Many health care providers have employees who are subject to immigration enforcement. Current stringent enforcement actions by U.S. Immigration and Customs Enforcement (ICE) are, consequently, of importance to providers. Historically, as a matter of policy, healthcare settings were considered to be “sensitive locations” or “protected areas.”
ICE generally considered these areas to be areas where it avoided enforcement actions, except in unusual circumstances and/or with approval from high-level managers. ICE issued a memorandum in 2011,“Enforcement Actions at or Focused on Sensitive Locations.” This memo identified hospitals, schools, places of worship, and other similar locations where enforcement actions should not occur. In another memo issued in 2021, “Guidelines for Enforcement Actions in or Near Protected Areas,” various types of healthcare providers were designated as “sensitive” or “protected” areas.
In January 2025, however, ICE revised this policy in another memo, “Common Sense Enforcement Actions in or Near Protected Areas.” This guidance permits enforcement actions regardless of location. Enforcers now have discretion on a case-by-case basis. This change in policy did not, however, expand ICE’s statutory authority or alter existing protections under the U.S. Constitution or healthcare requirements.
What are the current limitations on ICE enforcement actions that healthcare providers need to know?
ICE enforcers may generally enter areas open to the public; such as lobbies, reception areas, and waiting rooms. ICE officers may not enter non-public areas, including areas where patients are receiving treatment, staff-only areas, and medical records departments. Entry into these areas usually requires consent, a valid judicial warrant, a court order, or some other exception to requirements of the Fourth Amendment of the U.S. Constitution.
The general prohibition against entry to staff-only areas and medical records departments is especially important for providers that render services to patients in their homes, including Medicare-certified home health agencies, home care or private duty agencies, hospices, and home medical (HME) companies.
Since providers of services to patients in their homes often employ substantial numbers of employees from other countries, many of whom are subject to immigration enforcement, ICE may have a particular interest in gaining access to personnel records. This area should, therefore, be clearly designated as an area for staff only.
Likewise, ICE may also have considerable interest in access to information about home care providers’ patients. The area where medical records are kept should also be designated as “staff only.”
Needless to say, staff members must be thoroughly trained in these limitations on ICE enforcement actions. Likewise, it is important for staff to be knowledgeable about the types of warrants that ICE may typically present.
ICE often relies on so-called administrative warrants. These types of warrants are issued by U.S. Department of Health and Human Services (HHS) officials. They generally support the arrest of specific individuals only. They do not authorize entry into non-public areas of private property without consent.
Heads up! Providers often possess information that is valuable to a variety of enforcers.
©2026 Elizabeth E. Hogue, Esq. All rights reserved.
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