Trump’s Immigration Policy Changes Heighten Challenges for Nursing Home Nurses
Staffing issues in America’s nursing homes are an ongoing concern and involve several factors beyond the effects of post-pandemic burnout. Recent immigration policies are making it harder to hire foreign-born caregivers — a workforce that has long been the backbone of elder care in this country. The result? Possibly, immediate staffing concerns in facilities already likely struggling to meet the needs of their residents.
Foreign-born workers make up more than 25% of direct care staff in nursing homes, including nursing assistants and home health aides. These are the folks who handle the hands-on care our residents rely on every single day. Their numbers are shrinking fast, though, possibly due to tighter immigration restrictions — and nursing home administrators are feeling the squeeze.
Rachel Blumberg, CEO of Sinai Residences in Florida, shared that her facility has lost dozens of staff due to these policies. “Americans are not drawn to applying and working in the positions that we have available,” she explained. And she’s not alone in this struggle. Across the country, nursing homes are fighting to stay fully staffed, and many are losing the battle entirely.
What’s Contributing to the Staffing Concerns?
The staffing challenges may be influenced by several recent changes to immigration policies. One significant factor is the revocation of Temporary Protected Status (TPS) for individuals from countries experiencing disasters or instability. When TPS is rescinded, affected workers can receive very short notice—sometimes less than 24 hours—that their authorization to work in the U.S. has ended. This can result in caregivers quickly losing their legal ability to work, leaving employers with immediate staffing gaps and limited time to find replacements.
Some legally authorized workers have expressed concerns about immigration enforcement activities. In some cases, this apprehension has reportedly led individuals to reduce their participation in the workforce, either by cutting back on hours or avoiding certain jobs. Such uncertainty may contribute to ongoing workforce shortages in sectors that rely heavily on immigrant workers.
And timing couldn’t be worse. The Bureau of Labor Statistics predicts we’ll need 820,000 more caregiving positions by 2032 to keep up with the aging baby boomer population. Deke Cateau, CEO of A.G. Rhodes in Atlanta, says his facility hasn’t been hit too hard yet. But he’s worried about the future. “The pipeline is getting smaller and smaller,” he said, noting that it’s not just about today’s staffing but also about having enough workers for tomorrow.
What Does This Mean for Nurses and Residents?
Staffing shortages in nursing homes are reportedly associated with increased workloads for remaining staff, including longer shifts, higher patient-to-worker ratios, and, in some cases, mandatory overtime. As facilities work to maintain operations with fewer staff members, some have had to reduce admissions or temporarily close wings due to insufficient staffing.
Evidence suggests that adequate staffing levels in long-term care facilities are likely linked to improved resident outcomes, such as lower rates of pressure ulcers, reduced hospitalizations, and improved management of chronic conditions. Conversely, significant staff shortages can possibly negatively impact care quality and resident well-being.
These ongoing workforce challenges can contribute to a cycle where staff
departures—whether due to voluntary turnover or changes in immigration policy—could result in heavier workloads for those who remain. This, in turn, may lead to increased burnout and further turnover, posing risks to the stability of nursing home care delivery.
What’s Next for Nursing Homes?
Nursing homes across the United States are experiencing ongoing staffing challenges as immigration policy discussions continue. Research indicates that immigrant workers make up a significant proportion of the direct care workforce in these facilities. As a result, changes in immigration policy can affect the availability of staff needed to provide resident care. Even with adjustments in funding or regulations, maintaining an adequate workforce remains an important factor for meeting the daily needs of nursing home residents.
For nurses, this might feel like just another concern in an already challenging field. But it’s important to understand the role immigration plays in staffing and care quality. Whether you’re a nursing student or an experienced RN, this issue may affect you, your colleagues, and your patients.
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