As chronic labor shortages continue in the nursing care industry, Indonesia has grown into one of the most important source countries of international talent for Japanese nursing care operators. Beginning with the acceptance of certified care worker candidates under the Japan–Indonesia EPA (Economic Partnership Agreement), which entered into force in 2008, employers can now hire Indonesian talent through multiple statuses of residence, including Technical Intern Training, Specified Skilled Worker, and the route for those who obtain certified care worker qualifications.

However, among nursing care operators that move ahead with hiring, many still assume that “as long as the paperwork is in order, there will be no problems,” only to face workplace adjustments and turnover issues after onboarding. A defining feature of hiring Indonesians is that consideration for religious and cultural background—not only the institutional framework—greatly affects retention.

This article systematically organizes key points when hiring Indonesian nursing care workers along three axes—systems, culture, and day-to-day practice—and delivers concrete insights hiring managers can apply directly on site. For the fundamentals of hiring foreign nationals, please also see our basic article on hiring foreign nationals.

Current Landscape and Hiring Environment for Indonesian Nursing Care Talent

Indonesia is Southeast Asia’s largest country, with a population of about 280 million (2024 estimate), and has an abundant young working-age population. Since the EPA entered into force in 2008, Japan and Indonesia have continued personnel exchange in the medical and nursing care fields, and several thousand EPA certified care worker candidates in total have worked and trained in Japan.

Ministry of Health, Labour and Welfare foreign employment policy pages show that acceptance of foreign workers in nursing care has risen sharply in recent years, and Indonesia remains among the top sending countries alongside the Philippines and Vietnam. With the spread of the Specified Skilled Worker system, pathways beyond the EPA have also widened, making hiring a realistic option even for small and mid-sized nursing care operators.

At the same time, employers must recognize that “the substance of the system differs for each entry route.” The scope of work permitted, renewal requirements, and whether family accompaniment is allowed all vary by status of residence, so confirmation before hiring is essential.

Basics of Status of Residence and Entry Routes, and Decision Criteria

The main statuses of residence and entry routes for accepting Indonesian nursing care talent are as follows.

EPA (Economic Partnership Agreement) certified care worker candidate route Under the EPA between Japan and Indonesia, accepting organizations receive candidates under coordination by JICA (Japan International Cooperation Agency). Candidates must pass the national certified care worker examination within four years of arrival; after passing, they can switch to the “Nursing Care” status of residence and work long term. Because candidates are required to have Japanese ability of N3 or higher, their readiness to contribute soon after joining is relatively high.

Technical Intern Training (nursing care occupation) Under the Technical Intern Training Act, there are steps from post-entry training through Technical Intern Training (i) to (iii). For the nursing care occupation, Japanese ability equivalent to N4 or higher is required at entry, and N3 or higher is required when moving to Technical Intern Training (ii). A notable feature is the heavy administrative burden on the accepting side, including selection of a supervising organization and preparation of a training plan.

Specified Skilled Worker (i) (nursing care field)Immigration Services Agency of Japan route under the Specified Skilled Worker system; nursing care is included among the eligible fields. Requirements are passing the skills exam and a Japanese language test (N4 equivalent or higher), or completing Technical Intern Training (ii). The period of stay is up to five years (renewable). Procedures are relatively flexible, and this has become the most widely used route in recent years.

Route for holders of certified care worker qualifications (status of residence “Nursing Care”) Foreign nationals who pass the national certified care worker examination may work under the “Nursing Care” status of residence, with no upper limit on renewals of the period of stay. Development takes longer, but this is the most stable route in terms of workforce contribution.

Because multiple routes coexist, it is important to clarify, as pre-hire decision criteria, “over what time horizon you want to utilize the talent,” “how much cost and administrative burden you can accept,” and “how much lead time until onboarding you can allow,” and then select the route. For detailed comparisons by status of residence, see also our explanation of statuses of residence for highly skilled foreign professionals.

