Nursing homes across the United States, already facing chronic staffing shortages, are bracing for further strain as President Donald Trump’s renewed crackdown on immigration threatens one of their most reliable labor pipelines: foreign-born workers.
Facilities that care for older adults and disabled individuals are beginning to feel the impact of Trump’s restrictive immigration policies, reporting the loss of key employees whose legal protections have been revoked. Even more concerning, industry leaders say, is the longer-term effect—a significant slowdown in the flow of new immigrant workers amid a broader downturn in legal immigration.
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“We feel completely beat up right now,” said Deke Cateau, CEO of A.G. Rhodes, which operates three nursing homes in the Atlanta area. About one-third of the facility’s staff are immigrants from nearly three dozen countries.
Cateau, himself an immigrant from Trinidad and Tobago who moved to the U.S. 25 years ago, said eight of his employees are slated to leave due to the revocation of their Temporary Protected Status (TPS)—a designation that allows individuals from countries facing natural disasters or civil unrest to live and work legally in the U.S.
While TPS recipients make up a small fraction of A.G. Rhodes’ 500-person staff, their absence will be deeply felt. “They will be very difficult, if not impossible, to replace,” Cateau said. “It may be eight today, but who knows what it’s going to be down the road.”
Nationwide, immigrants are a critical part of the healthcare labor force. Nearly one in five civilian workers in the U.S. is foreign born, according to the Bureau of Labor Statistics. In caregiving occupations—such as nursing assistants, home health aides, and personal care aides—immigrants are even more overrepresented, comprising more than 25% of the estimated four million direct care workers, according to PHI, a nonprofit focused on the long-term care workforce.
The demand for such workers is expected to skyrocket as the Baby Boomer generation ages. The Bureau of Labor Statistics projects that home health and personal care aide roles will see the largest growth of any job category, with an estimated 820,000 new positions added by 2032.
Care providers had counted on immigrant labor to fill many of those roles. But Trump’s return to the White House and his administration’s aggressive stance on nearly all forms of immigration—legal and otherwise—has sent a chill through the industry.
“Nursing homes, assisted living centers, and home health agencies were already struggling,” said one industry executive. “Now we’re facing a perfect storm: rising demand, an aging population, and fewer workers coming in to help.”
The concern among providers is clear: without access to immigrant labor, the quality of elder care in the U.S. could suffer significantly in the years to come.
