Immigrant and non-citizen workers make up 23% of the long-term healthcare workforce, with one in three working in nursing homes. Additionally, 43% of undocumented healthcare workers are employed in long-term care (LTC).
Many nursing home residents come from diverse backgrounds, including immigrant communities. Facilities have a legal and ethical responsibility to ensure the safety, privacy, and well-being of both staff and residents. They are also regularly inspected by various regulatory agencies.
Most facilities have a plan for visits from state licensing boards, the Department of Health, and OSHA. It’s equally important to know how to prepare for a visit from Immigration and Customs Enforcement (ICE) or other immigration agencies.
A few best practices, detailed payroll records, and the right record-keeping software can help you gather essential documents, prepare for these visits, and maintain compliance.
Understand the scope of immigration enforcement authorities
Immigration and federal agencies like ICE can visit a nursing home and seek information about a resident or employee. However, ICE agents are limited on areas they’re allowed to access.
For instance, agents can enter any public area, such as a lobby or parking lot. Access to non-public areas, like a staff room or resident living space, is only allowed with a warrant signed by a federal judge or with consent from the facility.
Plus, patient information is generally protected under HIPAA laws, meaning administrators and healthcare workers are prohibited from disclosing immigration status or other protected information.
Develop a clear policy and train staff
Your nursing home staff may not know what to do during an ICE or immigration inspection. Providing clear policies gives your staff guidelines to follow for handling visits and maintaining compliance.
One of the most important steps of a visit is to avoid actions or statements that might interfere with an inspection or ICE action.
In short, you want to create a policy that outlines:
- Who ICE agents should talk to, whether the legal team or the administrator
- How to verify warrants
- How to handle documents and protect information
- What to do if agents request access to records or non-public areas
Offer regular training and digital simulations to help staff understand the process and the steps to take. Keep track of these training records with record-keeping software, and set automatic reminders to review policies and make sure training is complete.
Require proper legal documentation for entry
The first step an ICE agent or team may take can be an I-9 audit. During this process, ICE requests to review your I-9 forms for proper work permits and worker identity. Every new employee must fill out the I-9, which your company needs to keep on file for three years.
You have three business days to provide I-9 forms and 10 days to present proof of employment authorization if a worker is found to be unauthorized. HRIS solutions that digitally store and track documents make this process much easier with all your details in one central location.
After an audit, the next step may be an ICE investigation. Immigration officials require appropriate legal documents to enter private areas of a nursing home or access private information.
Immigration officials may present the following documents, though they may have certain limitations:
Judicial warrant: an order authorized by a judicial court that authorizes an agent or agency to search, seize, or arrest. It is signed by a magistrate or judge.
Administrative warrant: a formal letter from the Department of Homeland Security that authorizes an agent to make an arrest or seizure. It’s usually signed by an immigration officer or judge but doesn’t authorize a search.
Subpoena: an order that requests documents or testimony and may be judicial or administrative.
Contact the legal team immediately
Your legal counsel is the best resource for guidance on handling an I-9 audit or a request for access. Contact them immediately for advice on responding to inquiries, reviewing warrants and subpoenas, how to best protect residents and staff, and determining whether to grant access.
Your legal team can also suggest additional help for employees or residents. This might include how to access legal aid centers or employee assistance programs. Partner with HR teams to offer support and guidance.
Protect resident and employee privacy
Healthcare organizations and workers are required to follow strict privacy laws that protect against unauthorized disclosure of personal information. Carefully review any ICE or immigration requests to see records and send these requests to your legal team for sign-off before releasing information. Staff should not share personal information without proper legal authorization.
Carry out regular workplace audits and review your data security, document permissions, and user access. An internal audit can detect weaknesses or poor practices, such as failing to log out properly or leaving paper files unsecured, which could lead to accidental information leaks.
Document the visit
Following proper record-keeping can prevent mistakes and fines during an audit. However, it’s still important to write down everything that happens during an immigration visit.
Document:
- Names of agents and their agencies
- Credentials or ID numbers of agents
- Reason for the visit
- Documents presented and the time period on the warrant
- Any agent interactions with residents, staff, or records
- Actions your facility takes
You may need this information in the future to show you’ve complied with warrants or for other legal purposes. HR software and record-keeping tools with ready-made or custom templates can help you quickly record and update information as events come up.
Simplify compliance with Empeon
An ICE or immigration visit is one of several regulatory inspections that can happen at any time at your nursing home. A clear policy, regular training, legal guidance, and strong record-keeping practices can help you and your staff respond appropriately and maintain compliance.
Automated payroll and record-keeping solutions like Empeon help you build a proactive approach. You can also create custom onboarding workflows to ensure you get the I-9 forms and proper documents. Run batch audits for missing forms and payroll items and receive instant alerts for outstanding issues.
Train staff, send policies for review, and maintain detailed and secure records with smart tools. Simplify compliance and avoid disruption with Empeon. Get in touch to discover how.
