Hiring Guide for Foreign Caregivers [2026 Edition]: Four Statuses of Residence, Cost Estimates, Hiring Steps, and Retention Support

Staff shortages in nursing care settings are now a challenge that directly affects facility operations. Many managers are interested in hiring foreign caregivers. Yet we often hear concerns such as “Which status of residence should we use?”, “How much will it cost?”, and “The procedures seem complicated and worrying…”.

In fact, once you understand the basic process, hiring foreign caregivers is not that difficult. If you grasp how to choose the right system and the steps involved, you can move forward steadily.

This article answers those questions. We have compiled the information practitioners need: the differences among the four statuses of residence available for hiring foreign caregivers, estimated hiring costs, concrete steps, points to avoid hiring failures, and retention support after joining.

Background: Why Hiring of International Talent Is Surging in the Nursing Care Industry

The current labor shortage in the nursing care industry is growing more severe. According to estimates by the Ministry of Health, Labour and Welfare, about 690,000 nursing care workers are projected to be short by 2040. That is not a level that can be filled by Japanese workers alone.

In response, the government has gradually expanded acceptance of international talent in the nursing care field. There are currently four types of status of residence under which foreign nationals can work at nursing care facilities. Eligible countries, requirements, periods of stay, and scope of work differ by system. Choosing the route that fits your facility’s situation is the starting point for successful hiring.

Four Statuses of Residence for Hiring Foreign Caregivers

Before hiring foreign caregivers, you need to understand the types and overview of statuses of residence. Below we explain each of the four main systems related to the nursing care field.

1. Status of Residence “Nursing Care”

This can be obtained by foreign nationals who have graduated from a Japanese certified care worker training institution (such as a vocational school or university) and passed the national examination. There is no upper limit on renewals of the period of stay, and they may engage in all duties, including home-visit nursing care. Family accompaniment is also permitted, making this the optimal route when you want to develop long-term core staff.

The main hiring targets are international students currently enrolled in or who have completed Japanese training institutions. The typical path is arrival under the “Student” status of residence, completion of the training institution, passing the national examination, and then applying to change status of residence. Completing the hire takes about six months to one year, but post-hire stability is especially high among the four routes. Facilities that want to develop talent they can work with over the long term should consider this route first.

2. Specified Skilled Worker (i) (Nursing Care Field)

This is currently the most commonly used status of residence because hiring is fast and many candidates are ready to contribute immediately. It targets people who have passed three exams: the Nursing Care Skills Evaluation Test, the Nursing Care Japanese Language Evaluation Test, and the Japanese-Language Proficiency Test (JLPT) N4 or higher.

The period of stay is capped at a total of five years, and family accompaniment is not permitted. Work in home-visit services such as home-visit nursing care (home help) is also not allowed. Detailed requirements can be checked on the Immigration Services Agency of Japan’s Specified Skilled Worker page.

The five-year cap may look like a drawback at first, but long-term retention is fully achievable when combined with talent aiming to switch to the “Nursing Care” status of residence. This route suits facilities that want to prioritize hiring speed first.

3. EPA (Economic Partnership Agreement)

This system covers three countries: Indonesia, the Philippines, and Vietnam. Candidates come to Japan as certified care worker candidates and aim to pass the national examination over a maximum of four years while working at a facility. After passing, they can change to the “Nursing Care” status of residence, opening a path to long-term retention.

Acceptance requires the facility to establish a training framework. Candidate matching is conducted through JICA and similar bodies, so completing a hire often takes more than one year. Be aware in advance that hiring costs are relatively high and the preparation period is long. This fits facilities that want to emphasize international exchange and development.

4. Technical Intern Training (Nursing Care Occupation)

Through the stages of Technical Intern Training (i), (ii), and (iii), interns acquire skills while working at a designated nursing care facility for up to five years. Work in home-visit services is not allowed, and certification of a technical intern training plan and involvement of a supervising organization are required.

The Technical Intern Training Program is scheduled to transition to the “Employment for Skill Development Program” around 2027. Under the new system, protection of workers’ rights will be strengthened, and job changes under certain conditions are expected to be allowed. If you start accepting trainees now, it is important to plan with the system change in mind.

