International Nurse Recruitment Agencies: Fees, Contracts, and What They Won't Tell You
Last updated: June 2026 · Outreach ongoing — cells update as responses arrive
None of these agencies publicly disclose their nurse-facing fees or contract terms. The figures below come from court records, DOJ settlements, investigative journalism, and nurse reports — not agency disclosures. Figures sourced from litigation or journalism are cited inline. Forum-sourced figures are directionally accurate but unverified.
Agency Comparison
| Agency | Contract | Breach Fee | Upfront Fee | Training Pay | Investigation / Legal Record | CGFNS Help? |
|---|---|---|---|---|---|---|
PTU (Professionals to USA) Independent | 3 years | $30,000 (contract); $40,000 sought in court via Type Investigations, 2023; court filings | $2,500 | Hospital rate (direct hire) via PTU website | Type Investigations (2023) + 2024 settlement | Verify |
PassportUSA Health Carousel International | 3 years / 6,240 hrs | $20,000–$35,000 (raised over time) via Type Investigations, 2023; court filings | Not disclosed | Not disclosed | $9.25M DOJ settlement — visa fraud (2024); named in Type Investigations; class action | Yes |
Avant Healthcare Envision Healthcare | 3+ years | Not disclosed ("tens of thousands" alleged) via RICO lawsuit, 2023 | Not disclosed | $10/hour (1 month) via Florida Trend, Feb 2026 | RICO lawsuit; ~$3M settlement (2024) | Yes |
O'Grady Peyton AMN Healthcare | 3 years | $20K–$30K (reported) via Nurse forum reports (unverified) | Not disclosed | Not disclosed | None found | Yes (covered by OGP) |
Connetics USA AMN Healthcare | Hospital-dependent | Hospital-dependent Direct hire — hospital is employer, not Connetics | Not disclosed | Not disclosed | None found | Verify |
Last outreach sent: June 2026. Agencies were emailed requesting disclosure of nurse-facing fees and contract terms. Table updates as responses arrive.
What the Records Show
PassportUSA (Health Carousel International) — $9.25M DOJ settlement, 2024
The Department of Justice found that Health Carousel submitted fraudulent visa applications — providing false job placement letters so visas would be approved faster, before nurses were actually placed with a facility. Separately, a class action documented that the breach fee was raised from $20,000 to $35,000 for nurses recruited later. One nurse paid the $20,000 fee to exit her contract after being assigned to a facility with low wages, mandatory overtime excluded from her commitment hours, and a gag clause.
Avant Healthcare (Envision Healthcare) — RICO lawsuit, ~$3M settlement, 2024
Nurses alleged Avant threatened deportation and "tens of thousands of dollars" in penalties for leaving early. A February 2026 investigation by Florida Trend documented that Avant paid nurses $10/hour during their mandatory one-month training, then $30/hour during regular work — substantially below American peer compensation. The $3M settlement covered approximately 2,000 current and former nurses.
PTU (Professionals to USA) — Type Investigations (2023) + 2024 settlement
The primary subject of the 2023 Type Investigations report. PTU charged nurses a $2,500 upfront fee and a $30,000 liquidated damages clause — and sought $40,000 in at least one court case. Nurses reported being told not to mention their recruitment fee or PTU contracts to US consular officials during their visa interviews. A 2024 settlement prohibited PTU from threatening nurses with immigration consequences.
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