How Islamic Faith and Cultural Background Affect Workplace Operations

Indonesia has the world’s largest Muslim population, and about 87% of citizens practice Islam. The Indonesian Ministry of Religious Affairs (Kementerian Agama), which oversees religious administration in Indonesia, plays an important role in announcing religious holidays and promoting religious norms, and is an institution worth knowing as background to staff members’ faith.

Cultural and religious considerations nursing care operators should understand are summarized below.

Prayer (salat) and time management

Muslims are obligated to pray (salat) five times a day. Prayer times fall at dawn, noon, afternoon, sunset, and night, and each takes about five to ten minutes. Because long shifts are common in Japanese nursing care settings, shift design that accounts for prayer times is key to improving retention. Facilities that provide a prayer space (prayer room) on site or temporarily open part of a break room tend to see stronger staff belonging and lower turnover.

Accommodating halal food

Halal means “permitted” under Islamic law. Pork and alcohol-containing foods are prohibited, and careful attention is also needed regarding the origin of ingredients. At facilities that have not considered halal options for meals at facility events, welcome parties, or year-end gatherings, situations arise where “there is nothing I can eat,” and staff may feel isolated. Taking the extra step of checking with the individual in advance when selecting banquet menus or boxed lunches directly builds trust.

Shift adjustments during Ramadan (the fasting month)

Ramadan is the ninth month of the Islamic calendar and lasts about one month each year (dates on the Gregorian calendar differ every year). During this period, Muslims abstain from food and drink from sunrise to sunset. Because nursing care work is physically demanding, consideration is needed so that fasting staff are not assigned overly heavy shifts. Explicitly stating a policy such as “during Ramadan, overtime and very early pre-dawn starts will be avoided as much as possible” increases staff peace of mind and trust in the facility.

Religious holidays and annual shift planning

Especially important holidays for Indonesians are Eid al-Fitr (the festival marking the end of the fast: Lebaran) and Eid al-Adha (the Festival of Sacrifice). Lebaran is the largest family occasion, comparable to Obon or the New Year for Japanese people, and is also a time when the desire to return home strengthens. Factoring this timing into annual shift adjustment plans is important from a turnover-prevention standpoint.

Common On-Site Questions

Below we summarize common on-site questions raised by hiring managers and facility administrators.

“How should we secure a prayer space?” A dedicated room is not required; many facilities respond by opening a quiet, clean space (such as a corner of the locker room or an unused meeting room) for limited periods. Prayer mats (janamaz) are usually brought by individuals, but keeping a few on hand at the facility is often appreciated.

“We are worried about whether communication in Japanese will work” On the Specified Skilled Worker and Technical Intern Training routes, candidates receive Japanese training at the N4–N3 level before entry, but acquiring specialized nursing care terminology requires ongoing on-the-job learning. Facilities that add furigana to work manuals and consistently give instructions in plain, easy Japanese tend to see higher retention. For workplace communication with multinational staff, our article on workplace communication with Myanmar talent is also useful.

“Is family accompaniment possible?” It depends on the status of residence. Specified Skilled Worker (i) generally does not allow family accompaniment; EPA candidates and holders of certified care worker qualifications (status of residence “Nursing Care”) may bring family under certain requirements. Accurate information must be provided at the hiring interview; misleading explanations become a source of later trouble.

“Is using disinfectants that contain pork-derived ingredients a problem?” Halal rules mainly cover food and drink and usually do not apply to nursing care supplies used at work (disinfectants, gloves, and the like). If the individual feels uneasy, however, it is important to discuss the matter one-on-one and show respect for their religious views.

Failure Patterns and How to Avoid Them

We categorize cases in which problems arose after hiring and present concrete failure patterns and how to avoid them.

Failure 1: Running facility events without halal accommodation At welcome parties or year-end gatherings, menus centered on pork dishes and alcohol left Indonesian staff feeling excluded because “there was nothing I could eat.” As a preventive measure, confirm participants’ dietary restrictions in advance and always provide halal or vegetarian options. Individual boxed lunches are also effective.