Comparison Table of the Four Systems

Eligible Countries

Status of residence “Nursing Care”: Worldwide
Specified Skilled Worker (i): Worldwide
EPA: Indonesia, the Philippines, and Vietnam
Technical Intern Training: Worldwide

Main Requirements

Status of residence “Nursing Care”: Certified care worker national qualification
Specified Skilled Worker (i): Pass three exams
EPA: Selection based on the EPA agreement
Technical Intern Training: Certification of technical intern training plan

Period of Stay

Status of residence “Nursing Care”: No renewal cap
Specified Skilled Worker (i): Total of five years
EPA: Up to four years (renewable after passing)
Technical Intern Training: Up to five years

Family Accompaniment

Status of residence “Nursing Care”: Permitted
Specified Skilled Worker (i): Not permitted
EPA: Not permitted (permitted after passing)
Technical Intern Training: Not permitted

Home-Visit Nursing Care

Status of residence “Nursing Care”: Permitted
Specified Skilled Worker (i): Not permitted
EPA: Not permitted
Technical Intern Training: Not permitted

Time Until Hire

Status of residence “Nursing Care”: 6 months to 1 year
Specified Skilled Worker (i): 1 to 3 months
EPA: 1 to 2 years
Technical Intern Training: About 1 year

Long-Term Retention

Status of residence “Nursing Care”: Very high
Specified Skilled Worker (i): Five-year cap applies
EPA: High after passing
Technical Intern Training: Five-year cap applies

Hiring Flow for Foreign Caregivers (Explained Using Specified Skilled Worker (i) as an Example)

The overall process for hiring foreign nationals differs by status of residence, but here we explain the most commonly used Specified Skilled Worker (i) route in four steps.

Step 1: Advance Confirmation of the Acceptance Framework

Before accepting Specified Skilled Workers, confirm and put the following in place.

Whether you meet the accepting organization requirements for the nursing care field (such as ratio rules with full-time Japanese nursing care staff)
Whether you will formulate and implement the Specified Skilled Worker (i) support plan in-house or outsource it to a Registered Support Organization
Preparation of work rules and employment contracts (working conditions equivalent to those of Japanese workers are mandatory)

If formulating and implementing the support plan in-house is difficult, outsourcing to a Registered Support Organization is a practical option. A Registered Support Organization fulfills the legally required support obligations on your behalf, which can greatly reduce administrative burden.

Step 2: Securing and Screening Candidates

There are mainly three ways to secure candidates.

Using a staffing agency: Have candidates matching your conditions introduced from a database of international talent already in Japan. Changes of status of residence tend to be relatively smooth, and hiring is fast
Hello Work and job sites: Useful when you want to keep costs down. However, building a candidate pool often takes time
Inviting candidates from overseas: Because this takes cost and time, actively using talent already in Japan is more efficient

In screening, confirm Japanese language ability, nursing care work experience, and pass status on the three exams. It is important to verify directly in the interview whether even Japanese at about the N4 level poses no problem for on-the-job communication.

Step 3: Application and Change Procedures for Status of Residence

After a job offer, file an application for permission to change status of residence with the Immigration Services Agency of Japan. From application to permission usually takes one to three months. Prepare on a schedule with some buffer. The main required documents are as follows.

Application for Permission to Change Status of Residence
Employment contract (copy)
Specified Skilled Worker (i) support plan
Documents outlining the accepting organization (certificate of registered matters, financial statements, etc.)
Candidate’s passport and residence card

Step 4: Concluding the Employment Contract and Preparing for Acceptance

Once the status of residence is permitted, conclude a formal employment contract. Japan’s Labor Standards Act applies even to international talent. Be sure to ensure that wages, working hours, and days off are equivalent to those of Japanese workers.

Support for getting settled is also essential, including securing housing, opening a bank account, and completing social insurance enrollment. Because Registered Support Organizations can handle many of these tasks on your behalf, facilities hiring international talent for the first time should actively consider outsourcing.

Estimated Costs of Hiring Foreign Caregivers

Costs vary depending on the hiring route and how procedures are handled. The following are approximate guidelines.

For Specified Skilled Worker (i) (via a staffing agency)

Staffing agency fees

Estimated amount: About 15–25% of annual salary (¥0 until a job offer is made under a success-based fee model)

Status of residence application fees

Estimated amount: About ¥50,000–100,000 (when outsourcing to an administrative scrivener or similar professional)

Registered Support Organization outsourcing fees

Estimated amount: About ¥20,000–30,000 per month

For Technical Intern Training (via a supervising organization)

Supervision fees

Estimated amount: About ¥30,000–50,000 per month

Fees paid to the sending organization

Estimated amount: About ¥200,000–500,000 (varies by country and organization)

Initial costs such as post-entry training and housing

Estimated amount: May be required separately in some cases

When using a staffing agency, it is important to confirm whether fees are success-based (zero cost until a job offer is made). Starting recruitment with no upfront costs helps minimize hiring risk.

Common Pitfalls in Hiring Foreign Caregivers—and How to Avoid Them

Facilities hiring foreign caregivers for the first time are prone to several common mistakes. Knowing them in advance helps you avoid trouble.

