How to Succeed at Hiring Foreign Caregivers: Four Statuses of Residence and the Application Process Explained

“We post nursing care staff openings but get no applicants.” “We can’t fill night shifts.” These concerns are serious challenges now heard at many nursing care facilities. According to estimates by the Ministry of Health, Labour and Welfare, there will be a shortfall of about 690,000 nursing care workers in fiscal 2040.

Hiring foreign caregivers is drawing attention as an option to address labor shortages. Still, many facilities feel uneasy about questions such as “Which status of residence should we use?” and “Aren’t the procedures complicated?”

This article systematically explains the differences among the four statuses of residence for hiring foreign caregivers, the concrete process flow, cost estimates, and keys to successful acceptance. Drawing on the current labor shortage in the nursing care industry, find a recruitment strategy that fits your organization.

Why the nursing care industry is moving to hire foreign caregivers

Labor shortages in nursing care grow more severe each year. According to the Ministry of Health, Labour and Welfare’s “Acceptance of International Talent in the Nursing Care Field”, there were about 2.15 million nursing care workers in fiscal 2023, but supply has not kept pace with the speed of population aging.

The active job openings-to-applicants ratio has hovered around 3.0—about three times the all-industry average—and hiring is especially difficult at facilities in regional areas. Against this backdrop, accepting foreign caregivers is shifting from “one option” to an “essential management strategy.”

As of the end of June 2024, international talent working in nursing care exceeded about 60,000, a substantial year-on-year increase. The government is also expanding acceptance quotas and making systems more flexible, so the presence of foreign caregivers is expected to grow further.

Comparing the four statuses of residence for hiring foreign caregivers

There are mainly four statuses of residence under which foreign nationals can work at nursing care facilities in Japan. Because purpose, requirements, and period of stay differ for each, it is important to choose the system that fits your facility’s situation. Please also see the four statuses of residence for foreign caregivers.

Comparison table of the four statuses of residence

|---|---|---|---|---|

EPA certified care worker candidates

This system accepts candidates from three countries—Indonesia, the Philippines, and Vietnam—under Economic Partnership Agreements (EPA). The Japan International Corporation of Welfare Services (JICWELS) is the sole matching organization.

Candidates must pass the national certified care worker examination by their fourth year after entry; once they pass, they can continue working without a limit on the period of stay. A distinctive feature is that accepting facilities are required to build a learning support system.

Status of residence “Nursing Care”

This status is for foreign nationals who have graduated from a Japanese certified care worker training institution (such as a vocational school) and obtained the certified care worker qualification. There is no upper limit on renewals of the period of stay, and they may also engage in home-visit nursing care, so they can be expected to serve as long-term workforce.

However, because graduation from a training institution is a prerequisite, facilities typically hire prospective graduates as new graduates rather than recruiting them directly in other ways.

Technical Intern Training “Nursing Care”

This system aims to transfer skills to developing countries and accepts trainees through supervising organizations. The training period is up to five years, and trainees may be counted toward staffing standards from the second year onward.

In 2024, a review of the Technical Intern Training program was decided, and a transition to the Employment for Skill Development Program is planned. Because the system is in a transitional period, checking the latest information is essential.

Specified Skilled Worker (i) “Nursing Care”

This system is designed squarely to ease labor shortages and is best suited to securing ready workforce. It covers foreign nationals who have passed the nursing care skills evaluation exam and a Japanese language test (N4 or higher), or who have completed Technical Intern Training in “Nursing Care.”

They can be counted toward staffing standards from day one, and job changes are allowed, so the system is designed to better protect workers’ rights. You can check the latest acceptance status on the Immigration Services Agency of Japan’s “About the Specified Skilled Worker System”.

Process flow for hiring foreign caregivers

Here we explain the hiring process steps, focusing on Specified Skilled Worker (i), the most commonly used pathway.

Step 1: Build an acceptance framework

To accept foreign caregivers, the facility must first put its own framework in place. Specifically, the following preparations are required.

Decide internal policy on accepting international talent
Appoint instructors (such as certified care workers)
Consider outsourcing to a Registered Support Organization (to prepare and implement the support plan on your behalf)

Under the Specified Skilled Worker system, accepting employers are required to prepare and implement a “Support Plan for Specified Skilled Workers (i).” If handling this in-house is difficult, outsourcing to a Registered Support Organization makes the process smoother.

Step 2: Recruit and select talent

The process differs depending on whether you hire international talent already in Japan or bring candidates from overseas.

Candidates already in Japan: Select from candidates already in Japan, such as those who have completed Technical Intern Training or international students. A change of status of residence is required, but interviews are easier and Japanese ability is easier to confirm.

Candidates overseas: Recruit through local sending organizations. Entry can take about two to five months, so you need a schedule with enough lead time.

Step 3: Conclude an employment contract

After interviews and a hiring decision, conclude an employment contract. The law requires that compensation be equal to or higher than that of Japanese workers. Explain working conditions in the candidate’s native language as well, and confirm that both sides share the same understanding.

Step 4: Apply for status of residence

File an Application for Certificate of Eligibility (when bringing someone from overseas) or an Application for Change of Status of Residence (for someone already in Japan) with a regional immigration services bureau. Screening usually takes one to three months.

Step 5: Onboarding and start of acceptance

Conduct a life orientation before the start date and share workplace rules and local living information. After onboarding, hold regular one-on-one meetings and provide support on both work and daily life—this is key to retention.