Failure 2: Not managing status of residence renewal deadlines Cases in which renewal procedures were not started until one month before the period of stay expired, resulting in overstay. As a preventive measure, obtain copies of the passport and residence card at hiring and register renewal deadlines on the internal calendar. Set an alert three months before renewal and begin consulting a gyoseishoshi (administrative scrivener) or social insurance and labor consultant.

Failure 3: Shifts that did not account for prayer times Long continuous work shifts left staff unable to pray for days on end, which surfaced as psychological stress. As a preventive measure, build prayer times into shift design from the start as “short breaks of five to ten minutes.” Adding operating rules for “prayer accommodation breaks” to the work rules also deepens facility-wide understanding.

Failure 4: Skipping due diligence on sending organizations and supervising organizations Hiring through a sending organization with opaque fee burdens led to discovery after entry that the staff member carried excessive debt, which developed into a labor management problem. As a preventive measure, at the selection stage confirm filing status with the Organization for Technical Intern Training (OTIT) and any history of misconduct for sending organizations and supervising organizations. Cross-checking OTIT information published by the Ministry of Health, Labour and Welfare is recommended.

Points Hiring Managers Often Overlook

Even when institutional checks are done, the following are points hiring managers often overlook.

Insufficient confirmation of Japanese ability in emergencies Even if everyday conversation is manageable at N3 level, specialized vocabulary needed in medical and nursing care emergencies may be lacking. In hiring interviews, it is practically effective to include role-plays such as “Can you explain emergency response in Japanese?” rather than everyday conversation alone.

Missing checks that the status of residence on the residence card matches the job duties When hiring foreign nationals, checking the residence card is mandatory. Always confirm that the status of residence stated on the residence card matches the intended duties. If unlawful employment is facilitated, the employer may also face criminal penalties for the offense of promoting unlawful employment. The Ministry of Health, Labour and Welfare foreign employment policy pages explain the verification steps in detail.

Failure to file the foreign national employment status notification with Hello Work When you employ a foreign national, notification to Hello Work is mandatory. It must be completed by the end of the month following the start of employment; failure to notify is subject to a fine of up to 300,000 yen. Because delayed filing is common, build the notification task into the hiring workflow.

Insufficient explanation of health checkups Without a careful explanation of the purpose of the pre-employment health checkup, staff may feel anxiety or suspicion. Explaining the content and purpose of tests in advance in plain Japanese or Indonesian helps prevent misunderstanding and resistance.

Diagram: Pre-Hire Confirmation Flow

Matters to confirm before hiring, organized by step, are as follows. Use each step as a practical checklist for hiring managers so it can be applied visually in operations.

Step 1 is “confirming the hiring route.” Choose among EPA, Technical Intern Training, Specified Skilled Worker, and the certified care worker route based on the facility’s needs and acceptance capacity. The four decision criteria are “scope of work permitted,” “cost burden,” “lead time until onboarding,” and “years of retention you expect.”

Step 2 is “selecting and screening sending organizations, supervising organizations, and Registered Support Organizations.” Obtain quotes from multiple organizations and compare histories of misconduct, track records, and support systems. Cross-check filing status with the Immigration Services Agency of Japan and information published by the Organization for Technical Intern Training (OTIT).

Step 3 is “confirming the candidate’s status of residence and Japanese ability.” Cross-check the passport, residence card, and Japanese language certificates (JLPT, etc.) and confirm fit with the job duties. Set a reminder for the period of stay on the internal calendar.

Step 4 is “preparing the workplace environment.” Complete securing a prayer space, setting a halal meal policy, converting emergency manuals into plain Japanese, and designing a welcome training program.

Step 5 is “concluding the employment contract and filing notifications.” Prepare the employment contract in both Japanese and Indonesian when possible, and confirm signatures and seals. After employment begins, file the foreign national employment status notification with Hello Work by the end of the following month.

Step 6 is “building a post-onboarding follow-up system.” Conduct regular one-on-ones (at least monthly), introduce a mentor system, and set up a consultation channel where cultural background can be shared.

Practical Checklist

Use the following practical checklist by hiring phase.