Pitfall 1: Choosing the wrong status of residence

Some facilities hire under Specified Skilled Worker (i) only to realize they wanted the person to perform home-visit nursing care. The scope of work permitted depends on the status of residence. Before you start hiring, clarify what work you want the person to do. Once the job duties are defined, the appropriate status of residence becomes clear.

Pitfall 2: Underestimating the application timeline

Changing a status of residence takes one to three months. Rushing because of urgent staffing shortages can lead to incomplete documents and longer screening. Building in ample time is essential. Engaging a professional such as an administrative scrivener improves document quality and helps the review proceed smoothly.

Pitfall 3: Inadequate Japanese language checks during interviews

Some facilities hire based only on documented Japanese proficiency without confirming whether real communication is possible. Passing an exam is only a minimum benchmark. In interviews, conduct practical checks—for example, having candidates listen to a simple explanation of job duties.

Pitfall 4: Thin post-hire support leading to early turnover

Treating hiring as the finish line raises the risk that international talent will not settle in and will leave early. Building post-acceptance systems—training on nursing care terminology, support for getting settled, and cross-cultural awareness training for Japanese staff—is as important as hiring itself. Prepare with the mindset of welcoming a colleague to work alongside you, not merely filling a headcount.

Key Points for Retention Support After Hiring

Hiring a foreign caregiver is not the end of the process. Post-hire support systems have a major impact on retention.

Japanese training on nursing care terminology

Even at roughly N4 everyday conversation level, specialized terms used on the job—such as vital signs measurement, transfer assistance, and care records—must be learned separately. Combining OJT with nursing care–specific Japanese training accelerates on-site integration. Planning training for the first three months in advance is effective.

Daily living support systems

Getting daily life started—securing housing, handling utility setup, and filing administrative notifications—takes time and effort. Using staff who can respond in the person’s native language or a Registered Support Organization eases anxiety for international talent and helps improve retention.

Building a workplace communication environment

Creating a welcoming environment across the whole team matters—adding furigana to work manuals, preparing handover templates, and providing cross-cultural awareness training for Japanese staff. The better prepared the accepting side is, the sooner foreign caregivers can thrive. Retaining international talent also improves the workplace environment for the facility as a whole.

Conclusion: Choosing the Right Route for Your Facility Is the Key to Hiring Success

When hiring foreign caregivers, correctly understanding the characteristics of the four statuses of residence is the starting point.

Status of residence “Nursing Care”: Holders of the certified care worker qualification. Suited to long-term retention and eligible for all duties, including home-visit nursing care
Specified Skilled Worker (i): Many job-ready candidates who have passed three exams. Hiring takes one to three months. Cumulative stay is capped at five years
EPA: Limited to Indonesia, the Philippines, and Vietnam. Strong for long-term retention after passing the national exam
Technical Intern Training: A staged development model. A shift to the Employment for Skill Development Program in 2027 has already been decided

If you prioritize hiring speed and job readiness, Specified Skilled Worker (i) is a good fit. If you prioritize long-term retention and a broad scope of duties, focus on the status of residence “Nursing Care” route. On cost, using a success-based staffing agency is an effective way to minimize hiring risk.

Whatever route you choose, planning through post-hire retention support is the key to making foreign caregiver hiring a true success.

YourBright introduces nursing care talent matched to your facility from a database of more than 170,000 international talent candidates, with no upfront fees. For details, see our nursing care talent introduction service page. If you have questions about how to proceed with hiring, feel free to contact us.

Phone: 03-6908-6143 (Hours: 9:00 a.m.–6:00 p.m.)

Acceptance Case Study: Foreign Caregivers Who Settled Successfully On Site

In addition to systems and hiring steps, reviewing how acceptance actually worked on a nursing care floor makes preparation more concrete. At Day Service Dandan, before welcoming Vietnamese Specified Skilled Worker nursing care talent, the facility shared Japan–Vietnam cultural differences and common Japanese language stumbling points with staff and service users. After joining, duties were expanded step by step, and relationship-building with users and support for junior colleagues have also been recognized.

What the case shows is that retention should not be judged by Japanese ability at the time of hire alone. Designing one acceptance plan that includes advance notice to the floor, an atmosphere in which users and colleagues can explain unfamiliar words, ongoing support for reading and writing, and a clear picture of future roles makes it easier for both the individual and existing staff to feel growth.

Share the acceptance policy and communication considerations with staff and users before the start date
Expand assigned duties step by step—tea service, exercise, assistance, and so on—based on understanding and safety
Continuously support not only conversation but also reading and writing of care records and notes
Share future roles with the individual, such as supporting juniors or serving as a floor leader