It is inevitable to introduce human resources development structures in the clinics of the rural regions of Lower Saxony to address the acute needs of skilled workers. Currently, the houses have difficulties in filling and retaining staff. The improvement of the skilled workers’ situation and long-term livelihoods will only occur if employees succeed in binding. In addition, the recruitment and sustainable integration of international professionals must be designed to ensure the quality of patient care and cooperation. A systematic selection of personnel, good preparation and support for international doctors and nurses should contribute to this. Accompanied by systematic and structured personnel development, the management quality and multi-professional cooperation should also be improved, with the aim of employee retention.