Confirmation items for the pre-hire (planning and selection) phase are as follows.

  • Confirm the hiring route (EPA, Technical Intern Training, Specified Skilled Worker, certified care worker) and obtain internal agreement
  • Complete selection of the sending organization or Registered Support Organization and checks for any history of misconduct
  • Confirm that the facility meets acceptance standards (for Technical Intern Training, notification as an implementing organization)
  • Responsible staff have reviewed Immigration Services Agency of Japan guidelines
  • Policies on prayer space and halal meal accommodation have been decided

Confirmation items for the hiring and entry procedures phase are as follows.

  • Obtain copies of the passport and residence card and register the period of stay on the internal calendar
  • Confirm fit between status of residence and job duties (record in writing)
  • Prepare and issue the employment contract (including the notice of working conditions)
  • Clearly state wages, working hours, days off, and leave
  • Complete enrollment in social insurance, employment insurance, and workers’ compensation insurance

Confirmation items for the post-onboarding (retention support) phase are as follows.

  • File the foreign national employment status notification with Hello Work (by the end of the following month)
  • Explain the prayer space and operating rules
  • Communicate the halal meal policy to all staff
  • Prepare and distribute work manuals in plain Japanese
  • Assign a mentor (support contact) and set a monthly one-on-one schedule
  • Prepare shift adjustment plans for Ramadan and religious holidays
  • Verify that the three-months-before-renewal alert for status of residence is working

Frequently Asked Questions (FAQ)

Q1. How many years can an Indonesian who joins under Specified Skilled Worker (i) work?

The period of stay under Specified Skilled Worker (i) is up to five years (combinations of one-year, six-month, and four-month renewals). If the person passes the certified care worker examination and switches to the “Nursing Care” status of residence, they can continue working with no limit on the number of renewals. For the latest system information, check the official pages of the Immigration Services Agency of Japan.

Q2. Should prayer time for Indonesian staff be treated as working time?

In general, it is often treated as part of “break time.” Prayer that falls during working hours is typically at most two to three times (about five to ten minutes each), so it rarely causes major operational disruption. Stating operating rules in the work regulations can prevent labor–management disputes in advance.

Q3. Where can we obtain halal meals?

Halal boxed-lunch and catering providers are increasing in Japan as well. In major cities, many accept online orders, and searching for “halal bento delivery” yields multiple options. For facilities in regional areas, vegetarian meals without pork or alcohol can be offered as an alternative. In all cases, confirming with the individual in advance is most important.

Q4. What happens if an EPA candidate fails the national examination?

Under the EPA program, as a general rule, candidates who do not pass the Certified Care Worker examination within four years of arrival in Japan (with possible extensions under certain conditions) are required to return home. However, if they meet the requirements for changing their status of residence to Specified Skilled Worker, they may be able to continue working. Please check the latest notices from the Immigration Services Agency of Japan and the Ministry of Health, Labour and Welfare for the most current operational details.

Q5. Where should I go for individual consultation on hiring and retention support?

Consulting specialists focused on hiring and retention support for international talent is the most efficient approach. For specific inquiries, please feel free to contact us via the Foreign Talent Insights inquiry page.

Summary

Hiring Indonesian nursing care talent requires extensive preparation, from selecting the right program to accommodating cultural and religious needs. In particular, responses to prayer times, halal food, and the fasting month based on Islam are areas unfamiliar to many Japanese nursing care facilities, and understanding and consideration in these areas greatly affect retention rates. On the institutional side, it is essential to regularly refer to the Immigration Services Agency of Japan’s Specified Skilled Worker program pages and the Ministry of Health, Labour and Welfare’s information on foreign worker employment measures to stay current with the latest requirements.

Using the practical checklist and pre-hiring confirmation flow introduced in this article to build a consistent system from the planning stage through retention support is the shortest path to long-term collaboration with Indonesian talent. If you would like to learn more about hiring and retention support, or if you have individual questions, please feel free to contact us via the Foreign Talent Insights inquiry page.

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