The purpose of this study is to provide information so that nursing regulators can make policy decisions regarding the level of English language proficiency needed to practice nursing at the entry-level. This is a non-experimental study in which twenty-five nurses with varying backgrounds met in order to provide their expert opinions on the level of English proficiency that is needed to practice nursing at the entry-level. Two different methods of standard setting, the Simulated Minimally Competent Candidate (SMCC) and the Examinee Paper Selection Method, were used to set a passing standard on an English proficiency examination, the Test of English as a Foreign Language (TOEFLä). Results of the study were used by the National Council of State Boards of Nursing's (NCSBN) Examination Committee to make a policy decision on the level of English proficiency needed by entry-level nurses (TOEFL score of 220). The results of the study have implications for those boards of nursing which choose to adopt the NCSBN recommendation as well as for those nurses seeking licensure in the United States. Furthermore, the findings have implications for the public and health care.