International Nurse Recruitment Agencies: Fees, Contracts, and What They Won't Tell You
Last updated: June 2026 · Outreach ongoing — cells update as responses arrive
This table is the only independently compiled comparison of international nurse recruitment agency terms. Most cells show "Not disclosed" because agencies refuse to publish their fee and contract terms publicly. That refusal is itself the data point — and one of the key criteria nurses should use when evaluating an agency. As agencies respond to outreach or information becomes available through public records, this table will be updated.
Agency Comparison
| Agency | Fee to Nurse | Training Salary | Contract Length | Breach Fee | Conflict Disclosed? | CGFNS Help? |
|---|---|---|---|---|---|---|
| PassportUSA | Not disclosed | Not disclosed | Not disclosed | Not disclosed | Buried footer only | Yes |
| O'Grady Peyton (Adecco) | Not disclosed | Not disclosed | Not disclosed | Not disclosed | None | Yes |
| Connetics USA (AMN) | Not disclosed | Not disclosed | Not disclosed | Not disclosed | None | Yes |
| Avant Healthcare (Envision) | Not disclosed | Not disclosed | Not disclosed | Not disclosed | None | Yes |
| Emerald Health Services | Not disclosed | Not disclosed | Not disclosed | Not disclosed | Verify | Verify |
Last outreach sent: June 2026. Agencies were emailed requesting disclosure of nurse-facing fees and contract terms. Table updates as responses arrive.
The $30,000 Breach Fee Pattern
In 2023, Type Investigations (typeinvestigations.org) published an investigation documenting recruitment agencies charging upfront fees of $8,000 or more, plus breach penalties of up to $30,000. These penalties were applied to nurses who left their first US hospital — often to escape unsafe conditions or to move closer to family.
These terms were rarely disclosed before nurses signed contracts. In some documented cases, contracts required nurses to repay all recruitment costs plus penalties, leaving nurses financially unable to leave their first employer.
What to Ask Every Agency
Before signing any contract, get written answers to these questions:
- 1What are your fees charged to the nurse, in total dollars?
- 2What is my salary during orientation and training, and who pays it?
- 3What is the full contract length, and what constitutes a breach?
- 4What is the breach fee in dollar terms — not a percentage?
- 5Do I need to sign any document for my US consular interview?
- 6What states and facilities are available, and can I choose?
- 7Is CGFNS/VisaScreen assistance included, or are those my costs?
- 8What happens if the hospital I'm placed with has unsafe staffing conditions?
Red Flags
- ✗Upfront fees exceeding $2,000 before your first paycheck
- ✗Breach fees exceeding $10,000
- ✗Any clause requiring you to conceal information from the US consulate
- ✗Vague language about salary during orientation or training (e.g., 'training allowance' instead of a named hourly rate)
- ✗Refusal to provide contract terms in writing before you sign an intent to work
- ✗Pressure to sign quickly with limited time to consult a lawyer