational requirements of particular occupations. 
A review of the duties of the proposed position finds closely aligned to the responsibilities of medical and 
health services managers. As discussed in the 2006-2007 edition of the Handbook: 
Healthcare is a business and, like every other business, it needs good management to 
keep it running smoothly. Medical and health services managers, also referred to as 
health care executives or health care administrators, plan, direct, coordinate, and 
supervise the delivery of health care. Specialists are in charge of specific clinical 
departments or services, while generalists manage or help to manage an entire facility or 
system. 
The structure and financing of healthcare is changing rapidly. 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 of 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. Increasingly, medical and health services managers will work in organizations 
in which they must optimize efficiency of a variety of interrelated services-for example, 
those ranging from inpatient care to outpatient followup care. 
Clinical managers have training or experience in a specific clinical area and, accordingly, 
have more specific responsibilities than do generalists. For example, directors of physical 
therapy are experienced physical therapists, and most health information and medical 
record administrators have a bachelor's degree in health information or medical record 
administration. Clinical managers establish and implement policies, objectives, and 
procedures for their departments; evaluate personnel and work; develop reports and 
budgets; and coordinate activities with other managers. 
In that the proposed position appears closely aligned to that of a medical and health services manager, the 
AAO next turns to the Handbook's discussion of whether the occupation normally requires a 
baccalaureate or higher degree, or its equivalent, for entry into the profession. The Handbook reports the 
following educational requirements for those seeking employment as medical and health services 
managers: 
Medical and health services managers must be familiar with management principles and 
practices. A master's degree in health services administration, long-term care 
administration, health sciences, public health, public administration, or business 
administration is the standard credential for most generalist positions in this field. 
However, a bachelor's degree is adequate for some entry-level positions in smaller 
facilities. . . . 
WAC 03 225 55770 
Page 5 
For persons seeking to become heads of clinical departments, a degree in the appropriate 
field and work experience may be sufficient early in their career. However, a master's 
degree in health services administration or a related field might be required to advance. 
For example, nursing service administrators usually are chosen from among supervisory 
registered nurses with administrative abilities and a graduate degree in nursing or health 
services administration. 
The petitioner is a skilled nursing and rehabilitation services facility with 152 employees. Its staff is 
comprised of registered nurses, physical therapists, physical therapist assistants, 
electroneuromyographers, as well as other professionals and administrative staff. As the beneficiary 
would supervise the facility's rehabilitation services, the AAO finds that the educational requirements for 
the position would be similar to those of a clinical department head. According to the Handbook, a 
degree in the appropriate field and work experience are sufficient for entry for clinical department heads. 
The AAO disagrees with the director's characterization of the proposed position as that of a nursing home 
administrator and finds no support in the record for such a conclusion. While the petitioner is a skilled 
nursing and rehabilitation services facility, the beneficiary would not supervise the entire facility; she 
would supervise its rehabilitation services only. Therefore, nursing home administrator licensure is 
irrelevant for this position. 
As such, the proposed position qualifies as a specialty occupation under 8 C.F.R. 9 214.2(h)(4)(iii)(A)(I). 
The record reflects that the beneficiary earned a bachelor's degree in physical therapy from th 
in the Philippines, in 1999. According to an evaluation 
contained in the record, this degree is equivalent to a bachelor's degree in physical therapy from an accredited 
college or university in the United states. Therefore, she is qualified to perform the duties of this specialty 
occupation. 
The petitioner has established that the proposed position qualifies as a specialty occupation and that the 
beneficiary is qualified to perform the duties of a specialty occupation. Accordingly, the appeal will be 
sustained, and the petition will be approved. 
The burden of proof in these proceedings rests solely with the petitioner. Section 291 of the Act, 8 U.S.C. 
13 6 1. The petitioner has sustained that burden. 
ORDER: 
 The appeal is sustained. The petition is approved.