Nearly One-third of Nursing Assistants Are Immigrants In MN - Here’s Why

Minnesota's healthcare sector, particularly nursing homes, is experiencing significant workforce challenges. The state is confronting demographic shifts, including declining fertility rates, an aging population, increased retirements, and reduced net migration. These factors have led to a shrinking talent pool, with the state's working-age population (16-64) projected to reach a historic low by 2030. The shortages also have led to the closure of several nursing homes across the state, especially in rural communities.

To be fair, other states face similar challenges, but they are particularly acute in Minnesota where the state’s job deficit is still below pre-pandemic figures (vs. national employment which has surpassed pre-pandemic levels).

Immigrants, esp. Certified Nursing Assistants (CNAs), have played a critical role in addressing Minnesota's nursing home workforce shortage. Why has this happened and will it continue to be a solution to fill the deficit of direct care staff?

Minnesota’s Immigrant Workforce

Foreign-born workers make up about 18% of the direct caregiver workforce in Minnesota, despite comprising only 12% of the overall workforce. For nursing assistants and personal care aides specifically, the percentages are even higher, approaching nearly one-third of the workforce. 

This trend is part of a larger national pattern, where the share of immigrant CNAs in nursing homes has been growing, especially during the COVID-19 pandemic, but Minnesota’s CNA share is significantly higher than the US average (33% in Minnesota vs. 21% nationwide).

How has Minnesota done this? To attract and train more immigrants, the state has launched several initiatives:

• The Follow Your Heart to a Caring Career campaign reaches out to "New Americans" in 10 different languages.
• The Minnesota Department of Human Services has implemented programs to support the training and certification of immigrant CNAs, distributing $28 million to two dozen organizations to assist. These efforts include providing resources to connect prospective CNAs with training programs and offering language support.
• The International Institute of Minnesota offers free CNA training for “New Americans” with impressive results:
  • Over 3,000 nursing assistants trained and certified
  • 90% certification success rate
  • $19.90 average starting salary for graduates
  • 100% job offer guarantee for certified graduates

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Research suggests that nursing homes with a higher share of immigrant CNAs are associated with more direct care staff hours per resident day and better quality performance. This indicates that immigrant workers are not only filling critical gaps but also potentially contributing to improved care standards.

Challenges and Opportunities for Integration

While immigrant healthcare workers offer a promising solution, their integration into the workforce is not without challenges. Language barriers, cultural differences, and the need for additional training to meet U.S. healthcare standards are common hurdles. Fortunately, Minnesota’s various state initiatives attempt to address these challenges. 

And without immigrants filling crucial staffing roles, the Minnesota Chamber Foundation estimates that the labor force would begin to shrink by 2040.

It is clear that the state's welcoming stance towards immigrants has helped “New American” communities become an increasingly important source of workers for nursing facilities, in turn helping those facilities better meet the needs of Minnesota’s aging population.