Issued May 21, 2026, the U.S. Citizenship and Immigration Services’ (USCIS)  Policy Memorandum PM-602-0199 directs officers to treat adjustment of status—the process by which eligible foreign nationals already in the United States apply for adjustment to lawful permanent residence  (aka “green card” status)—as a “matter of discretion and administrative grace” and an “extraordinary” form of relief rather than a standard procedure. The memo appears to have taken effect immediately and without prior notice, meaning hundreds of thousands of pending adjustment of status cases for many immigrant visa types are most likely subject to the new standard. Note that this does not affect those who are seeking an EB-3 or other immigrant visa through an embassy or consulate overseas, or who have already received an EB-3 visa or completed adjustment of status.

What Changed

For more than 50 years, eligible foreign nationals could complete the entire permanent residence process without leaving the country. Under PM-602-0199, USCIS officers are reminded that nonimmigrant visa holders are expected to depart the United States and apply for an immigrant visa abroad through consular processing at a U.S. embassy or consulate, absent “extraordinary” circumstances.

Why This Matters for Your Workforce

For aging services employers, this policy arrives at an already difficult time. Immigrants constitute more than 30% of home care aides, more than 20% of nursing assistants, and roughly 20% of registered nurses in nursing homes. Many of these workers, including EB-3 visa applicants (such as registered nurses and certified nursing assistants recruited by providers to address persistent workforce shortages), are currently facing a multi-year employer-sponsored green card process, with adjustment of status applications pending at USCIS. These workers often have an active Employment Authorization Document (EAD) that allows them to remain employed while their cases are pending.

Forcing those workers to travel abroad for consular processing could interrupt employment authorization, create extended absences from the workplace, and in some cases strand workers entirely. Since January 2026, the State Department has suspended immigrant visa processing for nationals of 75 countries at U.S. embassies and consulates. For workers from those countries, PM-602-0199 does not redirect them to an alternative pathway. It effectively eliminates the pathway altogether for the duration of that suspension.

What Employers Should Know Now

As this memo is already in effect, aging services employers may want to take the following steps:

• Identify employees with pending Form I-485 (adjustment of status) applications and assess their country of birth, current visa status, and EAD validity
• Work with immigration counsel to evaluate which employees may be redirected to consular processing and what that would mean for their work authorization
• Communicate proactively and carefully with affected employees, in coordination with counsel, to prevent unnecessary departures or lapses in status

What Comes Next

USCIS has indicated it may issue category-specific guidance in the weeks ahead, which could clarify how the policy applies to employment-based classifications. LeadingAge is monitoring the situation closely and will report as warranted.

Employers with questions about how this change intersects with their specific workforce situation should consult qualified immigration counsel promptly. For general guidance related to immigration enforcement preparedness, please see this resource. To learn more about this topic and other immigration compliance issues facing our members, sign up for our upcoming webinar Immigration Compliance for Aging Services Employers, to be held on Thursday, June 4, 2:00-3:15 p.m. ET.