Nursing homes around the country are experiencing severe worker shortages, due in part to restrictive immigration policies put in place by the Trump administration. Immigrants make up more than 20 percent of the workforce at these facilities, a lifesaving share. In fact, over a quarter of the projected four million nursing assistants, home health aides, personal care aides, and other direct care workers are foreign-born. This upcoming demographic shift represents a monumental challenge for nursing homes. Yet they can barely keep up with our rapidly aging seniors.
Deke Cateau, an immigrant from Trinidad and Tobago, who helps run a nursing home. He’s expressed grave worries about the impact that recent immigration enforcement policies are having on his job site. “The work is hard. It’s not always been the highest paying job that one can get,” he said, highlighting the challenges faced by those in caregiving roles. Cateau’s center has already lost eight staff members due to the revocation of their Temporary Protected Status (TPS). What we’ve done, essentially, is leave the few people still there in a ridiculous catch-22 situation. It’s eight today, but who knows what it’s going to be in the future,” he continued.
The Trump administration’s decision to halt most refugee admissions and end humanitarian parole programs has further complicated recruitment efforts for nursing homes. Rachel Blumberg, CEO of Toby and Leon Cooperman Sinai Residences, reported losing ten workers almost overnight: “I got less than 24 hours’ notice when my employees lost their work authorization.” Not to mention this unexpected departure is further complicating efforts to recruit and retain staff at the lab. The industry already faces significant challenges due to high turnover rates.
As it stands, the typical nursing home faces an appalling 50% annual staff turnover rate. As the aging Baby Boomer generation drives demand for caregivers—expected to add 820,000 new positions by 2032—finding qualified workers has become increasingly vital. Lynne Katman, founder and CEO of Juniper Communities, said it was maddening to only have so many applicants. Sadly enough, Americans are not attracted to the work and application for the jobs we have open,” she said.
Katie Smith Sloan, CEO of LeadingAge, shone a light on how widely these restrictions have impacted nursing homes around the country. To have it come back like this is a punch in the gut,” she said. She pointed to the recent exodus of workers and the effect that has on ameliorating the quality of care.
Mark Sanchez, chief operating officer of United Hebrew, highlighted the challenges posed by the lengthy visa approval process for recruited nurses. A constant cascade of cli-fi,” he described. He emphasized that these bureaucratic delays are driving away potential hires from seeking and accepting opportunities to flourish within the caregiving workforce.
Despite these macroeconomic challenges, Robin Wolzenburg of LeadingAge in Wisconsin has seen some hopeful trends. She pointed out that companies that hire refugees have experienced staff retention levels over 90%. This suggests that newcomers to caregiving professions typically come with a deep sense of purpose to their work. Katman echoed this feeling, sharing that many immigrants see caregiving as a revered profession—all the highs and the lows.
And as immigration policies shift again with each new administration, the staffing picture in nursing homes is going to continue to be bleak. Cateau’s story is part of a growing crisis impacting facilities across the country. With an aging population and a dwindling workforce, nursing homes must navigate these obstacles while striving to maintain high standards of care for their residents.