Cost estimates for hiring foreign caregivers

Cost structure varies greatly by status of residence and hiring route. The following are estimates centered on Specified Skilled Worker (i).

| Cost item | Approximate amount | Notes |

|---|---|---|

| Recruitment agency fee | ¥200,000–¥500,000 per person | Varies by agency |

| Status of residence application costs | About several tens of thousands to ¥100,000 | When using a gyoseishoshi (administrative scrivener) |

| Fees to a Registered Support Organization | ¥20,000–¥30,000 per person per month | Outsourcing implementation of the support plan |

| Travel costs (overseas hires) | ¥100,000–¥200,000 per person | Often borne by the facility |

| Housing arrangement costs | Initial costs ¥100,000–¥300,000 | Deposit, key money, furniture, etc. |

When using a recruitment agency on a success-fee basis, no fees arise until an offer is made. YourBright’s nursing care talent recruitment service is a fully success-based model with zero upfront costs, enabling hiring with lower cost risk.

Practical checklist to review before hiring foreign caregivers

In foreign caregiver hiring, if you proceed based only on status of residence, the workplace is more likely to fall into confusion just before or after onboarding. In practice, it is important to first lock in whether you have a system that can truly accept people.

Start by confirming the duties planned for the assignment. Breaking down physical care, daily living assistance, documentation work, whether night shifts are involved, and whether home-visit services can be assigned makes it easier to judge which status of residence is appropriate. Pay particular attention to the scope of work allowed under Specified Skilled Worker and Technical Intern Training.

Next, confirm on-site training systems. Beyond appointing an OJT lead, you need to organize shift handoff phrasing, documentation formats, and incident reporting flows in ways foreign staff can understand. Nursing care workplaces use many abbreviations and tacit knowledge, so it is realistic to brief existing staff as well.

Housing, life orientation, and support with administrative procedures are also points to settle in advance. Residual anxiety outside work—resident registration, mobile phones, bank accounts, commuting, garbage rules, and so on—directly affects retention. Even when using a Registered Support Organization, drawing a clear line between what the facility handles and what is outsourced stabilizes operations.

In practice, listing the following points before hiring reduces oversights.

Which status of residence will be used for acceptance
Planned department and scope of assigned duties
Training schedule until night shifts begin
OJT lead and consultation contact point
Who handles housing, commuting, and daily-life support
Whether Japanese language learning and qualification support are provided
Frequency of one-on-one meetings to prevent early turnover

Completing this check first makes it easier to avoid typical post-hire problems such as “the work is different from what we expected” or “no one is assigned to provide follow-up.”

Five keys to successful acceptance of foreign caregivers

Hiring is the start, not the finish line. Here are points to keep in mind so foreign caregivers can thrive on site and keep working for the long term.

1. Communicate in plain, easy Japanese

Nursing care workplaces tend to be full of technical terms and local dialects. Simply being mindful of plain Japanese—for example, rephrasing “gasho” as “lying down in bed”—can greatly improve communication quality.

2. Clearly assign instructors

Not knowing whom to ask is a major source of stress for foreign staff. Appoint instructors and create an environment where questions are easy to ask.

3. Presenting a Career Path

Showing future prospects—such as the ability to pursue Certified Care Worker qualifications or promotion to leadership roles—helps improve retention. It is effective to communicate a long-term career design that also contemplates a transition to Specified Skilled Worker (ii) or a change to the “Nursing Care” status of residence.

4. Daily Living Support Systems

Support with everyday life—securing housing, opening a bank account, and learning how to sort and dispose of garbage—is most needed immediately after joining. By using a Registered Support Organization, you can provide life orientation and regular interviews in the worker’s native language and reduce the burden on your facility.

5. Advance Briefings for Existing Staff

It is important to explain the acceptance of foreign staff to existing employees in advance and gain their understanding. Sharing differences in culture and work styles and creating an atmosphere of welcoming them as a team improves relationships across the workplace.

list of status of residence types as well will make it easier to answer questions about foreign staff visas.

Conclusion

Hiring foreign caregivers is an effective way to address staffing shortages at nursing care facilities if you correctly understand the systems and make appropriate preparations. Finally, here are the key points of this article.

The four statuses of residence (EPA, Nursing Care, Technical Intern Training, and Specified Skilled Worker) each differ in purpose, requirements, and duration
Specified Skilled Worker (i) “Nursing Care” is the system best suited to securing ready-to-work talent, and the number of users is growing rapidly
The hiring process proceeds in five steps from building your framework through to onboarding
Costs can have initial risk reduced by using a success-fee placement agency
The keys to retention are plain Japanese, presenting a career path, and daily living support

If your facility is unsure which status of residence fits your organization, or would like to entrust the procedures to someone else, please feel free to contact us. As a Registered Support Organization (registration number: 19登-000992), YourBright introduces talent suited to the nursing care field from a database of more than 170,000 people. There are no upfront fees, and no payment is due until an offer is made.

We also accept inquiries by phone.

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

Frequently Asked Questions

Q1. How long does it take to hire a foreign caregiver?

When accepting talent already residing in Japan through a change of status of residence, the guideline is about one to three months from the start of selection to the start of employment. When bringing someone from overseas, local selection, issuance of a Certificate of Eligibility, visa issuance, and travel preparations are added, so many cases take about three to six months.

Q2. Which should you choose: Specified Skilled Worker or the “Nursing Care” status of residence?

If you want to hire ready-to-work talent quickly, Specified Skilled Worker is a better fit. On the other hand, if you expect long-term employment and a broader range of work including home-visit nursing care, hiring talent who hold Certified Care Worker qualifications under the “Nursing Care” status of residence may be a better match. You should set priorities according to your facility’s hiring goals.

Q3. What is the most common failure when hiring foreign caregivers?

In practice, facilities more often stumble due to insufficient follow-up after acceptance than due to a lack of understanding of statuses of residence. When inadequate explanation of job duties, insufficient consideration for Japanese-language communication, and gaps in daily living support pile up, the result is early turnover and dissatisfaction on the floor. You need to place as much importance on retention support after joining as on confirming the systems before hiring.